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Bustamante P, Coblentz J, Mastromonaco C, Youhnovska E, Ito H, Proença RP, Fonseca C, Dickinson K, Marcotte E, MacDonald M, Toledo-Dias AB, Bergeron S, Goyeneche A, Schmidt Andujar RA, Tsering T, Laskaris A, Jin E, Nadeau A, Porraccio T, Burnier MN, Burnier JV. Comprehensive clinical imaging, histopathological analysis and liquid biopsy-based surveillance of human uveal melanoma in a prolonged rabbit xenograft model. Melanoma Res 2024; 34:285-295. [PMID: 38847739 DOI: 10.1097/cmr.0000000000000964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
Uveal melanoma is the most common intraocular tumor in adults. Our group has previously developed a human uveal melanoma animal model; however, adverse effects caused by the immunosuppressive agent, cyclosporine A, prevented animals from surviving more than 12 weeks. In this study, we tested multiple cyclosporine A doses over an extended disease course up to 20 weeks, providing complete clinical imaging of intraocular tumors, histopathological analysis and liquid biopsy biomarker analysis. Twenty albino rabbits were divided into four groups with different daily cyclosporine A schedules (0-10 mg/kg) and inoculated with human uveal melanoma cell lines, 92.1 or MP41, into the suprachoroidal space. Rabbits were monitored with fundoscopy, ultrasound and optical coherence tomography. Intraocular tumors (macroscopic or microscopic) were detected in all study animals. Tumor size and growth were correlated to cyclosporine A dose, with tumors regressing when cyclosporine A was arrested. All tumors expressed HMB-45 and MelanA; however, tumor size, pigmentation and cell morphology differed in 92.1 vs. MP41 tumors. Finally, across all groups, circulating tumor DNA from plasma and aqueous humor was detected earlier than tumor detection by imaging and correlated to tumor growth. In conclusion, using three clinically relevant imaging modalities (fundoscopy, ultrasonography and optical coherence tomography) and liquid biopsy, we were successfully able to monitor tumor progression in our rabbit xenograft model of human uveal melanoma.
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Affiliation(s)
- Prisca Bustamante
- Cancer Research Program, Research Institute of the McGill University Health Centre
- McGill University Ocular Pathology and Translational Research Laboratory, McGill University
- Department of Pathology, McGill University, Montréal, Canada
| | - Jacqueline Coblentz
- Cancer Research Program, Research Institute of the McGill University Health Centre
- McGill University Ocular Pathology and Translational Research Laboratory, McGill University
| | - Christina Mastromonaco
- McGill University Ocular Pathology and Translational Research Laboratory, McGill University
| | - Emma Youhnovska
- Cancer Research Program, Research Institute of the McGill University Health Centre
| | - Hiroaki Ito
- McGill University Ocular Pathology and Translational Research Laboratory, McGill University
- Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan
| | - Rita Pinto Proença
- McGill University Ocular Pathology and Translational Research Laboratory, McGill University
- Coimbra University Hospital Center, Coimbra
- Faculty of Medicine, University of Lisbon, Lisbon
- Hospital CUF Cascais, Cascais, Portugal
| | - Cristina Fonseca
- McGill University Ocular Pathology and Translational Research Laboratory, McGill University
- Coimbra University Hospital Center, Coimbra
| | - Kyle Dickinson
- Cancer Research Program, Research Institute of the McGill University Health Centre
| | - Emily Marcotte
- Cancer Research Program, Research Institute of the McGill University Health Centre
- McGill University Ocular Pathology and Translational Research Laboratory, McGill University
| | - Myriam MacDonald
- McGill University Ocular Pathology and Translational Research Laboratory, McGill University
| | | | - Sabrina Bergeron
- McGill University Ocular Pathology and Translational Research Laboratory, McGill University
| | - Alicia Goyeneche
- McGill University Ocular Pathology and Translational Research Laboratory, McGill University
| | | | - Thupten Tsering
