J.ophthalmol.(Ukraine).2019;51:42-48.

http://doi.org/10.31288/oftalmolzh201954248

Received: 02 September 2019; Published: 30 October 2019


Opportunities of diagnostic imaging in monitoring the radiosurgery treatment for uveal melanoma

T.M. Babkina,1 Dr Sc (Med), Prof.;  N.Iu. Spizhenko,2 Cand Sc (Med); S.V. Valchishin,2 Roentgenologist, MD; I.N. Dykan,3 Dr Sc (Med), Prof.; N.N. Kolotilov,3 Dr Sc (Biol)

1 Shupik National Medical Academy of Postgraduate Education; Kyiv (Ukraine)

2 Spizhenko Medical Center LLC, Spizhenko ClinicTM; Kyiv (Ukraine)

2 Institute for Nuclear Medicine and Diagnostic Imaging, NAMS of Ukraine; Kyiv (Ukraine)

E-mail: tbabkina@ukr.net

TO CITE THIS ARTICLE: Babkina TM, Spizhenko NIu, Valchishin SV, Dykan IN, Kolotilov NN. Opportunities of diagnostic imaging in monitoring the radiosurgery treatment for uveal melanoma. J.ophthalmol.(Ukraine).2019;5:42-48. http://doi.org/10.31288/oftalmolzh201954248  

 

Background: Uveal melanoma (UM) is a primary choroidal tumor of neuroectodermal origin with a high malignant potential. Organ-preserving stereotactic radiosurgery (SRS) treatment strategies can be used for patients with UM.

Purpose: To assess the potential of diagnostic imaging methods, computed tomography (CT) and magnetic resonance imaging (MRI), for the monitoring of SRS treatment outcomes for UM.

Methods: Twenty-six patients with UM (age, 27 years to 68 years) were involved in this study and underwent an examination. The uveal melanomas were classified as per the classification system by Shields. A standard bolus protocol with iodine-containing contrast agent (Ultravist) was used to perform CT imaging on an Activion TSX-031A Multislice CT Scanner. A standard brain MRI protocol (Т1, Т2, FLAIR, T1 Fsat, T2 Fsat, Short 3D 2mm T1) with non-ionic paramagnetic contrast medium (Omniscan™) was used to perform diffusion-weighted MRI and obtain apparent diffusion coefficient (ADC) values on a 1.5T Vantage Atlas MRI system. The G4 Cyberknife System was used to perform SRS treatment for UM with the clinical target volume coverage of 99.9%. 

Results: Post-SRS changes in semiological elements in CT and MRI images were examined. Our imaging monitoring of patients with UM showed that UM ADC values substantially increased as early as month 1 or month 2 after SRS (whereas tumor tissue volumes decreased only 6 months after SRS). Thus, in small, medium-size and large tumors, UM ADC values increased by 18.1%, 20.0%,  and 35.7 %, respectively, at 1-2 months, and by  41.9%, 38.8%, and 64.3%, respectively, at 11-12 months.

Conclusion: CT and MRI are diagnostic imaging modalities provide valuable information in monitoring patients with UM. Diffusion-weighted MRI provides qualitative and quantitative characteristics of post-SRS changes in tumor process.

Key words: uveal melanoma, CT, MRI, stereotactic radiosurgery

References

1.Char DH. History of ocular oncology. Ophthalmology. 1996 Aug;103(8 Suppl):S96-101.

Crossref   

2.Shirina TV. [Prognosis for survival at late time points after treatment for uveal melanoma]. [Abstract of Cand Sc (Med) Thesis]. Moscow: Helmholtz Research Institute of Eye Diseases; 2013. Russian.

3.Afshar AR, Damato BE. Uveal melanoma: Evidence for efficacy of therapy. Int Ophthalmol Clin. 2015 Winter;55(1):23-43. 

Crossref   PubMed  

4.Avakian KV. [Early diagnosis of metastatic disease in uveal melanoma]. [Cand Sc (Med) Thesis]. Moscow: Helmholtz Research Institute of Eye Diseases; 2018. Russian.

5.Metastasis of uveal melanoma millimeter-by-millimeter in 8033 consecutive eyes. Shields CL, Furuta M, Thangappan A, et al. Arch Ophthalmol.  2009 Aug;127(8):989-98. doi: 10.1001/archophthalmol.2009.208.

Crossref    PubMed

6.Beenakker J-WM, Ferreira TA, Doemarwoto KP, et al. Clinical evaluation of ultra-high-field MRI for three-dimensional visualisation of tumour size in uveal melanoma patients, with direct relevance to treatment planning. MAGMA. 2016 Jun;29(3):571-7. 

Crossref    PubMed

7.Vazhenin AV, Panova IE, Semionova LE. [Our first experience of treating choroidal melanoma with the use of Cyber Knife]. Sibirskii onkologicheskii zhurnal. 2012;1(49):48-50. Russian.

8.Zabelin MV, Klimanov VA, Galiautdinova ZhZh. [Proton radiation therapy: clinical application opportunities and research prospects]. Issledovaniia i praktika v meditsine. 2018;(1):82-95.  Russian.

Crossref   

9.Iarovoi AA, Golanov AV, Il’ialov SR. [CyberKnife stereotactic surgery as an alternative to enucleation in patients with uveal melanoma]. Ophthalmosurgery. 2014;(2):74-80. Russian.

10.Foti PV, Longo A, Reibaldi M, et al. Uveal melanoma: Quantitative evaluation of diffusion-weighted MR imaging in the response assessment after proton-beam therapy, long-term follow-up. Radiol Med. 2017 Feb;122(2):131-9. 

Crossref   PubMed  

11.Ternovoy NK, Kolotilov NN, Tuz EV, Drobotun OV, Ulyanchich NV. Quantifiable tumor diffusion coefficient (overview and own data). Luchevaia diagnostika, luchevaia terapiia. 2018;(3):70-6.

12.Ferreira TA, Saraiva P, Genders SW, et al. CT and MR imaging of orbital inflammation. Neuroradiology. 2018 Dec;60(12):1253-1266. 

Crossref   PubMed 

13.Pulido JS, Campeau NG, Klotz E. Correlation of histological findings from a large ciliochoroidal melanoma with CT perfusion and 3T MRI dynamic enhancement studies. Clin Ophthalmol. 2008 Jun;2(2):275-81.

Crossref   PubMed  

14.Ferreira TA, Grech Fonk L, Jaarsma-Coes MG, et al. MRI of Uveal Melanoma. Cancers (Basel). 2019 Mar 17;11(3). 

Crossref    PubMed  

15.Jaarsma-Coes MG, van Haren GR, Ferreira TA, et al. MR-imaging enables accurate diagnosis and follow-up in uveal melanoma patients after vitrectomy. Melanoma Res. 2019 Jan 16. 

Crossref    PubMed  

16.Jiang X, Asbach P, Willerding G. Dynamic contrast-enhanced MRI of ocular melanoma. Melanoma Res. 2015 Apr;25(2):149-56. 

Crossref     PubMed

17.Kamrava M,. Sepahdari AR, Leu K. Quantitative multiparametric MRI in uveal melanoma: Increased tumor permeability may predict monosomy 3. Neuroradiology. 2015 Aug;57(8):833-40. 

Crossref    PubMed

 

The authors certify that they have no conflicts of interest in the subject matter or materials discussed in this manuscript.