Preoperative staging of liver metastases from uveal melanoma by magnetic resonance imaging (MRI) and fluorodeoxyglucose-positron emission tomography (FDG-PET)

Servois, Vincent; Mariani, Pascale; Malhaire, Caroline; Petras, Slavomir; Piperno‐Neumann, Sophie; Plancher, Corine; Lévy-Gabriel, Christine; Rouic, Livia Lumbroso‐Le; Desjardins, Laurence; Rj, Salmon

doi:10.1016/j.ejso.2009.08.010

Cited by 62 publications

(43 citation statements)

References 17 publications

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“…An issue in high-risk patients is to detect relapse at the earliest stage after primary tumor treatment. Unfortunately, clinically available methods to assess the extent of the disease such as detection by liver function tests or imaging are generally positive when the metastatic tumor burden is already high (7,8). Indeed, the detection of small lesions remains a real challenge especially for the miliary form of metastases, which is frequent in uveal melanoma (9).…”

Section: Introductionmentioning

confidence: 99%

Pyrophosphorolysis-Activated Polymerization Detects Circulating Tumor DNA in Metastatic Uveal Melanoma

Madic

Piperno‐Neumann

Servois

et al. 2012

Clinical Cancer Research

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Purpose: To develop a molecular tool to detect circulating tumor-derived DNA (ctDNA) in the plasma from patients with uveal melanoma as a marker of tumor burden and monitor treatment efficacy.Experimental Design: A real-time PCR was developed on the basis of bidirectional pyrophosphorolysisactivated polymerization (bi-PAP) for the quantification of ctDNA using 3 0 blocked primer pairs specific for the 3 recurrent mutually exclusive mutations of Ga subunits GNAQ and GNA11.Results: Sensitivity and specificity of bi-PAP were assessed on serial dilutions of tumor DNA in normal DNA for the 3 recurrent mutations. Each assay could detect a single mutated molecule per reaction, whereas 10 4 copies of normal DNA were not detected. The ctDNA was readily detected in plasma of mice bearing uveal melanoma xenografts in amounts proportional to circulating human DNA. Finally, plasma was almost always found positive (20 of 21 tested patients) in a prospective analysis of patients with metastatic uveal melanoma. Conclusions: Bi-PAP assays detect and quantify ctDNA in patients with metastatic uveal melanoma. A prospective study is ongoing to assess the clinical usefulness of ctDNA level in uveal melanoma.

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Section: Introductionmentioning

confidence: 99%

Pyrophosphorolysis-Activated Polymerization Detects Circulating Tumor DNA in Metastatic Uveal Melanoma

Madic

Piperno‐Neumann

Servois

et al. 2012

Clinical Cancer Research

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“…Localization of small metastases is also limited by respiratory motion artefacts. 6 In a study by Orcurto et al, 12 only 4% of 108 hepatic lesions were detected by PET alone as compared with 65% by MRI alone.…”

Section: Treated Lesionsmentioning

confidence: 99%

“…In Europe, ultrasound of the liver is typically performed every 6 months for 10 years, with CT or MRI being performed if a suspicious lesion is visualized. 6 At tertiary-care centres in the USA, surveillance is usually carried out in a twofold manner, using MRI of the abdomen with i.v. contrast for optimal liver surveillance and CT chest, abdomen and pelvis for whole-body surveillance, with the timing based on the risk of metastasis indicated by the tumour histology and genetic profile.…”

