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Raz E, Shapiro M, Shepherd TM, Nossek E, Yaghi S, Gold DM, Ishida K, Rucker JC, Belinsky I, Kim E, Grory BM, Mir O, Hagiwara M, Agarwal S, Young MG, Galetta SL, Nelson PK. Central Retinal Artery Visualization with Cone-Beam CT Angiography. Radiology 2021; 302:419-424. [PMID: 34783593 DOI: 10.1148/radiol.2021210520] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Background There are multiple tools available to visualize the retinal and choroidal vasculature of the posterior globe. However, there are currently no reliable in vivo imaging techniques that can visualize the entire retrobulbar course of the retinal and ciliary vessels. Purpose To identify and characterize the central retinal artery (CRA) using cone-beam CT (CBCT) images obtained as part of diagnostic cerebral angiography. Materials and Methods In this retrospective study, patients with catheter DSA performed between October 2019 and October 2020 were included if CBCT angiography included the orbit in the field of view. The CBCT angiography data sets were postprocessed with a small field-of-view volume centered in the posterior globe to a maximum resolution of 0.2 mm. The following were evaluated: CRA origin, CRA course, CRA point of penetration into the optic nerve sheath, bifurcation of the CRA at the papilla, visualization of anatomic variants, and visualization of the central retinal vein. Descriptive statistical analysis was performed. Results Twenty-one patients with 24 visualized orbits were included in the analysis (mean age, 55 years ± 15; 14 women). Indications for angiography were as follows: diagnostic angiography (n = 8), aneurysm treatment (n = 6), or other (n = 7). The CRA was identified in all orbits; the origin, course, point of penetration of the CRA into the optic nerve sheath, and termination in the papilla were visualized in all orbits. The average length of the intraneural segment was 10.6 mm (range, 7-18 mm). The central retinal vein was identified in six of 24 orbits. Conclusion Cone-beam CT, performed during diagnostic angiography, consistently demonstrated the in vivo central retinal artery, demonstrating excellent potential for multiple diagnostic and therapeutic applications. © RSNA, 2021 Online supplemental material is available for this article.
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Affiliation(s)
- Eytan Raz
- From the Departments of Radiology (E.R., M.S., T.M.S., O.M., M.H., M.G.Y., P.K.N.), Neurology (M.S., S.Y., D.M.G., K.I., J.C.R., S.A., S.L.G.), Neurosurgery (E.N., P.K.N.), and Ophthalmology (J.C.R., I.B., E.K., S.L.G.), Bernard and Irene Schwartz Neurointerventional Section (E.R., M.S., P.K.N.), NYU Langone Health, 660 First Ave, 7th Floor, New York, NY 10016; Department of Neurology, Brown University, Providence, RI (S.Y.); and Department of Neurology, Duke University School of Medicine, Durham, NC (B.M.G.)
| | - Maksim Shapiro
- From the Departments of Radiology (E.R., M.S., T.M.S., O.M., M.H., M.G.Y., P.K.N.), Neurology (M.S., S.Y., D.M.G., K.I., J.C.R., S.A., S.L.G.), Neurosurgery (E.N., P.K.N.), and Ophthalmology (J.C.R., I.B., E.K., S.L.G.), Bernard and Irene Schwartz Neurointerventional Section (E.R., M.S., P.K.N.), NYU Langone Health, 660 First Ave, 7th Floor, New York, NY 10016; Department of Neurology, Brown University, Providence, RI (S.Y.); and Department of Neurology, Duke University School of Medicine, Durham, NC (B.M.G.)
| | - Timothy M Shepherd
- From the Departments of Radiology (E.R., M.S., T.M.S., O.M., M.H., M.G.Y., P.K.N.), Neurology (M.S., S.Y., D.M.G., K.I., J.C.R., S.A., S.L.G.), Neurosurgery (E.N., P.K.N.), and Ophthalmology (J.C.R., I.B., E.K., S.L.G.), Bernard and Irene Schwartz Neurointerventional Section (E.R., M.S., P.K.N.), NYU Langone Health, 660 First Ave, 7th Floor, New York, NY 10016; Department of Neurology, Brown University, Providence, RI (S.Y.); and Department of Neurology, Duke University School of Medicine, Durham, NC (B.M.G.)
| | - Erez Nossek
- From the Departments of Radiology (E.R., M.S., T.M.S., O.M., M.H., M.G.Y., P.K.N.), Neurology (M.S., S.Y., D.M.G., K.I., J.C.R., S.A., S.L.G.), Neurosurgery (E.N., P.K.N.), and Ophthalmology (J.C.R., I.B., E.K., S.L.G.), Bernard and Irene Schwartz Neurointerventional Section (E.R., M.S., P.K.N.), NYU Langone Health, 660 First Ave, 7th Floor, New York, NY 10016; Department of Neurology, Brown University, Providence, RI (S.Y.); and Department of Neurology, Duke University School of Medicine, Durham, NC (B.M.G.)
