Color flow mapping: a non-invasive tool for characterizing and differentiating between uveal melanomas and choroidal metastases

Neudorfer, Meira; Waisbourd, Michael; Anteby, Irene; Liran, Alon; Goldenberg, Dafna; Barak, Adiel; Kessler, Ada

doi:10.3892/or_00001046

Cited by 8 publications

(11 citation statements)

References 10 publications

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“…The diagnosis of a choroidal tumor is based mainly on clinical characteristics. Additional diagnostic testing includes ultrasonography (US), fluorescein angiography, and color Doppler testing [ 1 ]. US enables localization of the intraocular mass, estimation of its size, and characterization of its tissue texture.…”

Section: Introductionmentioning

confidence: 99%

Optical Coherence Tomography: An Adjunctive Tool for Differentiating between Choroidal Melanoma and Metastasis

Vishnevskia‐Dai

Zur²,

Yaacobi³

et al. 2016

Journal of Ophthalmology

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Purpose. To investigate the value of optical coherence tomography (OCT) for differentiation between choroidal melanoma and metastasis based on characteristics of the anterior choroidal surface and the chorioretinal interface. Methods. This retrospective observational case series included 29 patients with untreated choroidal melanomas and 21 patients with untreated choroidal metastases. Regularity and lobularity characteristics of the anterior choroidal surface were evaluated in a masked manner. Retinal and retinal pigment epithelium (RPE) findings were documented as well. Results. OCT demonstrated a regular and smooth anterior choroidal surface in 89.7% of the eyes with melanoma and in 47.6% of the eyes with metastasis (p = 0.002; sensitivity = 89.7%; specificity = 52.4%). The anterior choroidal contour was lobulated in 81.0% of the eyes with metastasis versus 17.2% of the eyes with melanoma (p < 0.001; sensitivity = 82.8%; specificity = 81.0%). RPE thickness and neuroretinal characteristics (e.g., retinal thickness, the presence of cysts, and the presence of subretinal fluid) were similar in both choroidal tumors. Conclusion. OCT may serve as a noninvasive adjunctive tool for the differential diagnosis of choroidal tumors. Choroidal melanomas usually demonstrate regular surfaces on OCT, while choroidal metastases usually have an irregular and lobulated surface.

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Section: Introductionmentioning

confidence: 99%

Optical Coherence Tomography: An Adjunctive Tool for Differentiating between Choroidal Melanoma and Metastasis

Vishnevskia‐Dai

Zur²,

Yaacobi³

et al. 2016

Journal of Ophthalmology

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“…As far as we are aware, only one case of PDT for choroidal metastasis from carcinoid tumor has been reported previously 5. Choroidal metastasis has a hypervascular pattern, as demonstrated by color-flow mapping 20. Therefore, PDT may be effective for choroidal hemangioma and hypervascular choroidal tumors 21,22.…”

Section: Discussionmentioning

confidence: 98%

A case of presumed choroidal metastasis from carcinoid tumor treated by photodynamic therapy with verteporfin

Kawakami¹,

Wakabayashi²,

Gotô³

2013

OPTH

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We report a case of metastatic choroidal carcinoid tumor with favorable outcome after photodynamic therapy. A 75-year-old woman was presumptively diagnosed with bilateral choroidal metastases from carcinoid tumor. Although the tumor in the right eye showed a tendency toward rapid expansion and required aggressive treatment to preserve vision, the size was still small and we hesitated to use external-beam radiotherapy because of the risk of radiation retinopathy. Consequently, photodynamic therapy was performed on the right eye, resulting in drastic reduction of the size and height of the choroidal tumor. Good visual acuity was maintained after photodynamic therapy. Photodynamic therapy may be an effective treatment for choroidal metastasis from carcinoid tumor.

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“…Color Doppler flow imaging allows real-time observation on the characteristics of blood flow in the tumor [8]. Previous literature has reported that choroidal metastases and choroidal melanomas can be differentiated based on the velocity of blood flow in the tumor vessels and presence of central dominant vessels in the tumor [9]. Although color Doppler flow imaging could obtain the information on blood flow in the lesion, under the condition of insufficient blood supply, extremely high intraocular pressure, low blood flow velocity, or because of the limited sensitivity of the instrument for the detection of blood flow, it may only be able to exhibit low blood flow signal (if any) in the lesion, leading to inaccurate diagnosis or even misdiagnosis as nontumorous lesion [10,11].…”

Section: Discussionmentioning

confidence: 99%

Quantitative Analysis of Perfusion Characteristics Using Contrast-Enhanced Ultrasound in Patients with Choroidal Metastasis

Wang

Chen

et al. 2020

Ophthalmic Res

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Purpose: The aim of the study was to quantitatively analyze the perfusion characteristics of choroidal metastasis using contrast-enhanced ultrasound (CEUS) and compare its perfusion characteristics with these of choroidal hemangioma and choroidal melanoma. Methods: The patients who were clinically diagnosed with choroidal metastasis were classified as the study group, and the patients who were diagnosed with choroidal hemangioma and choroidal melanoma during the same period were classified as the comparison group. All patients underwent CEUS examination, and Sonoliver was used to obtain the data on quantitative parameters of the tumor and the adjacent normal orbital tissues, including maximum of intensity (IMAX), rise time (RT), time to peak (TTP), and mean transit time (mTT). Wilcoxon signed rank test was performed to compare the quantitative parameters of choroidal metastasis and normal orbital tissues. Kruskal-Wallis test was adopted to compare the quantitative parameters of the 3 types of tumors, and Bonferroni was used to correct the results of the multiple comparisons. Receiver operating characteristic (ROC) curve analysis was used to identify valuable parameters. Results: Twenty-six patients (26 eyes) with choroidal metastasis, 55 patients (55 eyes) with choroidal hemangioma, and 49 patients (49 eyes) with choroidal melanoma were enrolled in this study. The IMAX of choroidal metastasis was significantly higher than that of normal orbital tissues, while RT, TTP, and mTT were significantly shorter than these of normal orbital tissues (all p values were <0.001). The IMAX of choroidal metastasis was lower than that of choroidal hemangioma, and RT, TTP, and mTT were shorter than these of choroidal hemangioma and choroidal melanoma (p = 0.002, p = 0.004, p = 0.007). ROC curve analysis showed that areas under the ROC curves (AUCs) of RT and mTT (AUC = 0.851, 95% CI 0.783–0.918 and 0.849, 95% CI 0.783–0.915) were larger. Conclusion: Quantitative analysis with CEUS can reflect the perfusion characteristics of choroidal metastasis and can exhibit the difference between its perfusion characteristics and these of choroidal hemangioma and choroidal melanoma. RT and mTT may serve as useful parameters for differentiating choroidal metastasis from choroidal hemangioma and choroidal melanoma.

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Color flow mapping: a non-invasive tool for characterizing and differentiating between uveal melanomas and choroidal metastases

Cited by 8 publications

References 10 publications

Optical Coherence Tomography: An Adjunctive Tool for Differentiating between Choroidal Melanoma and Metastasis

Optical Coherence Tomography: An Adjunctive Tool for Differentiating between Choroidal Melanoma and Metastasis

A case of presumed choroidal metastasis from carcinoid tumor treated by photodynamic therapy with verteporfin

Quantitative Analysis of Perfusion Characteristics Using Contrast-Enhanced Ultrasound in Patients with Choroidal Metastasis

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