This retrospective multicenter study examines therapy-induced orbital and ocular MRI findings in retinoblastoma patients following selective intra-arterial chemotherapy (SIAC) and quantifies the impact of SIAC on ocular and optic nerve growth. Patients were selected based on medical chart review, with inclusion criteria requiring the availability of posttreatment MR imaging encompassing T2-weighted and T1-weighted images (pre- and post-intravenous gadolinium administration). Qualitative features and quantitative measurements were independently scored by experienced radiologists, with deep learning segmentation aiding total eye volume assessment. Eyes were categorized into three groups: eyes receiving SIAC (Rb-SIAC), eyes treated with other eye-saving methods (Rb-control), and healthy eyes. The most prevalent adverse effects post-SIAC were inflammatory and vascular features, with therapy-induced contrast enhancement observed in the intraorbital optic nerve segment in 6% of patients. Quantitative analysis revealed significant growth arrest in Rb-SIAC eyes, particularly when treatment commenced ≤ 12 months of age. Optic nerve atrophy was a significant complication in Rb-SIAC eyes. In conclusion, this study highlights the vascular and inflammatory adverse effects observed post-SIAC in retinoblastoma patients and demonstrates a negative impact on eye and optic nerve growth, particularly in children treated ≤ 12 months of age, providing crucial insights for clinical management and future research.
本回顾性多中心研究旨在探讨视网膜母细胞瘤患者接受选择性眼动脉灌注化疗（SIAC）后治疗诱发的眼眶及眼部磁共振成像表现，并量化SIAC对眼球及视神经生长的影响。研究通过病历回顾筛选患者，纳入标准要求具备包含T2加权像及静脉注射钆对比剂前后T1加权像的治疗后磁共振影像资料。由经验丰富的放射科医师独立评估定性特征并进行定量测量，同时借助深度学习分割技术辅助眼球总体积测算。将眼球分为三组：接受SIAC治疗的眼球（Rb-SIAC组）、采用其他保眼疗法治疗的眼球（Rb对照组）以及健康眼球。SIAC术后最常见的不良反应为炎症性和血管性特征，其中6%的患者在眶内段视神经出现治疗诱发的对比剂强化。定量分析显示Rb-SIAC组眼球生长显著停滞，尤其在≤12月龄开始治疗的患儿中更为明显。视神经萎缩是Rb-SIAC眼球的重要并发症。综上所述，本研究揭示了视网膜母细胞瘤患者SIAC术后观察到的血管性和炎症性不良反应，并证实该疗法对眼球及视神经生长存在负面影响，特别是在≤12月龄接受治疗的儿童中，这为临床管理和未来研究提供了重要依据。
肿瘤(癌症)患者之家