1
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Mirshahvalad SA, Zamani-Siahkali N, Pirich C, Beheshti M. A Systematic Review and Meta-Analysis on the Diagnostic and Prognostic Values of 18F-FDG PET in Uveal Melanoma and Its Hepatic Metastasis. Cancers (Basel) 2024; 16:1712. [PMID: 38730664 PMCID: PMC11082998 DOI: 10.3390/cancers16091712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 04/26/2024] [Accepted: 04/26/2024] [Indexed: 05/13/2024] Open
Abstract
In this systematic review and meta-analysis (PRISMA-compliant), we tried to investigate diagnostic and prognostic values of 18F-FDG PET in uveal melanoma. A systematic search was conducted on the main medical literature databases to include studies that evaluated 18F-FDG PET as the imaging modality to evaluate patients with uveal melanoma. Overall, 27 studies were included. Twelve had data about the detection rate of 18F-FDG PET in primary intra-ocular tumours. The pooled sensitivity was 45% (95%CI: 41-50%). Furthermore, studies showed that the larger the primary tumour, the higher its uptake. Among the included studies, 13 assessed 18F-FDG PET in detecting metastasis. The pooled sensitivity and specificity were 96% (95%CI: 81-99%) and 100% (95%CI: 94-100%), respectively. Regarding liver metastasis, they were 95% (95%CI: 79-99%) and 100% (95%CI: 91-100%), respectively. Noteworthy, the level of 18F-FDG uptake was a strong predictor of patient survival. Lastly, 18F-FDG PET could characterise lesions from the histopathology perspective, distinguishing high-risk from low-risk diseases. Overall, although not reliable in detecting primary intra-ocular tumours, 18F-FDG PET is highly accurate for diagnosing metastatic uveal melanomas. It can also be a highly valuable modality in terms of patient prognostication. Thus, 18F-FDG PET can be recommended in patients diagnosed with uveal melanoma to enhance decision-making and patient management.
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Affiliation(s)
- Seyed Ali Mirshahvalad
- Division of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital, Paracelsus Medical University, 5020 Salzburg, Austria; (S.A.M.); (N.Z.-S.); (C.P.)
- Joint Department of Medical Imaging, University Health Network, Mount Sinai Hospital & Women’s College Hospital, University Medical Imaging Toronto (UMIT), University of Toronto, Toronto, ON M5G 2N2, Canada
| | - Nazanin Zamani-Siahkali
- Division of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital, Paracelsus Medical University, 5020 Salzburg, Austria; (S.A.M.); (N.Z.-S.); (C.P.)
- Research Centre for Nuclear Medicine, Department of Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran 1461884513, Iran
| | - Christian Pirich
- Division of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital, Paracelsus Medical University, 5020 Salzburg, Austria; (S.A.M.); (N.Z.-S.); (C.P.)
| | - Mohsen Beheshti
- Division of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital, Paracelsus Medical University, 5020 Salzburg, Austria; (S.A.M.); (N.Z.-S.); (C.P.)
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2
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Solnik M, Paduszyńska N, Czarnecka AM, Synoradzki KJ, Yousef YA, Chorągiewicz T, Rejdak R, Toro MD, Zweifel S, Dyndor K, Fiedorowicz M. Imaging of Uveal Melanoma—Current Standard and Methods in Development. Cancers (Basel) 2022; 14:cancers14133147. [PMID: 35804919 PMCID: PMC9265106 DOI: 10.3390/cancers14133147] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/06/2022] [Accepted: 06/13/2022] [Indexed: 11/19/2022] Open
Abstract
Simple Summary Uveal melanoma is the most prevalent intraocular tumor in adults, derived from melanocytes; the liver is the most common site of its metastases. Due to troublesome tumor localization, different imaging techniques are utilized in diagnostics, i.e., fundus imaging (FI), ultrasonography (US), optical coherence tomography (OCT), single-photon emission computed tomography (SPECT), positron emission tomography/computed tomography (PET/CT), magnetic resonance imaging (MRI), fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA), or fundus autofluorescence (FAF). Specialists eagerly use these techniques, but sometimes the precision and quality of the obtained images are imperfect, raising diagnostic doubts and prompting the search for new ones. In addition to analyzing the currently utilized methods, this review also introduces experimental techniques that may be adapted to clinical practice in the future. Moreover, we raise the topic and present a perspective for personalized medicine in uveal melanoma treatment. 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.