- Cancer Research Program, Research Institute of the McGill University Health Centre
- Department of Pathology, McGill University, Montréal, Canada
| | - Alexander Laskaris
- Cancer Research Program, Research Institute of the McGill University Health Centre
- Department of Pathology, McGill University, Montréal, Canada
| | - Eva Jin
- Cancer Research Program, Research Institute of the McGill University Health Centre
- Department of Pathology, McGill University, Montréal, Canada
| | - Amélie Nadeau
- Cancer Research Program, Research Institute of the McGill University Health Centre
- Department of Pathology, McGill University, Montréal, Canada
| | - Tiffany Porraccio
- McGill University Ocular Pathology and Translational Research Laboratory, McGill University
| | - Miguel N Burnier
- Cancer Research Program, Research Institute of the McGill University Health Centre
- McGill University Ocular Pathology and Translational Research Laboratory, McGill University
- Department of Pathology, McGill University, Montréal, Canada
| | - Julia V Burnier
- Cancer Research Program, Research Institute of the McGill University Health Centre
- Department of Pathology, McGill University, Montréal, Canada
- Gerald Bronfman Department of Oncology, McGill University, Montréal, Canada
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Yousef YA, Alkhatib F, Elfalah M, AlRyalat SA, Mohammad M, AlHabahbeh O, AlJabari R, Zweifel S, AlNawiaseh I, Rejdak R, Toro MD. Assessing the Impact of Simulated Color Vision Deficiency on Ophthalmologists' Ability to Differentiate between Choroidal Melanoma and Choroidal Nevus. J Clin Med 2024; 13:3626. [PMID: 38930154 PMCID: PMC11204884 DOI: 10.3390/jcm13123626] [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: 05/09/2024] [Revised: 06/11/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024] Open
Abstract
Background: Color vision deficiency (CVD) is an often-overlooked issue within the medical community, and its consequences remain insufficiently explored. We aim to evaluate how CVD affects diagnostic accuracy and distinguish between malignant choroidal melanoma and benign choroidal nevus among ophthalmologists. Methods: In this cross-sectional study, we engaged ophthalmologists through a web-based survey distributed via the professional ophthalmology society's social media channels. The survey encompassed a series of three fundus images representing normal fundus, choroidal nevus, and choroidal melanoma. Each image underwent simulation for the three primary types of CVD-protanopia, deuteranopia, and tritanopia-alongside a non-simulated version. Results: The study included 41 participants, averaging 40 years of age (±9.2), comprising 28 (68%) men and 13 (32%) women. Significantly lower rates of identifying orange pigments were observed in simulated protanopia images compared to non-simulated ones (p = 0.038). In simulated deutranopia images, the recognition of melanotic lesions was notably reduced compared to non-simulated images (p = 0.048). No such limitation was observed for tritanopia. However, participants retained their ability to identify subretinal fluid and estimate tumor thickness in simulated and non-simulated images. Concerning simulated images of choroidal nevi, participants misdiagnosed nevi as choroidal melanoma in 37% of cases in simulated protanopia nevi images and 41% in simulated deutranopia nevi images. This resulted in unnecessary referrals of benign lesions as malignant, emphasizing the potential for mistaken diagnoses. Nevertheless, almost all simulated images of malignant melanoma were correctly referred for specialized oncological treatment. Conclusions: The simulated CVD conditions of protanopia and deuteranopia affected the accuracy of identifying the melanotic nature of the choroidal tumor and the presence of orange pigments. This limitation led to challenges in correctly diagnosing choroidal melanoma and choroidal nevus, resulting in extra referrals for nevus cases. However, participants were safe and could still determine the possible risk of eyes with choroidal melanoma, so most referred melanoma cases to specialized oncologists as needed.