| | - Shadi Yaghi
- From the Departments of Radiology (E.R., M.S., T.M.S., O.M., M.H., M.G.Y., P.K.N.), Neurology (M.S., S.Y., D.M.G., K.I., J.C.R., S.A., S.L.G.), Neurosurgery (E.N., P.K.N.), and Ophthalmology (J.C.R., I.B., E.K., S.L.G.), Bernard and Irene Schwartz Neurointerventional Section (E.R., M.S., P.K.N.), NYU Langone Health, 660 First Ave, 7th Floor, New York, NY 10016; Department of Neurology, Brown University, Providence, RI (S.Y.); and Department of Neurology, Duke University School of Medicine, Durham, NC (B.M.G.)
| | - Doria M Gold
- From the Departments of Radiology (E.R., M.S., T.M.S., O.M., M.H., M.G.Y., P.K.N.), Neurology (M.S., S.Y., D.M.G., K.I., J.C.R., S.A., S.L.G.), Neurosurgery (E.N., P.K.N.), and Ophthalmology (J.C.R., I.B., E.K., S.L.G.), Bernard and Irene Schwartz Neurointerventional Section (E.R., M.S., P.K.N.), NYU Langone Health, 660 First Ave, 7th Floor, New York, NY 10016; Department of Neurology, Brown University, Providence, RI (S.Y.); and Department of Neurology, Duke University School of Medicine, Durham, NC (B.M.G.)
| | - Koto Ishida
- From the Departments of Radiology (E.R., M.S., T.M.S., O.M., M.H., M.G.Y., P.K.N.), Neurology (M.S., S.Y., D.M.G., K.I., J.C.R., S.A., S.L.G.), Neurosurgery (E.N., P.K.N.), and Ophthalmology (J.C.R., I.B., E.K., S.L.G.), Bernard and Irene Schwartz Neurointerventional Section (E.R., M.S., P.K.N.), NYU Langone Health, 660 First Ave, 7th Floor, New York, NY 10016; Department of Neurology, Brown University, Providence, RI (S.Y.); and Department of Neurology, Duke University School of Medicine, Durham, NC (B.M.G.)
| | - Janet C Rucker
- From the Departments of Radiology (E.R., M.S., T.M.S., O.M., M.H., M.G.Y., P.K.N.), Neurology (M.S., S.Y., D.M.G., K.I., J.C.R., S.A., S.L.G.), Neurosurgery (E.N., P.K.N.), and Ophthalmology (J.C.R., I.B., E.K., S.L.G.), Bernard and Irene Schwartz Neurointerventional Section (E.R., M.S., P.K.N.), NYU Langone Health, 660 First Ave, 7th Floor, New York, NY 10016; Department of Neurology, Brown University, Providence, RI (S.Y.); and Department of Neurology, Duke University School of Medicine, Durham, NC (B.M.G.)
| | - Irina Belinsky
- From the Departments of Radiology (E.R., M.S., T.M.S., O.M., M.H., M.G.Y., P.K.N.), Neurology (M.S., S.Y., D.M.G., K.I., J.C.R., S.A., S.L.G.), Neurosurgery (E.N., P.K.N.), and Ophthalmology (J.C.R., I.B., E.K., S.L.G.), Bernard and Irene Schwartz Neurointerventional Section (E.R., M.S., P.K.N.), NYU Langone Health, 660 First Ave, 7th Floor, New York, NY 10016; Department of Neurology, Brown University, Providence, RI (S.Y.); and Department of Neurology, Duke University School of Medicine, Durham, NC (B.M.G.)
| | - Eleanore Kim
- From the Departments of Radiology (E.R., M.S., T.M.S., O.M., M.H., M.G.Y., P.K.N.), Neurology (M.S., S.Y., D.M.G., K.I., J.C.R., S.A., S.L.G.), Neurosurgery (E.N., P.K.N.), and Ophthalmology (J.C.R., I.B., E.K., S.L.G.), Bernard and Irene Schwartz Neurointerventional Section (E.R., M.S., P.K.N.), NYU Langone Health, 660 First Ave, 7th Floor, New York, NY 10016; Department of Neurology, Brown University, Providence, RI (S.Y.); and Department of Neurology, Duke University School of Medicine, Durham, NC (B.M.G.)
