>93% RB1 mutation detection sensitivity),  the risk of a germline RB1 mutation is reduced to less than 1%, a level at which only clinic examination (and not examinations under anaesthetic) is recommended for the affected individual and their future offspring (National Retinoblastoma Strategy, Canadian Guidelines for Care). Imaging
Traditional ultrasound B scan can detect calcifications in the tumour while high-frequency ultrasound B scan is able to provide higher resolution than the traditional ultrasound and determine the proximity of the tumour with front portion of the eye. MRI scan can detect high-risk features such as optic nerve invasion; choroidal invasion, scleral invasion, and intracranial invasion. CT scan is generally avoided because radiation can stimulate the formation of more eye tumours in those with RB1 genetic mutation. Staging
In order to properly diagnose retinoblastoma, there must be guidelines to follow to properly classify the risk of the tumor. The Reese Ellsworth Classification System, by Dr. Algernon Reese and Dr. Robert Ellsworth, is universally used to determine the size, location, and multi-focality of the tumor. The system was originally used to decide the best treatment result by using external beam radiotherapy, as well as, the likeliness of salvaging the globe of the eye. Due to chemotherapy not being part of the Reese Ellsworth Classification System, there needed to be an updated classification system to foresee the treatment outcomes of chemotherapy. The International Classification for Intraocular Retinoblastoma is now the current system being used, and it was created by Murphree and associates.
Notable cases
Tony Bland – first patient in English legal history to be allowed to die
Paul Brophy – first American to die after court-authorization
Sunny von Bülow – lived almost 28 years in a persistent vegetative state until her death
Gustavo Cerati – Argentine singer-songwriter, composer and producer who died after four years in a coma
Prichard Colón – Puerto Rican former professional boxer and gold medal winner who spent years in a vegetative state after a bout
Nancy Cruzan – American woman involved in a landmark United States Supreme Court case
Gary Dockery – American police officer who entered, emerged and later reentered a persistent vegetative state
Eluana Englaro – Italian woman from Lecco whose life was ended after a legal case after spending 17 years in a vegetative state
Elaine Esposito – American woman who was a previous record holder for having spent 37 years in a coma
Lia Lee – Hmong person who spent 26 years in a vegetative state and was the subject of a 1997 book by Anne Fadiman
Martin Pistorius South African man who is a rare example of a survivor as his state progressed to minimally conscious after 3 years, locked in syndrome after another 4 more years, and fully came out of a coma after another 5 years. He is now a web designer, developer, and author. In 2011, he wrote a book called Ghost Boy, in which he describes his many years of being comatose.