Optic Nerve Infiltration in Retinoblastoma: Correlation of Histopathological and MRI Findings in Enucleated Eyes.
MRI detected only 11% of prelaminar optic nerve invasion found on histopathology.
Optic Nerve Infiltration in Retinoblastoma: Correlation of Histopathological and MRI Findings in Enucleated Eyes.
And objective The accurate assessment of optic nerve invasion in retinoblastoma is critical for prognosis and treatment planning.
This study aimed to compare MRI findings with histopathological evaluation regarding optic nerve infiltration in enucleated eyes with group E retinoblastoma.
This cross-sectional study included 45 patients with group E retinoblastoma who underwent upfront enucleation.
MRI missed most early nerve invasion pathology later confirmed under the microscope
Histopathology detected post-laminar optic nerve invasion in 19 cases (42.2%), while MRI detected it in 17 cases (37.7%).
MRI showed a sensitivity of 76.0%, specificity of 72.7%, positive predictive value of 80.9%, negative predictive value of 66.7%, and overall accuracy of 75.0%.
MRI is a valuable noninvasive modality for assessing tumor extent and detecting post-laminar invasion; however, it consistently underestimates early (prelaminar) and microscopic optic nerve infiltration.
Histopathology remains the gold standard for definitive evaluation and risk stratification.
Regardless of MRI findings, obtaining an adequately long optic nerve stump during enucleation is crucial, as radiologic imaging may fail to detect microscopic invasion, and the cut-end status remains the most important prognostic determinant.