Prospective Determination of Orbital Perfusion Dominance before Intra-Arterial Chemotherapy for Retinoblastoma Using Time-of-Flight Magnetic Resonance Angiography

Eric J. Monroe; Jeffrey P. Otjen; Jason N. Wright; Francisco A. Perez; Jeffrey Forris Beecham Chick; Danial K. Hallam; Mark R. Ferguson

doi:10.1055/s-0042-1743498

Journal of Clinical Interventional Radiology ISVIR, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · Journal of Clinical Interventional Radiology ISVIR 2023; 07(01): 064-068
DOI: 10.1055/s-0042-1743498

Short Communication

Prospective Determination of Orbital Perfusion Dominance before Intra-Arterial Chemotherapy for Retinoblastoma Using Time-of-Flight Magnetic Resonance Angiography

Eric J. Monroe

¹Department of Radiology, Section of Interventional Radiology, American Family Children's Hospital and University of Wisconsin, Madison, Wisconsin, United States

,

Jeffrey P. Otjen

²Department of Radiology, Section of Pediatric Radiology; Seattle Children's Hospital and University of Washington, Seattle, Washington, United States

,

Jason N. Wright

²Department of Radiology, Section of Pediatric Radiology; Seattle Children's Hospital and University of Washington, Seattle, Washington, United States

,

Francisco A. Perez

²Department of Radiology, Section of Pediatric Radiology; Seattle Children's Hospital and University of Washington, Seattle, Washington, United States

,

Jeffrey Forris Beecham Chick

³Department of Radiology, Section of Interventional Radiology; Seattle Children's Hospital and University of Washington, Seattle, Washington, United States

,

Danial K. Hallam

⁴Department of Radiology, Section of Neurointerventional Radiology, Seattle Children's Hospital and University of Washington, Seattle, Washington, United States

,

Mark R. Ferguson

²Department of Radiology, Section of Pediatric Radiology; Seattle Children's Hospital and University of Washington, Seattle, Washington, United States

› Institutsangaben

Abstract

Intra-arterial chemotherapy (IAC) represents a mainstay in the treatment of retinoblastoma. In a minority of cases, the external carotid artery (ECA) serves as the dominant supply to the central retinal artery and is associated with prolonged fluoroscopy times and higher intraprocedural radiation doses. The aim of this study was to evaluate the utility of time-of-flight (TOF) magnetic resonance angiography (MRA) for prospective determination of internal (ICA) versus ECA dominance for procedural planning. Between April 2017 and December 2020 (44 months), staging MR prior to IAC for retinoblastoma included variant spatial saturation band position TOF angiography. Exams were then retrospectively reviewed for concordance of ICA versus ECA dominance between the two modalities. Eight consecutive patients were included in the study. Mean patient age at time of diagnosis was 20.3 ± 10.7 months (range: 2.7–33.2 months). Ten affected eyes were included (2 cases of bilateral disease), with stage D disease in eight eyes and stage B disease in two eyes. MRA techniques demonstrated antegrade ophthalmic artery (OA) flow in 9/10 (90%) of affected eyes. Subsequent catheter angiography confirmed ICA dominant supply in 9/9 (100%). For a single affected eye (10%), the OA was demonstrated as orthotopic by T2 flow void, nonvisualized on anterior saturation TOF sequences, and faintly visualized on posterior saturation TOF sequences. Aggregate MRA to catheter angiographic concordance was 10/10 (100%). Variant saturation TOF MRA predicts ICA versus ECA dominant supply to the central retinal artery in retinoblastoma.

Keywords

retinoblastoma - oncology - intra-arterial chemotherapy - angiography - magnetic resonance

Volltext

Referenzen

References
1 Wyse E, Handa JT, Friedman AD, Pearl MS. A review of the literature for intra-arterial chemotherapy used to treat retinoblastoma. Pediatr Radiol 2016; 46 (09) 1223-1233
2 Moll AC, Imhof SM, Schouten-Van Meeteren AY, Kuik DJ, Hofman P, Boers M. Second primary tumors in hereditary retinoblastoma: a register-based study, 1945-1997: is there an age effect on radiation-related risk?. Ophthalmology 2001; 108 (06) 1109-1114
3 Draper GJ, Sanders BM, Kingston JE. Second primary neoplasms in patients with retinoblastoma. Br J Cancer 1986; 53 (05) 661-671
4 Kleinerman RA. Radiation-sensitive genetically susceptible pediatric sub-populations. Pediatr Radiol 2009; 39 (Suppl. 01) S27-S31
5 Bracco S, Venturi C, Leonini S. et al. Transorbital anastomotic pathways between the external and internal carotid systems in children affected by intraocular retinoblastoma. Surg Radiol Anat 2016; 38 (01) 79-87
6 Bertelli E, Leonini S, Galimberti D. et al. Hemodynamic and anatomic variations require an adaptable approach during intra-arterial chemotherapy for intraocular retinoblastoma: alternative routes, strategies, and follow-up. AJNR Am J Neuroradiol 2016; 37 (07) 1289-1295
7 Guasti A, Leonini S, Bertelli E. et al. Intra-arterial chemotherapy for retinoblastoma: the dosimetric impact. Neuroradiology 2019; 61 (09) 1083-1091
8 Area C, Yen CJ, Chevez-Barrios P. et al. Technical and anatomical factors affecting intra-arterial chemotherapy fluoroscopy time and radiation dose for intraocular retinoblastoma. J Neurointerv Surg 2019; 11 (12) 1273-1276
9 Qureshi AM, Davies LK, Patel PA, Rennie A, Robertson F. Determinants of radiation dose in selective ophthalmic artery chemosurgery for retinoblastoma. AJNR Am J Neuroradiol 2019; 40 (04) 713-717
10 Monroe EJ, Chick JFB, Stacey AW. et al. Radiation dose reduction during intra-arterial chemotherapy for retinoblastoma: a retrospective analysis of 96 consecutive pediatric interventions using five distinct protocols. Pediatr Radiol 2021; 51 (04) 649-657
11 Abruzzo TA, Geller JI, Kimbrough DA. et al. Adjunctive techniques for optimization of ocular hemodynamics in children undergoing ophthalmic artery infusion chemotherapy. J Neurointerv Surg 2014
12 Bitar R, Leung G, Perng R. et al. MR pulse sequences: what every radiologist wants to know but is afraid to ask. Radiographics 2006; 26 (02) 513-537