| | - Brian Mac Grory
- From the Departments of Radiology (E.R., M.S., T.M.S., O.M., M.H., M.G.Y., P.K.N.), Neurology (M.S., S.Y., D.M.G., K.I., J.C.R., S.A., S.L.G.), Neurosurgery (E.N., P.K.N.), and Ophthalmology (J.C.R., I.B., E.K., S.L.G.), Bernard and Irene Schwartz Neurointerventional Section (E.R., M.S., P.K.N.), NYU Langone Health, 660 First Ave, 7th Floor, New York, NY 10016; Department of Neurology, Brown University, Providence, RI (S.Y.); and Department of Neurology, Duke University School of Medicine, Durham, NC (B.M.G.)
| | - Osman Mir
- From the Departments of Radiology (E.R., M.S., T.M.S., O.M., M.H., M.G.Y., P.K.N.), Neurology (M.S., S.Y., D.M.G., K.I., J.C.R., S.A., S.L.G.), Neurosurgery (E.N., P.K.N.), and Ophthalmology (J.C.R., I.B., E.K., S.L.G.), Bernard and Irene Schwartz Neurointerventional Section (E.R., M.S., P.K.N.), NYU Langone Health, 660 First Ave, 7th Floor, New York, NY 10016; Department of Neurology, Brown University, Providence, RI (S.Y.); and Department of Neurology, Duke University School of Medicine, Durham, NC (B.M.G.)
| | - Mari Hagiwara
- From the Departments of Radiology (E.R., M.S., T.M.S., O.M., M.H., M.G.Y., P.K.N.), Neurology (M.S., S.Y., D.M.G., K.I., J.C.R., S.A., S.L.G.), Neurosurgery (E.N., P.K.N.), and Ophthalmology (J.C.R., I.B., E.K., S.L.G.), Bernard and Irene Schwartz Neurointerventional Section (E.R., M.S., P.K.N.), NYU Langone Health, 660 First Ave, 7th Floor, New York, NY 10016; Department of Neurology, Brown University, Providence, RI (S.Y.); and Department of Neurology, Duke University School of Medicine, Durham, NC (B.M.G.)
| | - Shashank Agarwal
- From the Departments of Radiology (E.R., M.S., T.M.S., O.M., M.H., M.G.Y., P.K.N.), Neurology (M.S., S.Y., D.M.G., K.I., J.C.R., S.A., S.L.G.), Neurosurgery (E.N., P.K.N.), and Ophthalmology (J.C.R., I.B., E.K., S.L.G.), Bernard and Irene Schwartz Neurointerventional Section (E.R., M.S., P.K.N.), NYU Langone Health, 660 First Ave, 7th Floor, New York, NY 10016; Department of Neurology, Brown University, Providence, RI (S.Y.); and Department of Neurology, Duke University School of Medicine, Durham, NC (B.M.G.)
| | - Matthew G Young
- From the Departments of Radiology (E.R., M.S., T.M.S., O.M., M.H., M.G.Y., P.K.N.), Neurology (M.S., S.Y., D.M.G., K.I., J.C.R., S.A., S.L.G.), Neurosurgery (E.N., P.K.N.), and Ophthalmology (J.C.R., I.B., E.K., S.L.G.), Bernard and Irene Schwartz Neurointerventional Section (E.R., M.S., P.K.N.), NYU Langone Health, 660 First Ave, 7th Floor, New York, NY 10016; Department of Neurology, Brown University, Providence, RI (S.Y.); and Department of Neurology, Duke University School of Medicine, Durham, NC (B.M.G.)
| | - Steven L Galetta
- From the Departments of Radiology (E.R., M.S., T.M.S., O.M., M.H., M.G.Y., P.K.N.), Neurology (M.S., S.Y., D.M.G., K.I., J.C.R., S.A., S.L.G.), Neurosurgery (E.N., P.K.N.), and Ophthalmology (J.C.R., I.B., E.K., S.L.G.), Bernard and Irene Schwartz Neurointerventional Section (E.R., M.S., P.K.N.), NYU Langone Health, 660 First Ave, 7th Floor, New York, NY 10016; Department of Neurology, Brown University, Providence, RI (S.Y.); and Department of Neurology, Duke University School of Medicine, Durham, NC (B.M.G.)
| | - Peter Kim Nelson
- From the Departments of Radiology (E.R., M.S., T.M.S., O.M., M.H., M.G.Y., P.K.N.), Neurology (M.S., S.Y., D.M.G., K.I., J.C.R., S.A., S.L.G.), Neurosurgery (E.N., P.K.N.), and Ophthalmology (J.C.R., I.B., E.K., S.L.G.), Bernard and Irene Schwartz Neurointerventional Section (E.R., M.S., P.K.N.), NYU Langone Health, 660 First Ave, 7th Floor, New York, NY 10016; Department of Neurology, Brown University, Providence, RI (S.Y.); and Department of Neurology, Duke University School of Medicine, Durham, NC (B.M.G.)
