Evaluation of ultrasound examination informativity in diagnosing retinoblastoma

The aim of this work is to evaluate the informativity of the ultrasound (US) in detecting retinoblastoma (RB) and the local invasion of the tumor in children using modern multi-purpose ultrasound scanners.

Materials and methods. This study included 108 patients (216 eyes) examined for suspected RB. RB was diagnosed in 91 patients, 60 children had unilateral tumor, 31 – bilateral tumor (122 eyes). In the remaining 17 children (20 eyes damaged), different non-tumor pathology of the eye was revealed. Among 122 eyes affected by RB, 51 were removed with subsequent histological examination. 27 eyes were removed before treatment, 24 – after chemotherapy.

Results. In our study the informativity of ultrasound in detecting RB are: sensitivity – 98.4 %, specificity – 96.8 %, accuracy – 97.7 %. Sensitivity, specificity and accuracy in assessing tumor invasion to the anterior segment of the eye are 36.4 %, 95.0 % and 82.4 % respectively, to the vitreous body – 97.7 %, 100 % and 97.9 %, to the optic nerve – 54.5 %, 57.1 % and 54.9 %.

Conclusion. US examination using linear transducers of 9–18 MHz is highly informative in detecting RB, however, some indicators of the effectiveness in assessing local invasion are not high enough, due to the technical possibilities of the method. One possible way to improve the informativity – to use deep sedation during US examination.

1. Malakhova A.A., Mikhailova S.N., Ushakova T.L., Polyakov V.G. Determinants of late diagnosis and treatment of children with retinoblastoma. Analytical review of the organizational and methodological department of the Research Institute of Pediatric Oncology and Hematology at N.N. Blokhin National Medical Research Centre of Oncology, Ministry of Health of Russia. Rossiyskiy zhurnal detskoy gematologii i onkologii = Russian Journal of Pediatric Hematology and Oncology. 2021;8(4):20–30 (In Russ.)].

2. Men T.Kh., Polyakov V.G., Aliyev M.D. Epidemiology of malignant neoplasms in children in Russia. Onkopediatriya = Oncopediatria. 2014;1(1):7–12. (In Russ.)].

3. Ushakova T.L., Polyakov V.G., Rodina A.D., Vlasova V.E., Blankova T.I., Artemenko Yu.V., Mikhailova E.V., Krylov A.S., Odzharova A.A., Grigorenko V.A., Shirikov E.I., Kozlov N.A., Gasparyan T.G., Bekyashev A.Kh., Dokuchaeva Ya.Yu., Varfolomeeva S.R. Extraocular retinoblastoma: literature review and clinical case (intracranial retinoblastoma involving the visual tracts). Rossiyskiy zhurnal detskoy gematologii i onkologii = Russian Journal of Pediatric Hematology and Oncology. 2022;9(2):93–105. (In Russ.)].

4. Yanchenko T.V., Gromakina E.V. Epidemiological aspects of retinoblastoma. Meditsina v Kuzbasse = Medicine in Kuzbass. 2015;14(2):4–9. (In Russ.)].

5. Global Retinoblastoma Study Group. Global Retinoblastoma Presentation and Analysis by National Income Level. JAMA Oncol. 2020;6(5):685–95. doi: 10.1001/jamaoncol.2019.6716.

6. Clinical Recommendations ID:71. Intraocular retinoblastoma. Year of approval 2020. [Electronic resource]: https://specialist.nnood.ru/wp-content/uploads/sites/3/2020/11/Intraokulyarnaya-retinoblastoma-KR71.pdf. (In Russ.)].

7. Kozlova V.M., Kazubskaya T.P., Sokolova I.N., Alekseeva E.A., Babenko O.V., Bliznetz E.A., Ushakova T.L., Mikhailova S.N., Lubchenko L.N., Polyakov V.G. Retinoblastoma: diagnostics and genetic counseling. Onkopediatriya = Oncopediatria. 2015;2(1):30–8. (In Russ.)].

8. Ushakova T.L., Pavlovskaya A.I., Polyakov V.G. Morphological prognostic factors in children with unilateral retinoblastoma after initial enucleation. Onkokhirurgiya = Oncosurgery. 2011;3(4):4–8. (In Russ.)].

9. Ushakova T.L., Volkova A.S., Gorbunova T.V., Gorovtsova O.V., Dolgopolov I.S., Mikhailova E.V., Panferova T.R., Glekov I.S., Polyakov V.G. Retinoblastoma with extraocular extension on the optic nerve: the case report. Rossiyskiy zhurnal detskoy gematologii i onkologii = Russian Journal of Pediatric Hematology and Oncology. 2019;6(4):83–92. (In Russ.)].

10. Yarovoi A.A., Kotova E.S., Kotelnikova A.V., Yarovaya V.A. Diff erencial diagnosis of Coats retinitis and retinoblastoma. Meditsinskiy vestnik Bashkortostana = Medical Bulletin of Bashkortostan. 2020;15(4):88. (In Russ.)].

11. de Graaf P., Göricke S., Rodjan F., Galluzzi P., Maeder P., Castelijns J.A., Brisse H.J.; European Retinoblastoma Imaging Collaboration (ERIC). Guidlines for imaging retinoblastoma: imaging principles and MRI standartization. Pediatr Radiol. 2012;42(1):2–14. doi: 10.1007/s00247-011-2201-5.

12. Kiseleva T.N., Zaitsev M.S., Lugovkina K.V. The Safety of Diagnostic Ultrasound in Ophthalmology. Oftal’mologiya = Ophthalmology. 2018;15(4):447–54. (In Russ.)].

13. Echography in retinoblastoma. E. Gerke and W. Höpping. UniversitätsAugenklinik Essen, Hufelandstr. 55, 1983 г.

14. Goeres P., Zeiler F.A., Unger B., Karakitsos D., Gillman L.M. Ultrasound assessment of optic nerve sheath diameter in healthy volunteers. J Crit Care. 2016;31(1):168–71. doi: 10.1016/j.jcrc.2015.10.009.

15. Zileliolu G., Gunduz K. Ultrasonic fi ndings in intraocular retinoblastoma and correlation with histopathologic diagnosis. Int Ophthalmol. 1995;19:71–5. doi: 10.1007/bf00133175.

16. Albader F., Fatani D. Uses of Radiological Imaging in Retinoblastoma In: Retinoblastoma – Past, Present and Future, 2019. Pp. 1–14. doi: 10.5772/intechopen.86828.

17. AlAli A., Kletke S., Gallie B., Lam W.-C. Retinoblastoma for pediatric ophthalmologists. Asia Pac J Ophthalmol (Phila). 2018;7(3):160–8. doi: 10.22608/APO.201870.

18. Kiseleva T.N., Lugovkina K.V. Guseva N.V., Zaitsev M.S. Possibilities of ultrasound methods in diagnostics of eyelid tumors. Bulletin of Ophthalmology = The Russian Annals of Ophthalmology/Vestnik Oftalmologii. 2020;136(3):51–8. (In Russ.)].

19. Jeoung J.W., Yang H., Gardiner S., Wang Y.X., Hong S., Fortune B., Girard M.J.A., Hardin C., Wei P., Nicolela M., Vianna J.R., Chauhan B.C., Burgoyne C.F. Optical Coherence Tomography Optic Nerve Head Morphology in Myopia I: Implications of Anterior Scleral Canal Opening Versus Bruch Membrane Opening Off set. Am J Ophthalmol. 2020;218:105–19. doi: 10.1016/j.ajo.2020.05.015.