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Affiliation(s)
- Yacoub A. Yousef
- Department of Surgery (Ophthalmology), King Hussein Cancer Center, Amman 11941, Jordan; (F.A.); (M.M.); (O.A.); (R.A.); (I.A.)
| | - Fawzieh Alkhatib
- Department of Surgery (Ophthalmology), King Hussein Cancer Center, Amman 11941, Jordan; (F.A.); (M.M.); (O.A.); (R.A.); (I.A.)
| | - Mutasem Elfalah
- Division of Ophthalmology, Department of Special Surgery, School of Medicine, The University of Jordan, Amman 11942, Jordan; (M.E.); (S.A.A.)
| | - Saif Aldeen AlRyalat
- Division of Ophthalmology, Department of Special Surgery, School of Medicine, The University of Jordan, Amman 11942, Jordan; (M.E.); (S.A.A.)
| | - Mona Mohammad
- Department of Surgery (Ophthalmology), King Hussein Cancer Center, Amman 11941, Jordan; (F.A.); (M.M.); (O.A.); (R.A.); (I.A.)
| | - Omar AlHabahbeh
- Department of Surgery (Ophthalmology), King Hussein Cancer Center, Amman 11941, Jordan; (F.A.); (M.M.); (O.A.); (R.A.); (I.A.)
| | - Reem AlJabari
- Department of Surgery (Ophthalmology), King Hussein Cancer Center, Amman 11941, Jordan; (F.A.); (M.M.); (O.A.); (R.A.); (I.A.)
| | - Sandrine Zweifel
- Department of Ophthalmology, University of Zürich, 8057 Zürich, Switzerland;
| | - Ibrahim AlNawiaseh
- Department of Surgery (Ophthalmology), King Hussein Cancer Center, Amman 11941, Jordan; (F.A.); (M.M.); (O.A.); (R.A.); (I.A.)
| | - Robert Rejdak
- Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland;
| | - Mario Damiano Toro
- Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland;
- Eye Clinic, Public Health Department, University of Naples Federico II, 80131 Naples, Italy
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Zheng Y, Gu X, Yao Y, Pan H, Jia R, Xu X, Zhuang A. Adenomas of the ciliary body epithelium: clinics, histopathology and management. Br J Ophthalmol 2024; 108:826-832. [PMID: 37433648 DOI: 10.1136/bjo-2023-323845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 06/26/2023] [Indexed: 07/13/2023]
Abstract
AIMS Adenomas of the ciliary body epithelium, including adenoma of the pigmented ciliary body epithelium (APCE) and adenoma of the non-pigmented ciliary body epithelium (ANPCE), are extremely rare, and most knowledge about them comes from sporadic case reports. The purpose of this study was to provide a comprehensive understanding of adenomas of the ciliary body epithelium and to identify the similarities and differences between APCE and ANPCE. METHODS This study was a retrospective case series comprising data from 41 patients obtained from retrieved publications and five cases diagnosed at the Shanghai Ninth People's Hospital. The clinicopathological features, treatment and prognosis of APCE and ANPCE were compared using the non-parametric rank sum test, t-test and the χ2 test. RESULTS The clinical and histopathological features and treatment were analogous between APCE (n=23) and ANPCE (n=23). The overall visual prognosis associated with the two tumours was good, with 63% of the patients having stable or improved vision after treatment. Enucleation was the primary cause of eventual vision loss (three in APCE vs two in ANPCE, p=0.001). Notably, iris invasion was commonly observed in patients with APCE (six in APCE vs zero in ANPCE, p=0.014), and iris invasion was associated with decreased vision eventually (p=0.003). Tumour size was irrelevant to the vision outcome (p=0.65). Metastasis or recurrence did not occur in any of the patients. CONCLUSION In most cases, the clinicopathological features of ANPCE and APCE were similar. Iris invasion was commonly observed in patients with APCE, which was associated with poor visual prognosis.