Section: Imaging Of Ocular Melanoma Metastasismentioning

confidence: 99%

Imaging of ocular melanoma metastasis

Balasubramanya¹,

Selvarajan²,

Cox³

et al. 2016

BJR

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Ocular melanoma is the most common adult primary intraocular tumour. Although ,1% of patients have metastatic disease at the time of initial diagnosis, most will develop metastasis at varying lengths of time. Metastasis surveillance is therefore critical in the follow-up of patients with ocular melanoma. Liver is the most common site of metastasis and prognosis is based on the treatment of liver metastasis. Hence, imaging of liver metastasis is vital. MRI is the most specific modality for imaging liver metastasis and is at least as sensitive as CT. Extrahepatic metastasis such as retroperitoneal nodules and bone metastases are also better evaluated on MRI. Gadolinium-based contrast agents are extremely helpful for detecting liver lesions. In particular, newer hepatobiliary contrast agents which offer an additional hepatobiliary phase of excretion help in the detection of even tiny liver metastases. Diffusion-weighted imaging is helpful when an i.v. contrast cannot be administered. Treated lesions are also better evaluated with MRI. CT is useful for evaluating lung nodules, large liver metastasis or in patients in whom MRI is medically contraindicated. The disadvantage lies in its inability to detect small liver metastasis and the radiation dose involved. The lesions treated with iodized oil as part of chemoembolization procedures can be followed on CT. Ultrasound can be used only for detecting hepatic metastases. However, it is heavily operator dependent, technically challenging and time consuming especially in patients who are large. Extrahepatic metastasis cannot be seen on ultrasound. Its utility is primarily for the biopsy of liver lesions. Positron emission tomography (PET)-CT can detect lung nodules and large liver lesions but is insensitive to small liver lesions. Moreover, the high radiation dose is a major disadvantage. IMAGING OF OCULAR MELANOMA METASTASISOcular melanoma is the most common adult primary intraocular tumour, with a stable incidence over the past 30 years of 5.1 per million. The overwhelming majority of those affected are Caucasian. In ocular melanoma, unlike most cancers, ,1% of patients have metastatic disease at the time of initial diagnosis. However, unfortunately, many do go on to develop metastases. The Collaborative Ocular Melanoma Study, one of the largest prospective studies, with a longitudinal follow-up of 2320 patients, found a 10-year cumulative metastatic rate of 34%.1 The most frequent site of ocular melanoma metastasis is the liver (90%), followed by the lung (30%), bone (23%) and skin (17%). Metastatic disease is identified on an average about 3 years after the diagnosis of the primary tumour. 2,3The median survival time after diagnosis of metastasis in the largest series of patients with metastatic uveal melanoma was 3.6 months, 4, although time to metastasis can be prolonged up to 42 years in some cases. 5 As liver metastases are the most common cause of death in these patients, this review focused largely on imaging of the liver.Given the prolonged time frame i...

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“…Computerised tomography and positron emission tomography (PET) are less sensitive and expose patients to radiation. 67,68 18F-FDG PET/CT does not detect metastases from uveal melanoma as sensitively as secondaries from cutaneous melanoma. 69 Screening with magnetic resonance imaging is relatively expensive and uses up scarce healthcare resources.…”

Section: Screening For Metastatic Diseasementioning

confidence: 99%

Progress in the management of patients with uveal melanoma. The 2012 Ashton Lecture

Damato

2012

Eye

139

100

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Uveal melanomas are diverse in their clinical features and behaviour. More than 90% involve the choroid, the remainder being confined to the ciliary body and iris. Most patients experience visual loss and more than a third require enucleation, in some cases because of pain. Diagnosis is based on slitlamp biomicroscopy and/or ophthalmoscopy, with ultrasonography, autofluorescence photography, and/or biopsy in selected cases. Conservation of the eye with useful vision has improved with advances in brachytherapy, proton beam radiotherapy, endoresection, exoresection, transpupillary thermotherapy, and photodynamic therapy. Despite ocular treatment, almost 50% of patients develop metastatic disease, which occurs almost exclusively in patients whose tumour shows chromosome 3 loss and/or class 2 gene expression profile. When the tumour shows such lethal genetic changes, the survival time depends on the anatomical stage and the histological grade of malignancy. Prognostication has improved as a result of progress in multivariate analysis including all the major risk factors. Screening for metastases is more sensitive as a consequence of advances in liver scanning with magnetic resonance imaging and other methods. More patients with metastases are living longer, benefiting from therapies such as: partial hepatectomy; radiofrequency ablation; ipilumumab immunotherapy; selective internal radiotherapy; intra-hepatic chemotherapy, possibly with isolated liver perfusion; and systemic chemotherapy. There is scope for improvement in the detection of uveal melanoma so as to maximise any opportunities for conserving the eye and vision, as well as preventing metastatic spread. Patient management has been enhanced by the formation of multidisciplinary teams in specialised ocular oncology centres.

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Preoperative staging of liver metastases from uveal melanoma by magnetic resonance imaging (MRI) and fluorodeoxyglucose-positron emission tomography (FDG-PET)

Cited by 62 publications

References 17 publications

Pyrophosphorolysis-Activated Polymerization Detects Circulating Tumor DNA in Metastatic Uveal Melanoma

Pyrophosphorolysis-Activated Polymerization Detects Circulating Tumor DNA in Metastatic Uveal Melanoma

Imaging of ocular melanoma metastasis

Progress in the management of patients with uveal melanoma. The 2012 Ashton Lecture

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