Radiologic Features of Well-circumscribed Orbital Tumors With Histopathologic Correlation: A Multi-center Study

Kelsey A. Roelofs, Valerie Juniat, Michael O'Rouke, Luke Ledbetter, Sasha Hubschman, Thomas Hardy, Jean Lee, Samuel Baugh, Sheeja T. Pullarkat, Dinesh Selva, Robert A. Goldberg, Daniel B. Rootman

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Purpose: To delineate specific imaging characteristics of solitary fibrous tumors, schwannomas, cavernous venous malformations, and well-circumscribed orbital lymphoma. Methods: Patients undergoing excisional biopsy of solitary fibrous tumor, schwannomas, cavernous venous malformations, or well-circumscribed orbital lymphoma with preoperative MRIs available for review were identified at 3 academic centers in the United States and Australia. An exploratory statistical analysis was performed to identify important radiologic features, which were subsequently included in a random forest model. Histopathologic correlates were evaluated in representative cases. Results: A total of 91 cases were included with a mean age of 52.9 ± 17.2 years. Nearly all solitary fibrous tumors were located in the anterior or mid orbit (87.5%) and they more commonly demonstrated intralesional heterogeneity on T2-weighted imaging (45.5%) (p < 0.01). Compared with the other tumors, schwannomas tended to be intraconal (66.7%) and were often in the mid or posterior orbit (83.4%) (p < 0.01). Cavernous venous malformations characteristically demonstrated progressive contrast enhancement (93.9%; p < 0.01). Most lesions in all 4 groups were hypointense on T1-weighted imaging (80%-100%; p = 0.14) and only well-circumscribed orbital lymphoma tended to also be hypointense on T2 (81.8%) (p < 0.01). Finally, cases of lymphoma had significantly lower apparent diffusion coefficient ratios (0.9 ± 0.2) (p < 0.001), while the other 3 groups were not significantly different from one another (cavernous venous malformations: 1.8 ± 0.4; schwannomas: 1.8 ± 0.5; and solitary fibrous tumor: 1.6 ± 0.6) (p = 0.739). Conclusions: Key features that aid in the differentiation of these 4 tumors from one another include T2 intensity and homogeneity, early contrast-enhancement pattern, and ADC ratio.

Original languageEnglish (US)
Pages (from-to)380-387
Number of pages8
JournalOphthalmic plastic and reconstructive surgery
Volume40
Issue number4
DOIs
StatePublished - Jul 1 2024

All Science Journal Classification (ASJC) codes

  • Surgery
  • Ophthalmology

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