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Affiliation(s)
- Yue Zheng
- Department of Ophthalmology, Shanghai Jiao Tong University School of Medicine Affiliated Ninth People's Hospital, Shanghai, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Xiang Gu
- Department of Ophthalmology, Shanghai Jiao Tong University School of Medicine Affiliated Ninth People's Hospital, Shanghai, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Yiran Yao
- Department of Ophthalmology, Shanghai Jiao Tong University School of Medicine Affiliated Ninth People's Hospital, Shanghai, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Hui Pan
- Department of Ophthalmology, Shanghai Jiao Tong University School of Medicine Affiliated Ninth People's Hospital, Shanghai, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Renbing Jia
- Department of Ophthalmology, Shanghai Jiao Tong University School of Medicine Affiliated Ninth People's Hospital, Shanghai, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Xiaofang Xu
- Department of Ophthalmology, Shanghai Jiao Tong University School of Medicine Affiliated Ninth People's Hospital, Shanghai, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Ai Zhuang
- Department of Ophthalmology, Shanghai Jiao Tong University School of Medicine Affiliated Ninth People's Hospital, Shanghai, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
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Cao X, Zeng J, Ou Y, Chen J, Lyu J, Zhou Q. A prognostic nomogram for the cancer-specific survival rate of choroidal melanoma using the Surveillance, Epidemiology, and End Results database. Front Med (Lausanne) 2024; 11:1392336. [PMID: 38818391 PMCID: PMC11137212 DOI: 10.3389/fmed.2024.1392336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 05/02/2024] [Indexed: 06/01/2024] Open
Abstract
Objective This study was conducted to develop a comprehensive nomogram for individuals with choroidal melanoma (CM) to determine their cancer-specific survival (CSS). Methods Data of individuals with CM, diagnosed between 2004 and 2015, were accessed at the Surveillance, Epidemiology, and End Results (SEER) database. The selected individuals were randomly categorized into a training and validation cohort. Multivariate Cox regression analysis was applied to screen the relevant variables. Followed by the development of a nomogram based on independent variables. Ultimately, the net reclassification index (NRI), concordance index (C-index), calibration charts, integrated discrimination improvement (IDI), receiver operating characteristic curves (ROC), area under the curve (AUC), and decision-curve analysis (DCA), were utilized to evaluate the discrimination, accuracy, and effectiveness of the model. Results This study enrolled 3,782 patients. Seven independent factors linked to prognosis were screened via multivariate Cox regression analysis, encompassing age at diagnosis; race; AJCC (American Joint Committee on Cancer) stage; histologic type; and therapy method of radiotherapy, surgery, and chemotherapy. The respective C-indexes of the training and validation cohorts were 0.709 and 0.726, indicative of the excellent accuracy of the nomogram. Furthermore, the AUCs of the training and validation cohorts across 3, 5, and 8 years were 0.767, 0.744, and 0.722 as well as 0.772, 0.770, and 0.753, respectively. Evident of the superiority of the established nomogram over the AJCC staging, both the NRI and IDI values exhibited improvement. The favorable clinical impact and good performance of the nomogram were evident via decision curve analyses (DCAs) and calibration plots, respectively. Conclusion This research dealt with establishing and validating a nomogram as a prognostic tool for assessing the prognosis of adult patients with CM utilizing the SEER database. A comprehensive assessment of the nomogram via diverse variables demonstrated its accuracy in predicting the CSS probabilities of CM patients across 3, 5, and 8 years in clinical settings. Notably, its performance surpassed that of the AJCC staging system.
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Affiliation(s)
- Xianfen Cao
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Guangzhou, China
- Department of Ophthalmology, The First People’s Hospital of Chenzhou, Chenzhou, China
| | - Jing Zeng
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Guangzhou, China
- Ophthalmic Center, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Yulun Ou
- Department of Ophthalmology, The First People’s Hospital of Chenzhou, Chenzhou, China
| | - Jian Chen
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Jun Lyu
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Qing Zhou
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Guangzhou, China
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Zhu S, Dai L, Zhong X, Lin W. A highly selective probe engineered to detect polarity and distinguish normal cells and tumor cells in tissue sections. ANALYTICAL METHODS : ADVANCING METHODS AND APPLICATIONS 2024; 16:2850-2856. [PMID: 38644726 DOI: 10.1039/d4ay00438h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Early diagnostics and therapies for diseases such as cancer are limited by the fact that the inducing factors for the development of cytopathies are not clear. The stable polarity of lipid droplets is a potential biomarker for tumor cells; however, the complex intracellular biological environment poses great difficulties for specific detection of the polarity. Therefore, to meet this pressing challenge, we designed a highly selective fluorescent probe, DCI-Cou-polar, which used the ICT mechanism to differentiate normal cells and tumor cells in tissue sections by detecting changes in the polarities of intracellular lipid droplets. The introduction of a cyclic amine at the 7-position of coumarin (benzoquinolizine coumarin) reduced its ability to donate electrons compared with the diethylamino group, which increased the probe selectivity while retaining the sensitivity to polarity. With NIR emission and large Stokes shifts, DCI-Cou-polar has high sensitivity to polarity, excellent photostability, and biocompatibility, and it tracks lipid droplets with high fidelity. Therefore, we believe that this polarity-sensitive probe provides information on the connection between the polarity of lipid droplets and tumors while improving the development of highly selective polarity probes.
