Intraoperative echographic localization of iodine-125 episcleral plaque for brachytherapy of choroidal melanoma

Tabandeh, Homayoun; Chaudhry, Nauman; Murray, Timothy G.; Ehlies, Fiona J.; Hughes, Randall; Scott, Ingrid U.; Markoe, Arnold M.

doi:10.1016/s0002-9394(99)00315-3

Cited by 79 publications

(53 citation statements)

References 24 publications

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“…Fourteen studies were retrospective clinical chart reviews [14,15,22,23,24,25,26,27,28,29,30,31,32], and 1 was a prospective, randomized trial, the COMS trial [17]. One retrospective study included patients from the COMS trial [15].…”

Section: Resultsmentioning

confidence: 99%

Iodine-125 Brachytherapy for Uveal Melanoma: A Systematic Review of Radiation Dose

et al. 2017

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Aim: To investigate whether lower radiation doses may yield similar outcome measures to those from the COMS trial. Methods: A literature review of English language articles was performed using the PubMed database of the U.S. National Library of Medicine and the Cochrane Central Register of Controlled Trials using the following keywords: uveal melanoma, choroidal melanoma, primary uveal malignant melanoma, iodine-125 brachytherapy, local recurrence, local treatment failure, and local tumor control. The relationships between study local recurrence rate and median dosage were tested by linear regression, with each study weighted by the number of patients included. Results: Fifteen retrospective and prospective studies were selected for systematic review (2,662 patients). Ranges of reported mean or median radiation dose to tumor apex were 62.5-104.0 Gy. Local recurrence rates ranged from 0 to 24%. A 1.0-Gy increase in the average study dose was associated with a 0.14% decrease in local recurrence rate, which was not statistically significant (p value 0.336). Conclusion: The gold standard empirically derived 85.0-Gy radiation dose for the treatment of uveal melanoma could be tested in a randomized study.

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Section: Resultsmentioning

confidence: 99%

Iodine-125 Brachytherapy for Uveal Melanoma: A Systematic Review of Radiation Dose

et al. 2017

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“…This margin was deemed most appropriate in a prospective study by Char and associates, which demonstrated that extending the plaque border 2 mm beyond the tumor margin increased the rate of local tumor control. 48 Adequate tumor coverage is then verified with repeat transillumination. Two loose nylon sutures are placed through the eyelets of the dummy plaque, which is then subsequently exchanged for the radioactive plaque over the preplaced sutures.…”

Section: Surgical Technique-placementmentioning

confidence: 99%

Radioactive Plaque Therapy

Hui¹,

Murray²

2006

International Ophthalmology Clinics

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Brachytherapy is one of the most frequent treatment modalities for choroidal melanoma. 1,2 It allows for attempted preservation of vision and a more cosmetically acceptable outcome than enucleation. Pierre and Marie Curie first discovered radioactivity in 1898. 3 Moore first reported the use of brachytherapy in 1930 with radon seeds directly implanted into a ciliochoroidal melanoma. 4 Stallard introduced the use of cobalt 60 plaques 5 and Lommatzsch Ruthenium 106 plaques. 6 Plaque radiotherapy came into more widespread use in the 1970s as an alternative to enucleation. [6][7][8][9][10][11][12][13][14] Other isotopes that have been used in the treatment of uveal melanoma include iridium 192, gold 198, palladium 103, and iodine 125. The goal of brachytherapy is local tumor control to prevent metastatic disease. 15-18 Isotope SelectionCobalt 60 is a high-energy isotope that was used more often in the past. Advantages include availability in a standard plaque form and a long halflife that allows for multiple reuses. 19 Retrospective studies showed metastatic and all-cause death rates in Co-60-treated eyes were similar to enucleated eyes. 20,21 A study of 277 patients demonstrated a 5-year local tumor control rate of approximately 88%. 22 However, because Co-60 is a highenergy gamma emitter and cannot be adequately shielded, it poses a greater risk to nonaffected ocular structures as well as the treating physician and staff. 23 For example, an 11-mm lead shield blocks only 50% of the cobalt radiation. Only 1 mm of gold is needed to block more than 99.95% of emitted radiation from either ruthenium 106 or iodine 125. 9,24-29 Given these radiation safety concerns, lower-energy isotopes have largely 51

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“…One technique involves transillumination of the plaque's edges 8,9 ; a similar technique uses light-emitting diodes mounted on the plaque instead of a fiber-optic light pipe. 10,11 In addition, there have been several reports that have been written about the use of ultrasound to verify plaque placement [12][13][14] ; however, no mention has been made of possible limitations involved or errors that may arise.…”

Section: Discussionmentioning

confidence: 99%

Imaging Errors in Localization of COMS-Type Plaques in Choroidal Melanoma Brachytherapy

Bayat

Alizad

Tamminga

et al. 2013

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. To investigate mathematically and experimentally the sources of errors in localization of COMS-type plaques in melanoma brachytherapy when using ultrasound and transillumination and to give recommendations to avoid such errors. METHODS.A computer-aided simulation tool was developed to model the errors seen in the patient images when using ultrasound imaging and transillumination during localization of the COMS-type plaque in melanoma brachytherapy. Several laboratory experiments were performed on sheep eyes to confirm the validity of the error sources and the simulator outputs. Results were compared to the intraoperative ultrasonographic patient images for validation.RESULTS. Based on mathematical modeling and computer simulation results, transillumination provides acceptable accuracy for small to medium tumors with less than 7-mm height but shows poor accuracy as the tumor height increases. In ultrasound imaging, two sources of error are predicted in longitudinal scan using our computer simulation modeling, and the results are supported by the experiments on sheep eyes and patient images taken during the operation. Both errors are related to the lens. The first error is due to attenuation and refraction of the lens causing opaque areas and a change of curvature in the image of the plaque edge that is nearest to the lens. The second type of error is related to the total internal reflection from the lens. CONCLUSIONS.The simulation method presented in this article allows quantitative assessment of the sources, mechanisms, and measures of errors in localization of the CMOS-type plaques by ultrasound and transillumination techniques. Errors predicted by the simulation method are validated by experiments. Error assessment by this method provides guidelines for avoiding such errors.

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Intraoperative echographic localization of iodine-125 episcleral plaque for brachytherapy of choroidal melanoma

Cited by 79 publications

References 24 publications

Iodine-125 Brachytherapy for Uveal Melanoma: A Systematic Review of Radiation Dose

Iodine-125 Brachytherapy for Uveal Melanoma: A Systematic Review of Radiation Dose

Radioactive Plaque Therapy

Imaging Errors in Localization of COMS-Type Plaques in Choroidal Melanoma Brachytherapy

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