Multi-parametric magnetic resonance imaging characterization of orbital lesions: a triple blind study. (17th February 2020)

• Record Type: Journal Article
• Authors: Russo, Camilla; Strianese, Diego; Perrotta, Marianna; Iuliano, Adriana; Bernardo, Roberta; Romeo, Valeria; Ugga, Lorenzo; Brunetti, Lisa; Tranfa, Fausto; Elefante, Andrea
• Is Part Of: Seminars in ophthalmology. Volume 35:Number 2(2020)
• Page Start: 95
• Page End: 102
• Publication Date: 2020-02-17
• Subjects: diffusion weighted imaging -- dynamic contrast enhancement -- magnetic resonance imaging -- orbital mass -- perfusion; Ophthalmology -- Periodicals; Eye -- Diseases -- Periodicals; Eye -- Surgery -- Periodicals; 617.7005
• DOI: 10.1080/08820538.2020.1742358
• Languages: English
• ISSNs: 0882-0538

Abstract

ABSTRACT: Background : Multi-parametric MRI used for preoperative assessment of orbital lesions does not routinely include DCE-MRI, since its accuracy in differential diagnosis of orbital mass is still under debate. Aim of this study is to characterize orbital lesions by multi-parametric MRI, analysing the incremental predictive value of DCE-MRI in differential diagnosis of orbital lesions. Methods : In this prospective triple-blind study, 43 consecutive patients with unilateral orbital lesion underwent conventional multimodal MRI and DCE-MRI before biopsy in a tertiary referral centre. Pre-operative MRI examination including conventional unenhanced MRI protocol, DWI with ADC maps, static CE 3D-T1 w and dynamic CE T1 w sequences, was performed within 1 week from surgery (anterior/lateral orbitotomy depending on location of the lesion, to carry out incisional/excisional biopsy). Results : Comparison between conventional T1 w/T2 w, DWI, CE 3D-T1 w and DCE-MRI groups showed a statistically significant difference in scores distribution ( p < .001). Statistically significant difference was found between conventional T1 w/T2 w and DWI ( p < .005), as well as between DWI and CE 3D-T1 w ( p < .001). Conversely, no significant difference was found between CE 3D-T1 w and DCE ( p < .005). Conclusions and Relevance : This study confirmed the positive effect of DWI and CE 3D-T1 w on orbital lesions diagnosis when added to conventional T1 w/T2 w sequences, whereas no substantial impact on diagnostic performance was observed with the further addition of DCE-MRI. DCE does not strongly influence diagnostic performance and inter-rater agreement in characterizing orbital lesions; therefore, it should be recommended in selected patients whose assessment of flow dynamics is particularly useful for management. Abbreviations : US = ultrasonography; MRI = magnetic resonance imaging; CT = computed tomography; STIR = Short-TI Inversion Recovery; DWI = diffusion weighted imaging; DCE-MRI = dynamic contrast-enhanced MRI; SE = Spin-Echo; TSE = Turbo Spin-Echo; THRIVE = T1-weighted high resolution Isotropic Volume Examination (dynamic contrast-enhanced ultrafast spoiled gradient echo); ROI = regions of interest; IRR = inter-rater reliability; TIC = time–intensity curve.