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Affiliation(s)
- Sai Zhu
- Institute of Optical Materials and Chemical Biology, Guangxi Key Laboratory of Electrochemical Energy Materials, School of Chemistry and Chemical Engineering, Guangxi University, Nanning, Guangxi 530004, P. R. China.
| | - Lixuan Dai
- Institute of Optical Materials and Chemical Biology, Guangxi Key Laboratory of Electrochemical Energy Materials, School of Chemistry and Chemical Engineering, Guangxi University, Nanning, Guangxi 530004, P. R. China.
| | - Xiaoli Zhong
- Institute of Optical Materials and Chemical Biology, Guangxi Key Laboratory of Electrochemical Energy Materials, School of Chemistry and Chemical Engineering, Guangxi University, Nanning, Guangxi 530004, P. R. China.
| | - Weiying Lin
- Institute of Optical Materials and Chemical Biology, Guangxi Key Laboratory of Electrochemical Energy Materials, School of Chemistry and Chemical Engineering, Guangxi University, Nanning, Guangxi 530004, P. R. China.
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Wulff J, Koska B, Ahmad Khalil D, Richter R, Maximilian Bäcker C, Bäumer C, Foerster A, Bechrakis NE, Timmermann B. Uncertainties in ocular proton planning and their impact on required margins. Phys Med 2024; 121:103358. [PMID: 38643558 DOI: 10.1016/j.ejmp.2024.103358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 03/11/2024] [Accepted: 04/16/2024] [Indexed: 04/23/2024] Open
Abstract
PURPOSE To review required margins in ocular proton therapy (OPT) based on an uncertainty estimation and to compare them with widely used values. Further, uncertainties when using registered funduscopy images in the 3D model is investigated. METHODS An uncertainty budget in planning and delivery was defined to determine required aperture and range margins. Setup uncertainties were considered for a cohort of treated patients and tested in a worst-case estimation. Other uncertainties were based on a best-guess and knowledge of institutional specifics, e.g. range reproducibility. Margins for funduscopy registration were defined resulting from scaling, rotation and translation of the image. Image formation for a wide-field fundus camera was reviewed and compared to the projection employed in treatment planning systems. RESULTS Values for aperture and range with margins of 2.5 mm as reported in literature could be determined. Aperture margins appear appropriate for setup uncertainties below 0.5 mm, but depend on lateral penumbra. Range margins depend on depth and associated density uncertainty in tissue. Registration of funduscopy images may require margins of >2 mm, increasing towards the equator. Difference in the projection may lead to discrepancies of several mm. CONCLUSIONS The commonly used 2.5 mm aperture margin was validated as an appropriate choice, while range margins could be reduced for lower ranges. Margins may however not include uncertainties in contouring and possible microscopic spread. If a target base is contoured on registered funduscopy images care must be taken as they are subject to larger uncertainties. Multimodal imaging approach in OPT remains advisable.
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Affiliation(s)
- Jörg Wulff
- West German Proton Therapy Centre Essen (WPE), Essen, Germany; University Hospital Essen, Essen, Germany; West German Cancer Centre (WTZ), Essen, Germany.