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Bertelli E, Leonini S, Galimberti D, Moretti S, Tinturini R, Hadjistilianou T, De Francesco S, Romano DG, Vallone IM, Cioni S, Gennari P, Galluzzi P, Grazzini I, Rossi S, Bracco S. Hemodynamic and Anatomic Variations Require an Adaptable Approach during Intra-Arterial Chemotherapy for Intraocular Retinoblastoma: Alternative Routes, Strategies, and Follow-Up. AJNR Am J Neuroradiol 2016; 37:1289-95. [PMID: 26915566 DOI: 10.3174/ajnr.a4741] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 12/09/2015] [Indexed: 01/14/2023]
Abstract
BACKGROUND AND PURPOSE Intra-arterial chemotherapy for retinoblastoma is not always a straightforward procedure, and it may require an adaptable approach. This study illustrates strategies used when the ophthalmic artery is difficult to catheterize or not visible, and it ascertains the effectiveness and safety of these strategies. MATERIALS AND METHODS A retrospective study was performed on a series of 108 eyes affected by intraocular retinoblastoma and selected for intra-arterial chemotherapy (follow-up range, 6-82 months). We recognized 3 different patterns of drug delivery: a fixed pattern through the ophthalmic artery, a fixed pattern through branches of the external carotid artery, and a variable pattern through either the ophthalmic or the external carotid artery. RESULTS We performed 448 sessions of intra-arterial chemotherapy, 83.70% of them through the ophthalmic artery and 16.29% via the external carotid artery. In 24.52% of eyes, the procedure was performed at least once through branches of the external carotid artery. In 73 eyes, the pattern of drug delivery was fixed through the ophthalmic artery; for 9 eyes, it was fixed through branches of the external carotid artery; and for 17 eyes, the pattern was variable. Statistical analysis did not show any significant difference in the clinical outcome of the eyes (remission versus enucleation) treated with different patterns of drug delivery. Adverse events could not be correlated with any particular pattern. CONCLUSIONS Alternative routes of intra-arterial chemotherapy for intraocular retinoblastoma appear in the short term as effective and safe as the traditional drug infusion through the ophthalmic artery.
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Affiliation(s)
- E Bertelli
- From the Department of Molecular and Developmental Medicine (E.B., S.R.), University of Siena, Siena, Italy
| | - S Leonini
- Units of Neuroimaging and Neurointervention (S.L., D.G.R., I.M.V., S.C., P. Gennari, P. Galluzzi, I.G., S.B.)
| | | | | | - R Tinturini
- Neurosurgical Intensive Care (R.T.), Azienda Ospedaliera Universitaria Senese, University of Siena, Policlinico "Santa Maria alle Scotte," Siena, Italy
| | - T Hadjistilianou
- Department of Medicine, Surgery and Neuroscience (T.H., S.D.F.), Unit of Ophthalmology, University of Siena, Policlinico "Santa Maria alle Scotte," Siena, Italy
| | - S De Francesco
- Department of Medicine, Surgery and Neuroscience (T.H., S.D.F.), Unit of Ophthalmology, University of Siena, Policlinico "Santa Maria alle Scotte," Siena, Italy
| | - D G Romano
- Units of Neuroimaging and Neurointervention (S.L., D.G.R., I.M.V., S.C., P. Gennari, P. Galluzzi, I.G., S.B.)
| | - I M Vallone
- Units of Neuroimaging and Neurointervention (S.L., D.G.R., I.M.V., S.C., P. Gennari, P. Galluzzi, I.G., S.B.)
| | - S Cioni
- Units of Neuroimaging and Neurointervention (S.L., D.G.R., I.M.V., S.C., P. Gennari, P. Galluzzi, I.G., S.B.)
| | - P Gennari
- Units of Neuroimaging and Neurointervention (S.L., D.G.R., I.M.V., S.C., P. Gennari, P. Galluzzi, I.G., S.B.)
| | - P Galluzzi
- Units of Neuroimaging and Neurointervention (S.L., D.G.R., I.M.V., S.C., P. Gennari, P. Galluzzi, I.G., S.B.)
| | - I Grazzini
- Units of Neuroimaging and Neurointervention (S.L., D.G.R., I.M.V., S.C., P. Gennari, P. Galluzzi, I.G., S.B.)
| | - S Rossi
- From the Department of Molecular and Developmental Medicine (E.B., S.R.), University of Siena, Siena, Italy
| | - S Bracco
- Units of Neuroimaging and Neurointervention (S.L., D.G.R., I.M.V., S.C., P. Gennari, P. Galluzzi, I.G., S.B.)
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