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Affiliation(s)
- Małgorzata Solnik
- Faculty of Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland; (M.S.); (N.P.)
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 5 Roentgen Str., 02-781 Warsaw, Poland;
| | - Natalia Paduszyńska
- Faculty of Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland; (M.S.); (N.P.)
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 5 Roentgen Str., 02-781 Warsaw, Poland;
| | - Anna M. Czarnecka
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 5 Roentgen Str., 02-781 Warsaw, Poland;
- Department of Experimental Pharmacology, Mossakowski Medical Research Institute, Polish Academy of Sciences, 5 Pawinskiego Str., 02-106 Warsaw, Poland
| | - Kamil J. Synoradzki
- Department of Experimental Pharmacology, Mossakowski Medical Research Institute, Polish Academy of Sciences, 5 Pawinskiego Str., 02-106 Warsaw, Poland
- Small Animal Magnetic Resonance Imaging Laboratory, Mossakowski Medical Research Institute, Polish Academy of Sciences, 5 Pawinskiego Str., 02-106 Warsaw, Poland;
- Correspondence:
| | - Yacoub A. Yousef
- Department of Surgery (Ophthalmology), King Hussein Cancer Centre, Amman 11941, Jordan;
| | - Tomasz Chorągiewicz
- Department of General and Pediatric Ophthalmology, Medical University of Lublin, Chmielna 1, 20-079 Lublin, Poland; (T.C.); (R.R.); (M.D.T.)
| | - Robert Rejdak
- Department of General and Pediatric Ophthalmology, Medical University of Lublin, Chmielna 1, 20-079 Lublin, Poland; (T.C.); (R.R.); (M.D.T.)
| | - Mario Damiano Toro
- Department of General and Pediatric Ophthalmology, Medical University of Lublin, Chmielna 1, 20-079 Lublin, Poland; (T.C.); (R.R.); (M.D.T.)
- Eye Clinic, Public Health Department, Federico II University, via Pansini 5, 80131 Naples, Italy
| | - Sandrine Zweifel
- Department of Ophthalmology, University of Zurich, 8091 Zurich, Switzerland;
| | - Katarzyna Dyndor
- Department of Radiography, Medical University of Lublin, 8 Jaczewskiego Str., 20-090 Lublin, Poland;
| | - Michał Fiedorowicz
- Small Animal Magnetic Resonance Imaging Laboratory, Mossakowski Medical Research Institute, Polish Academy of Sciences, 5 Pawinskiego Str., 02-106 Warsaw, Poland;
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3
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Matsuo T, Yamasaki O, Tanaka T, Katsui K, Waki T. Proton beam therapy followed by pembrolizumab for giant ocular surface conjunctival malignant melanoma: A case report. Mol Clin Oncol 2021; 16:12. [PMID: 34881032 PMCID: PMC8647189 DOI: 10.3892/mco.2021.2445] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 10/27/2021] [Indexed: 12/12/2022] Open
Abstract
The present study describes proton beam therapy as a clinical option to achieve local control of giant conjunctival melanoma in an aged person, instead of orbital exenteration. An 80-year-old woman with one-year history of left-eye injection and hemorrhage experienced rapid growth of the ocular surface black mass. At the initial visit, a black, elastic hard, hemorrhage-prone, thickened mass in the size of 30x40 mm with a presumed wide stalk covered the total area of the lid fissure on the left side. Biopsy of the mass demonstrated anomalous melanin-containing cells in fibrin and hemorrhage, which were positive for cocktail-mix antibodies against tyrosinase, melanoma antigen recognized by T cells-1 and human melanoma black-45, indicative of malignant melanoma. One month after the initial visit, the patient underwent proton beam therapy at the total dose of 70.4 Gy (relative biological effectiveness) in 32 fractions (~10 min each) in one and a half months. One month after the end of proton beam therapy, 3.5 months from the initial visit, the patient was found by computed tomographic scan to have multiple metastatic lesions in bilateral lung fields. With the evidence of absent BRAF mutation, the patient underwent intravenous administration of pembrolizumab 77.2 mg every three weeks five times in total. Then, three months after proton beam therapy, ocular surface melanoma almost subsided and the clear cornea allowed visualization of the intraocular lens inside the eye. In three weeks, spontaneous corneal perforation was plugged with iris incarceration. The patient died suddenly of unknown cause 7.5 months from the initial visit. The local control of giant conjunctival melanoma was achieved by proton beam therapy, leading to patient's satisfaction and better quality of life. Proton beam therapy, followed by immune checkpoint inhibitors, would become the future standard of care for unresectable giant conjunctival melanoma.
