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AJP Rep 2012; 02(01): 055-062
DOI: 10.1055/s-0032-1316465
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

In Utero Detection of Retinoblastoma with Fetal Magnetic Resonance and Ultrasound: Initial Experience

Lisa B. Paquette
1   Division of Neonatology, Children's Hospital Los Angeles, Los Angeles, California
,
David Miller
2   Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California
,
Hollie A. Jackson
3   Department of Radiology, Children's Hospital Los Angeles, Los Angeles, California
,
Thomas Lee
4   Division of Ophthalmology, Children's Hospital Los Angeles, Los Angeles, California
,
Linda Randolph
5   Division of Medical Genetics, Children's Hospital Los Angeles, Los Angeles, California
,
A. Lynn Murphree
4   Division of Ophthalmology, Children's Hospital Los Angeles, Los Angeles, California
,
Ashok Panigrahy
6   Department of Radiology, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania
› Author Affiliations
Further Information

Publication History

17 January 2012

03 March 2012

Publication Date:
16 July 2012 (online)

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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