| | - Benjamin Koska
- West German Proton Therapy Centre Essen (WPE), Essen, Germany; University Hospital Essen, Essen, Germany; West German Cancer Centre (WTZ), Essen, Germany
| | - Dalia Ahmad Khalil
- West German Proton Therapy Centre Essen (WPE), Essen, Germany; University Hospital Essen, Essen, Germany; West German Cancer Centre (WTZ), Essen, Germany; Department of Particle Therapy, Essen, Germany
| | - Ronald Richter
- West German Proton Therapy Centre Essen (WPE), Essen, Germany; University Hospital Essen, Essen, Germany; West German Cancer Centre (WTZ), Essen, Germany; Department of Particle Therapy, Essen, Germany
| | - Claus Maximilian Bäcker
- West German Proton Therapy Centre Essen (WPE), Essen, Germany; University Hospital Essen, Essen, Germany; West German Cancer Centre (WTZ), Essen, Germany
| | - Christian Bäumer
- West German Proton Therapy Centre Essen (WPE), Essen, Germany; University Hospital Essen, Essen, Germany; West German Cancer Centre (WTZ), Essen, Germany; German Cancer Consortium (DKTK), Essen, Germany; Department of Physics, TU Dortmund University, Dortmund, Germany
| | - Andreas Foerster
- University Hospital Essen, Essen, Germany; Department of Ophthalmology, University Hospital Essen, Essen, Germany
| | - Nikolaos E Bechrakis
- University Hospital Essen, Essen, Germany; West German Cancer Centre (WTZ), Essen, Germany; Department of Ophthalmology, University Hospital Essen, Essen, Germany
| | - Beate Timmermann
- West German Proton Therapy Centre Essen (WPE), Essen, Germany; University Hospital Essen, Essen, Germany; West German Cancer Centre (WTZ), Essen, Germany; Department of Particle Therapy, Essen, Germany; German Cancer Consortium (DKTK), Essen, Germany
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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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8
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Kim BZ, Lim JZ, McGhee CNJ. Cysts and tumours of the iris: Diagnostic tools and key management considerations-A review. Clin Exp Ophthalmol 2024. [PMID: 38577954 DOI: 10.1111/ceo.14380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 03/24/2024] [Accepted: 03/24/2024] [Indexed: 04/06/2024]
Abstract
The iris is a unique structure, with exquisite variations in colour and form. Pathological changes, specifically including iris cysts and tumours are relatively uncommon, difficult to diagnose, and yet potentially blinding or life-threatening. Based on a comprehensive literature review, with highly illustrated key case examples, this report aims to guide the clinician in filtering the differential diagnoses of iris cysts and tumours. Evaluation is in the context of key diagnostic clinical tools and management considerations. Diagnostic imaging techniques include serial anterior segment photography, ultrasound, anterior segment optical coherence tomography, and iris fluorescein angiography, however, the roles of computerised topography and magnetic resonance imaging are also considered in this review. Management includes categorisation in terms of solid iris tumours (melanocytic vs. non-melanocytic), or iris cysts (primary vs. secondary) that may be usefully differentiated by clinical assessment, avoiding more invasive interventions. Cystic lesions are generally benign, although implantation cysts in particular cause significant complications and surgical challenges. Most solid tumours are melanocytic and also typically benign. However, in larger lesions, rapid growth, symptoms and complications more likely indicate malignancy, requiring further investigation.
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Affiliation(s)
- Bia Z Kim
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Department of Ophthalmology, Greenlane Eye Clinic, Health New Zealand (Te Whatu Ora) Auckland, Auckland, New Zealand
| | - Joevy Z Lim
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Department of Ophthalmology, Greenlane Eye Clinic, Health New Zealand (Te Whatu Ora) Auckland, Auckland, New Zealand
| | - Charles N J McGhee
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Department of Ophthalmology, Greenlane Eye Clinic, Health New Zealand (Te Whatu Ora) Auckland, Auckland, New Zealand
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9
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Semeniuk O, Yu E, Rivard MJ. Current and Emerging Radiotherapy Options for Uveal Melanoma. Cancers (Basel) 2024; 16:1074. [PMID: 38473430 DOI: 10.3390/cancers16051074] [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: 01/21/2024] [Revised: 03/01/2024] [Accepted: 03/04/2024] [Indexed: 03/14/2024] Open
Abstract
What treatment options are there for patients having uveal melanoma? A randomized, prospective, multi-institutional clinical trial (COMS) showed no difference in survival between brachytherapy and enucleation for medium-sized lesions. With the obvious benefit of retaining the eye, brachytherapy has flourished and many different approaches have been developed such as low-dose-rate sources using alternate low-energy photon-emitting radionuclides, different plaque designs and seed-loading techniques, high-dose-rate brachytherapy sources and applicators, and low- and high-dose-rate beta-emitting sources and applicators. There also have been developments of other radiation modalities like external-beam radiotherapy using linear accelerators with high-energy photons, particle accelerators for protons, and gamma stereotactic radiosurgery. This article examines the dosimetric properties, targeting capabilities, and outcomes of these approaches. The several modalities examined herein have differing attributes and it may be that no single approach would be considered optimal for all patients and all lesion characteristics.
