BMJ Case Reports 2012; doi:10.1136/bcr-2012-010508
  • Neuroimaging

Verification of supraselective drug delivery for retinoblastoma using intra-arterial gadolinium

  1. Ketan R Bulsara5
  1. 1Department of Ophthalmology and Visual Sciences, Yale School of Medicine, New Haven, Connecticut, USA
  2. 2Yale University School of Medicine, New Haven, Connecticut, USA
  3. 3Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut, USA
  4. 4Department of Diagnostic Radiology, Yale School of Medicine, New Haven, Connecticut, USA
  5. 5Department of Neurosurgery, Yale University, New Haven, Connecticut, USA
  1. Correspondence to Dr K R Bulsara, Department of Neurosurgery, Yale University, 333 Cedar Street, TMP 4, New Haven, Connecticut 06520, USA; ketan.bulsara{at}


We present a description of retinoblastoma treated with supraselective intra-arterial chemotherapy, demonstrating selective delivery of the infused chemotherapeutic agent into the tumor bed by MRI. A 7-month-old presented with group E (international classification) unilateral retinoblastoma. We treated the patient with several rounds of intra-ophthalmic artery melphalan. Gadolinium was infused along with melphalan to visualize the distribution of this chemotherapeutic drug. Intraoperative MRI was obtained within 15 min after treatment and showed increased enhancement of the tumor and subretinal space. We demonstrate here that supraselective administration of chemotherapy into the ophthalmic artery appears to result in drug delivery to the tumor and subretinal space.

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