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Affiliation(s)
- Toshihiko Matsuo
- Regenerative and Reconstructive Medicine (Ophthalmology), Okayama University Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama 700-8558, Japan.,Department of Ophthalmology, Okayama University Hospital, Okayama 700-8558, Japan
| | - Osamu Yamasaki
- Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan.,Melanoma Center, Okayama University Hospital, Okayama 700-8558, Japan
| | - Takehiro Tanaka
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Kuniaki Katsui
- Division of Radiation Oncology, Department of Radiology, Kawasaki Medical School, Kurashiki, Okayama 701-0192, Japan.,Department of Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Takahiro Waki
- Department of Radiology, Tsuyama Chuo Hospital, Tsuyama, Okayama 708-0841, Japan
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4
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Matsuo T, Tanaka T, Nakamura A, Wada K. Prostate Cancer Detected by Choroidal Tumor and Complete Response to Hormonal Therapy: Case Report and Literature Review of 24 Patients With Choroidal Metastasis From Prostate Cancer. J Investig Med High Impact Case Rep 2021; 9:23247096211026471. [PMID: 34159819 PMCID: PMC8226359 DOI: 10.1177/23247096211026471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Metastatic choroidal tumors derived from prostate cancer are rare. In this study,
we report a patient who manifested a choroidal tumor as the initial presenting
sign of prostate cancer and review 23 patients with choroidal metastasis of
prostate cancer in the literature to answer a clinical question how the
choroidal metastases would respond to hormonal therapy. A 73-year-old man
presented with a choroidal tumor in the right eye. He was in good health and had
no previous history except for current hemodialysis in 3 years due to chronic
renal failure as a sequel to glomerulonephritis. With the diagnosis of a
probable metastatic tumor, positron emission tomography was performed to
disclose high-uptake sites in multiple bones, lymph nodes, and the prostate,
together with multiple nodular lesions in bilateral lungs on computed tomography
(CT) scan. Serum prostate-specific antigen (PSA) was elevated to 541 ng/mL,
which supported prostate cancer as the primary site. He had degarelix injection,
and the choroidal tumor resolved rapidly and became flat degeneration in a
month. Prostate biopsy showed poorly differentiated adenocarcinoma, and he
underwent surgical castration. He had no medication until 3 years later when he
showed gradual increase of serum PSA up to 6.05 ng/mL and multiple bony
metastases on CT scan. Bicalutamide, switched to enzalutamide and then to
abiraterone, led to the undetectable level of serum PSA until the last visit
with no relapse of the choroidal metastasis, 6.8 years after the initial visit.
In the literature review of 24 patients with choroidal metastasis of prostate
cancer, including this patient, 8 patients presented a choroidal tumor as the
initial sign and the choroidal lesions mostly showed complete response to
hormonal therapy. Among 13 patients who were frequently in the course of
hormonal therapy, choroidal metastases showed complete or partial response to
external beam radiation to the eye in 11 patients and episcleral plaque
radiotherapy in 2 patients. In conclusion, metastatic choroidal tumors of
prostate cancer would show good response to hormonal therapy when the therapy
has not been initiated. Hormone-resistant choroidal metastases in the
therapeutic course of prostate cancer could be managed successfully by external
beam radiation to the eye.