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Affiliation(s)
- Oleksii Semeniuk
- Department of Radiation Oncology, Warren Alpert Medical School, Brown University and Rhode Island Hospital, Providence, RI 02903, USA
| | - Esther Yu
- Department of Radiation Oncology, Warren Alpert Medical School, Brown University and Rhode Island Hospital, Providence, RI 02903, USA
| | - Mark J Rivard
- Department of Radiation Oncology, Warren Alpert Medical School, Brown University and Rhode Island Hospital, Providence, RI 02903, USA
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10
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Lim JZ, Gokul A, Misra SL, Pan X, Charlton A, McGhee CNJ. An optimized 3T MRI scan protocol to assess iris melanoma with subsequent histopathological verification - A prospective study. Asia Pac J Ophthalmol (Phila) 2024; 13:100047. [PMID: 38417788 DOI: 10.1016/j.apjo.2024.100047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 02/02/2024] [Accepted: 02/09/2024] [Indexed: 03/01/2024] Open
Abstract
INTRODUCTION Magnetic resonance imaging (MRI) has demonstrated high levels of tissue contrast, accuracy and reproducibility in evaluating posterior uveal melanoma. Owing to smaller size, the role of MRI in detecting and characterising iris melanoma has not yet been explored. AIMS To develop a protocol to image iris melanoma and describe the MRI characteristics of histopathological-confirmed iris melanoma. MATERIALS AND METHODS An optimised MRI protocol, using a 3T MRI scanner and a 32-channel head coil, was developed to image iris tumours. A prospective, single-centre, 12-month study was conducted on all patients with lesions suspicious for iris melanoma. All patients were offered an MRI scan in addition to the standardised clinical procedures. Image quality comparison was made with existing clinical investigations. Iris melanoma characteristics on MRI are described. RESULTS A successful optimised MRI scan protocol was developed that was able to detect and characterise iris melanoma. One normal participant and five patients with subsequent histopathological-confirmed iris melanoma (n = 6) were recruited. Four patients completed the full MRI sequence. All iris melanoma were detected on at least one T1- or T2-weighted images. When compared to the vitreous, all iris melanomas demonstrated hyper-intensity on T1-weighted images and hypo-intensity on T2-weighted images. On T1-mapping, T1-values of iris melanoma demonstrated an inverse relationship with the degree of tumour pigmentation. CONCLUSIONS This study highlights an optimised, easily reproducible MRI scan protocol to image iris melanoma. Numerous MR imaging characteristics of iris melanoma are reported for the first time and a potential non-invasive tumour biomarker is described.
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Affiliation(s)
- Joevy Z Lim
- Department of Ophthalmology, New Zealand Eye Centre, University of Auckland, New Zealand; Department of Ophthalmology, Te Whatu Ora - Health New Zealand Auckland, New Zealand
| | - Akilesh Gokul
- Department of Ophthalmology, New Zealand Eye Centre, University of Auckland, New Zealand
| | - Stuti L Misra
- Department of Ophthalmology, New Zealand Eye Centre, University of Auckland, New Zealand
| | - Xingzheng Pan
- Department of Physiology, School of Medical Science, New Zealand Eye Centre, University of Auckland, New Zealand
| | - Amanda Charlton
- Department of Histopathology, Te Whatu Ora - Health New Zealand Auckland, New Zealand
| | - Charles N J McGhee
- Department of Ophthalmology, New Zealand Eye Centre, University of Auckland, New Zealand; Department of Ophthalmology, Te Whatu Ora - Health New Zealand Auckland, New Zealand.
