Imaging of Uveal Melanoma—Current Standard and Methods in Development

Abstract

Uveal melanoma is the most common primary intraocular malignancy in adults, characterized by an insidious onset and poor prognosis strongly associated with tumor size and the presence of distant metastases, most commonly in the liver. Contrary to most tumor identification, a biopsy followed by a pathological exam is used only in certain cases. Therefore, an early and noninvasive diagnosis is essential to enhance patients’ chances for early treatment. We reviewed imaging modalities currently used in the diagnostics of uveal melanoma, including fundus imaging, ultrasonography (US), optical coherence tomography (OCT), single-photon emission computed tomography (SPECT), fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA), fundus autofluorescence (FAF), as well as positron emission tomography/computed tomography (PET/CT) or magnetic resonance imaging (MRI). The principle of imaging techniques is briefly explained, along with their role in the diagnostic process and a summary of their advantages and limitations. Further, the experimental data and the advancements in imaging modalities are explained. We describe UM imaging innovations, show their current usage and development, and explain the possibilities of utilizing such modalities to diagnose uveal melanoma in the future.

Automatic Three-Dimensional Magnetic Resonance-based measurements of tumour prominence and basal diameter for treatment planning of uveal melanoma

“…However, on ultrasound, the extent of these flat tumours is also not clearly visible. Therefore, optical validation of the flat tumour extent, which can be measured on some fundus and OCT imaging modalities [10] , or increased margins, is necessary. For the SBD larger discrepancies with ultrasound were observed than for the LBD, however, the resulting ellipsoid model is more accurate than a circular model based on the LBD alone [8] , [9] , [42] , [43] , [44] , [45] .…”

“…Furthermore, tumour prominence and diameter measurements are of importance for radiotherapy planning: in brachytherapy, prominence and largest basal diameter (LBD) determine the application time and applicator size, while for PBT, these two-dimensional (2D) tumour measurements, together with the second basal diameter (SBD) are important factors in the definition of three-dimensional (3D) clinical target volume [2] , [7] . Additionally, prominence, LBD and SBD are used in tumour staging, prognosis and follow-up [8] , [9] , [10] , [11] , [12] .…”

Choroidal Melanoma: A Mini Review

“…It can be challenging to distinguish choroidal melanoma from benign pigmented nevus ( Figure 1 ); moreover, management may be complex as few nevi convert into choroidal melanomas (1 in 8000) (4). Fundus examination, fundus photography, and ocular ultrasound are the main evaluation aspects for ocular tumours [ 25 ].…”

“…Uveal nevi are generally flat, slate-gray lesions without sharply demarcated margins; their size is limited to about 6 mm in diameter [ 25 , 26 ]. However, there is considerable overlap in size distributions of nevi and indeterminate lesions compared with small melanomas [ 26 , 27 ].…”

Development of novel polymeric nanoagents and their potential in cancer diagnosis and therapy runing title: Polymeric nanoagents for cancer theranostics

“…Most cancer patients are diagnosed at the advanced stages because of lacking typical clinical symptoms. Conventional methods for cancer diagnosis mainly contain biopsy, magnetic resonance imaging (MRI), computed tomography (CT), positron emission tomography (PET), single photon emission computed tomography (SPECT) and ultrasound (US) (Solnik et al, 2022). Biopsy is still the gold standard, PET has a low resolution, and MRI causes a high false positive signal (Jin et al, 2021;Kowalchuk et al, 2021).…”