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Affiliation(s)
- Toshihiko Matsuo
- Okayama University, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama City, Japan.,Ophthalmology, Okayama University Hospital, Okayama City, Japan
| | - Takehiro Tanaka
- Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama City, Japan
| | - Aya Nakamura
- Urology, Okayama Saiseikai General Hospital, Okayama City, Japan
| | - Koichiro Wada
- Urology, Okayama University Hospital, Okayama City, Japan
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5
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Li X, Wang L, Zhang L, Tang F, Wei X. Application of Multimodal and Molecular Imaging Techniques in the Detection of Choroidal Melanomas. Front Oncol 2021; 10:617868. [PMID: 33634026 PMCID: PMC7902045 DOI: 10.3389/fonc.2020.617868] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 12/16/2020] [Indexed: 02/05/2023] Open
Abstract
Choroidal melanomas are the most common ocular malignant tumors worldwide. The onset of such tumors is insidious, such that affected patients often have no pain or obvious discomfort during early stages. Notably, enucleation is required for patients with a severe choroidal melanoma, which can seriously impact their quality of life. Moreover, choroidal melanomas metastasize early, often to the liver; this eventually causes affected patients to die of liver failure. Therefore, early diagnosis of choroidal melanomas is extremely important. Unfortunately, an early choroidal melanoma is easily confused with a choroidal nevus, which is the most common benign tumor of the eye and does not often require surgical treatment. This review discusses recent advances in the use of multimodal and molecular imaging to identify choroidal melanomas and choroidal nevi, detect early metastasis, and diagnose patients with choroidal melanomas.
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Affiliation(s)
- Xuying Li
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | - Lixiang Wang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | - Li Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | - Fei Tang
- Department of Ophthalmology, ShangjinNanfu Hospital, Chengdu, China
| | - Xin Wei
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China.,Department of Ophthalmology, ShangjinNanfu Hospital, Chengdu, China
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6
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Kalemaki MS, Karantanas AH, Exarchos D, Detorakis ET, Zoras O, Marias K, Millo C, Bagci U, Pallikaris I, Stratis A, Karatzanis I, Perisinakis K, Koutentakis P, Kontadakis GA, Spandidos DA, Tsatsakis A, Papadakis GZ. PET/CT and PET/MRI in ophthalmic oncology (Review). Int J Oncol 2020; 56:417-429. [PMID: 31939615 PMCID: PMC6959466 DOI: 10.3892/ijo.2020.4955] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 12/31/2019] [Indexed: 12/16/2022] Open
Abstract
Orbital and ocular anatomy is quite complex, consisting of several tissues, which can give rise to both benign and malignant tumors, while several primary neoplasms can metastasize to the orbital and ocular space. Early detection, accurate staging and re-staging, efficient monitoring of treatment response, non-invasive differentiation between benign and malignant lesions, and accurate planning of external radiation treatment, are of utmost importance for the optimal and individualized management of ophthalmic oncology patients. Addressing these challenges requires the employment of several diagnostic imaging techniques, such as high-definition digital fundus photography, ultrasound imaging, optical coherence tomography, optical coherence tomography (OCT)-angiography, computed tomography (CT) and magnetic resonance imaging (MRI). In recent years, technological advances have enabled the development of hybrid positron emission tomography (PET)/CT and PET/MRI systems, setting new standards in cancer diagnosis and treatment. The capability of simultaneously targeting several cancer-related biochemical procedures using positron emitting-radiopharmaceuticals, while morphologically characterizing lesions by CT or MRI, together with the intrinsic quantitative capabilities of PET-imaging, provide incremental diagnostic information, enabling accurate, highly efficient and personalized treatment strategies. Aim of the current review is to discuss the current applications of hybrid PET/CT and PET/MRI imaging in the management of patients presenting with the most commonly encountered orbital and ocular tumors.
