Abstract
Purpose Our aim was to evaluate and compare the ability of prenatal ultrasound (US) and fetal
magnetic resonance imaging (MRI) to detect retinoblastoma lesions in utero.
Methods Fetuses at risk for having bilateral retinoblastoma were enrolled in this prospective
study. High-resolution US of the fetal eye was performed at 16 to 18 weeks' gestation,
every 4 weeks until 32 weeks, then every 2 weeks until delivery. Fetal MRIs were performed
every 8 weeks starting at 16 to 18 weeks of gestation. An exam under anesthesia (EUA)
was performed postnatally, the gold standard of this study. Lesions were classified
as being elevated or minimally elevated based upon their morphology.
Results Of six fetuses suspected or confirmed to be at risk for developing bilateral retinoblastoma,
one had tumors on her first postnatal EUA exam. A total of two minimally elevated
lesions were seen by the EUA but not detected prenatally by imaging. One elevated
lesion (2 mm in height) identified by postnatal EUA was initially identified by prenatal
US. Fetal MRI did not detect any lesions.
Conclusion Both prenatal US and fetal MRI are limited in the detection of minimally elevated
retinoblastoma lesions. Prenatal US appears to be more sensitive than fetal MRI in
the detection of elevated retinoblastoma lesions.
Keywords
retinoblastoma - prenatal ultrasound - fetal MRI - extraocular abnormalities