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Affiliation(s)
- Maria S Kalemaki
- Department of Ophthalmology, Venizeleio General Hospital of Heraklion, 71409 Heraklion, Greece
| | | | - Dimitris Exarchos
- Department of CT‑MRI and PET/CT, Evangelismos Hospital, 10676 Athens, Greece
| | - Efstathios T Detorakis
- Department of Ophthalmology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Odysseas Zoras
- Department of Surgical Oncology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Kostas Marias
- Foundation for Research and Technology Hellas (FORTH), Computational Biomedicine Laboratory (CBML), 70013 Heraklion, Greece
| | - Corina Millo
- Positron Emission Tomography Department, Clinical Center (CC), National Institutes of Health (NIH), Bethesda, MD 20814, USA
| | - Ulas Bagci
- Center for Research in Computer Vision (CRCV), University of Central Florida (UCF), Orlando, FL 32816, USA
| | - Ioannis Pallikaris
- Department of Ophthalmology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Andreas Stratis
- Foundation for Research and Technology Hellas (FORTH), Computational Biomedicine Laboratory (CBML), 70013 Heraklion, Greece
| | - Ioannis Karatzanis
- Foundation for Research and Technology Hellas (FORTH), Computational Biomedicine Laboratory (CBML), 70013 Heraklion, Greece
| | - Kostas Perisinakis
- Department of Medical Physics, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Pavlos Koutentakis
- Department of Ophthalmology, Venizeleio General Hospital of Heraklion, 71409 Heraklion, Greece
| | - Georgios A Kontadakis
- Department of Ophthalmology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Demetrios A Spandidos
- Laboratory of Clinical Virology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Aristidis Tsatsakis
- Laboratory of Forensic Sciences and Toxicology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Georgios Z Papadakis
- Department of Radiology, Medical School, University of Crete, 71003 Heraklion, Greece
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7
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Matsuo T, Tanaka T, Yamasaki O. Lacrimal Sac Malignant Melanoma in 15 Japanese Patients: Case Report and Literature Review. J Investig Med High Impact Case Rep 2019; 7:2324709619888052. [PMID: 31747798 PMCID: PMC6873277 DOI: 10.1177/2324709619888052] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Background. Primary malignant melanoma of the lacrimal sac is
rare. A patient with lacrimal sac melanoma was presented, and 14 Japanese
patients with lacrimal sac melanoma in the literature were reviewed.
Case Presentation. A 78-year-old Japanese man was presented
with painless swelling of the lacrimal sac on the left side. Dacryocystectomy
revealed diffuse infiltration with large epithelioid cells, sometimes with
pigments, which were positive for cocktail mix of antibodies to tyrosinase,
melan A (MART-1), and HMB45, leading to pathological diagnosis of melanoma. One
month later, positron emission tomography (PET) revealed 2 high-uptake sites
(SUVmax = 10.29 and 15.38) at the levels of medial canthus and
nasolacrimal duct, but no abnormal uptake in the other site of the body. The
lesion had the BRAF V600E mutation. He began to take daily oral dabrafenib (BRAF
inhibitor) and trametinib (MEK inhibitor), leading to no abnormal uptake on PET
in half a year. He had stable disease in good physical status with small and
weak uptake sites of lymph nodes on PET 1 year later. Results.
In the review of 15 Japanese patients, including this patient, local recurrence
was noted in 4 patients, regional lymph node metastasis only in 3, distant
metastasis in 6, and no metastasis in 6. Five patients died within 2 years and
the others were alive in short follow-up periods. Conclusions.
Chemotherapy was the standard for local recurrence or metastasis. Emerging
molecular target drugs, as shown in the present patient, would change the
strategy for management of lacrimal sac melanoma.
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Affiliation(s)
- Toshihiko Matsuo
- Okayama University Graduate School of Interdisciplinary Science and Engineeing in Health Systems, Okayama City, Japan.,Department of Ophthalmology, Okayama University Hospital, Okayama City, Japan
| | - Takehiro Tanaka
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama City, Japan
| | - Osamu Yamasaki
- Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama City, Japan.,Melanoma Center, Okayama University Hospital, Okayama City, Japan
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8
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Yan B, Fu T, Liu Y, Wei W, Dai H, Fang W, Wang F. 99mTc-3PRGD2 single-photon emission computed tomography/computed tomography for the diagnosis of choroidal melanoma: A preliminary STROBE-compliant observational study. Medicine (Baltimore) 2018; 97:e12441. [PMID: 30290601 PMCID: PMC6200507 DOI: 10.1097/md.0000000000012441] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Recent successes in monitoring and diagnosing a variety of tumors using Tc-PEG4-E[PEG4-c(RGDfK)]2 (Tc-3PRGD2) single-photon emission computed tomography (SPECT) imaging encouraged us to expand the use of this tracer. This case-control study aimed to evaluate the feasibility of Tc-3PRGD2 imaging for detecting choroidal melanoma (CM) and for monitoring tumor response to plaque brachytherapy (PB). Ten consecutive patients with CM who underwent Tc-3PRGD2 imaging before and 3 months after PB were reviewed. The tumor-to-occipital bone (T/O) and mirrored contralateral normal tissue-to-occipital bone (N/O) ratios were calculated by region of interest analysis at baseline and 3 months post-PB. T/O values were compared between patients with CM with comorbid secondary retinal detachment (RD) and those without RD. The relationship between T/O value and tumor volume was also investigated. Tc-3PRGD2 SPECT/CT showed focal uptake in CM. The mean T/O ratio before PB was 1.90 ± 1.26 and the mean N/O ratio was 0.80 ± 0.21 (P = .02). The Tc-3PRGD2 concentrations in 5 patients with CM with RD were higher (T/O = 2.69 ± 1.39) than in those without secondary RD (T/O = 1.10 ± 0.18) (P = .008). T/O ratios at 3 months post-PB were significantly lower than that at baseline (1.23 ± 0.59, P = .03). There was a linear relationship between T/O and tumor volume (y-hat = 0.028 + 0.003x, R = 0.768, P = .001). The 95% confidence interval for the (T/O)/volume ratio was 0.002 to 0.005. Tc-3PRGD2 imaging is a feasible modality for the diagnosis of CM. Furthermore, follow-up for at least 20 months after PB indicated that coanalysis of Tc-3PRGD2 imaging and tumor volume may provide a promising prognostic predictor in patients with CM.
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Affiliation(s)
- Bing Yan
- Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology
- Department of Nuclear Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Tong Fu
- Institute of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany
- Department of Nuclear Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing
| | - Yueming Liu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University
| | - Wenbin Wei
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University
| | - Haojie Dai
- Department of Nuclear Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Wei Fang
- Cardiovascular Institute & Fu Wai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Feng Wang
- Department of Nuclear Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing
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9
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Neupane R, Gaudana R, Boddu SHS. Imaging Techniques in the Diagnosis and Management of Ocular Tumors: Prospects and Challenges. AAPS JOURNAL 2018; 20:97. [PMID: 30187172 DOI: 10.1208/s12248-018-0259-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 08/23/2018] [Indexed: 12/23/2022]
Abstract
Different types of imaging modalities are used in the diagnosis of ocular cancer. Selection of an imaging modality is based on the features of a tumor as well as the inherent characteristics of the imaging technique. It is vital to select an appropriate imaging modality in diagnosis of ocular tumor with confidence. This review focuses on five most commonly used imaging modalities, i.e., positron emission tomography-computed tomography (PET/CT), single photon emission computed tomography (SPECT), optical coherence tomography (OCT), ultrasound (US), and magnetic resonance imaging (MRI). The principal of imaging modalities is briefly explained, along with their role in the diagnosis and management of the most common ocular tumors such as retinoblastoma and uveal melanoma. Further, the diagnostic features of ocular tumors corresponding to each imaging modality and possibilities of utilizing imaging techniques in the process of ocular drug development are included in this review.
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Affiliation(s)
- Rabin Neupane
- College of Pharmacy and Pharmaceutical Sciences, The University of Toledo Health Science Campus, Toledo, OH, 43614, USA
| | - Ripal Gaudana
- Principal Scientist, Par Pharmaceuticals, 1 Ram Ridge Rd, Spring Valley, New York, 10977, USA
| | - Sai H S Boddu
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, Ajman University, P.O. Box 346, Ajman, United Arab Emirates.
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10
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Whole Body Positron Emission Tomography/Computed Tomography (PET/CT) in the Evaluation of Ophthalmic Tumors. Curr Med Sci 2018; 38:310-317. [PMID: 30074190 DOI: 10.1007/s11596-018-1880-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 01/26/2017] [Indexed: 10/17/2022]
Abstract
The clinical value of whole body positron emission tomography/computed tomography (PET/CT) as an imaging tool in diagnosis of ophthalmic tumors was investigated. The retrospective observational case series were performed on the patients with suspected ophthalmic tumors who underwent whole body PET/CT. The golden standard of diagnosis was the final pathological diagnosis or the results of long-term follow-up for patients without surgery/biopsy. PET/CT findings were compared with the golden standard. The sensitivity, specificity, accuracy and positive likelihood ratio of PET/CT in the detection of ophthalmic tumors were calculated. The clinical application of PET/CT in different types of ophthalmic tumors was evaluated. The results showed that 30 patients (18 males and 12 females) with a mean age of 43.0 years (range 4-63 years) were collected. The mean sizes of orbital tumors and intraocular tumors were 26.8 mm×17.8 mm and 11.2 mm×6.1 mm, respectively. The overall sensitivity, specificity, accuracy and positive likelihood ratio of whole body PET/CT in ophthalmic tumors were 76.5%, 71.4%, 75.0% and 2.67, and were 62.5%, 100% and 70.0% in intraocular tumors, and those were 100%, 60.0% and 84.6% in orbital tumors, respectively. PET/CT findings were applied to help make appropriate treatment options in 27 out of 30 patients (90.0%), and 12 (40.0%) patients changed the treatment strategy. False negative results in 4 cases and false positive results in 2 cases were observed in this series. It was suggested that PET/CT was an effective imaging modality in detecting, diagnosing and developing therapeutic schedule for patients with ophthalmic tumors. It was more sensitive and accurate for detecting orbital tumors than for detecting intraocular tumors.
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Altenbernd J, Wetter A, Forsting M, Umutlu L. Dual-energy CT of liver metastases in patients with uveal melanoma. Eur J Radiol Open 2016; 3:254-258. [PMID: 27830163 PMCID: PMC5094679 DOI: 10.1016/j.ejro.2016.10.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 10/22/2016] [Indexed: 01/08/2023] Open
Abstract
Objective To investigate the value of different kVp images of dual-energy CT (DECT) for the detection of liver metastases. Methods 20 Patients with uveal melanoma were investigated with DECT of the liver. In each patient contrast-enhanced DECT imaging with arterial delay was performed. Number and size of metastases were documented on arterial phase 80-kVp images, virtual 120-kVp images and following angiographic images (DSA) as part of hepatic chemoperfusion. Attenuation of metastases and several anatomic regions, subjective (image noise, image quality) and objective (SNR, CNR) parameters were documented. Results The mean number of liver metastases detected was significant higher on 80-kVp images than on virtual 120-kVp/DSA images (5.6 ± 2.1 vs. 4.1 ± 1.8/4.3 ± 1.6); (p < 0.001). All lesions sizes were significant better detected with 80 kVp images than with virtual 120 kVp and DSA-Images (80 kVp vs. 120 kVp: <10 mm: 34 vs. 19, p < 0.05; 10–20 mm:, 33 vs. 25, p < 0.05; >20 mm: 56 vs. 42, p < 0.05/80 kVp vs. DSA: <10 mm: 34 vs. 18 p < 0.05; 10–20 mm: 33 vs. 24, p < 0.05; >20 mm: 56 vs. 41, p < 0.05). Number of detected small lesions <10 mm with 120 kVp compared to DSA-images were significant higher (19 vs. 13; p < 0.05), lesions 10–20 mm and >20 mm were measured statistically equally. Noise, SNR and CNR of 80 kVp images were higher compared to 120 kVp images. Image quality of 120 kVp images was higher compared to 80 kVp images. Conclusion Low-kVp images of DECT datasets are more sensitive in detecting liver metastases of patients with uveal melanoma than virtual 120 kVp- and DSA images.
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Affiliation(s)
- Jens Altenbernd
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany
| | - Axel Wetter
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany
| | - Michael Forsting
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany
| | - Lale Umutlu
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany
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Sharma RS, Shah PK, Narendran V. Poor Uptake of Fluorodeoxyglucose in Positron Emission Tomography-Computed Tomography Scan for Intraocular Choroidal Melanoma in Asian Indian Eyes. World J Nucl Med 2016; 15:53-5. [PMID: 26912980 PMCID: PMC4729016 DOI: 10.4103/1450-1147.167599] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) scan is fast becoming a very useful tool in diagnosing and staging of several malignancies that affect the human body. We report three cases of ocular choroidal malignant melanoma, wherein FDG PET-CT scan did not show as good uptake as seen in other cancers.
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Affiliation(s)
- Rahul S Sharma
- Department of Pediatric Retina and Ocular Oncology, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Coimbatore, Tamil Nadu, India
| | - Parag K Shah
- Department of Pediatric Retina and Ocular Oncology, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Coimbatore, Tamil Nadu, India
| | - Venkatapathy Narendran
- Department of Pediatric Retina and Ocular Oncology, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Coimbatore, Tamil Nadu, India
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