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11
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Rossi A, Zeng Y, Rahimi M, Son T, Heiferman MJ, Gong C, Sun X, Soleimani M, Djalilian AR, Humayun MS, Zhou Q, Yao X. Integrating a Fundus Camera with High-Frequency Ultrasound for Precise Ocular Lesion Assessment. BIOSENSORS 2024; 14:127. [PMID: 38534234 DOI: 10.3390/bios14030127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 02/22/2024] [Accepted: 02/27/2024] [Indexed: 03/28/2024]
Abstract
Ultrasound A-scan is an important tool for quantitative assessment of ocular lesions. However, its usability is limited by the difficulty of accurately localizing the ultrasound probe to a lesion of interest. In this study, a transparent LiNbO3 single crystal ultrasound transducer was fabricated, and integrated with a widefield fundus camera to guide the ultrasound local position. The electrical impedance, phase spectrum, pulse-echo performance, and optical transmission spectrum of the ultrasound transducer were validated. The novel fundus camera-guided ultrasound probe was tested for in vivo measurement of rat eyes. Anterior and posterior segments of the rat eye could be unambiguously differentiated with the fundus photography-guided ultrasound measurement. A model eye was also used to verify the imaging performance of the prototype device in the human eye. The prototype shows the potential of being used in the clinic to accurately measure the thickness and echogenicity of ocular lesions in vivo.
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Affiliation(s)
- Alfa Rossi
- Department of Biomedical Engineering, University of Illinois Chicago, Chicago, IL 60607, USA
| | - Yushun Zeng
- Alfred E. Mann Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA 90089, USA
- USC Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Mojtaba Rahimi
- Department of Biomedical Engineering, University of Illinois Chicago, Chicago, IL 60607, USA
| | - Taeyoon Son
- Department of Biomedical Engineering, University of Illinois Chicago, Chicago, IL 60607, USA
| | - Michael J Heiferman
- Department of Ophthalmology and Visual Sciences, University of Illinois Chicago, Chicago, IL 60612, USA
| | - Chen Gong
- Alfred E. Mann Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA 90089, USA
- USC Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Xin Sun
- Alfred E. Mann Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA 90089, USA
- USC Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Mohammad Soleimani
- Department of Ophthalmology and Visual Sciences, University of Illinois Chicago, Chicago, IL 60612, USA
| | - Ali R Djalilian
- Department of Ophthalmology and Visual Sciences, University of Illinois Chicago, Chicago, IL 60612, USA
| | - Mark S Humayun
- Alfred E. Mann Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA 90089, USA
- USC Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
- USC Ginsburg Institute for Biomedical Therapeutics, University of Southern California, Los Angeles, CA 90033, USA
| | - Qifa Zhou
- Alfred E. Mann Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA 90089, USA
- USC Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
- USC Ginsburg Institute for Biomedical Therapeutics, University of Southern California, Los Angeles, CA 90033, USA
| | - Xincheng Yao
- Department of Biomedical Engineering, University of Illinois Chicago, Chicago, IL 60607, USA
- Department of Ophthalmology and Visual Sciences, University of Illinois Chicago, Chicago, IL 60612, USA
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12
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Sreenivasa S, Wösle M, Gager Y, Vordermark D, Grajewski L, Krause L, Ciernik IF. Impact of tumour volume and treatment delay on the outcome after linear accelerator-based fractionated stereotactic radiosurgery of uveal melanoma. Br J Ophthalmol 2024; 108:457-464. [PMID: 36894300 PMCID: PMC10894830 DOI: 10.1136/bjo-2022-322750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 01/19/2023] [Indexed: 03/11/2023]
Abstract
BACKGROUND/AIMS Primary radiation therapy is used to treat malignant uveal melanoma (UM). We report our single-centre experience with fractionated radiosurgery (fSRS) with a linear accelerator (LINAC) after specific adaptation for small target volumes with HybridArc. METHODS From October 2014 to January 2020, 101 patients referred to Dessau City Hospital with unilateral UM underwent fSRS with 50 Gy given in five fractions on five consecutive days. Primary endpoints were local tumour control, globe preservation, metastasis and death. Potential prognostic features were analysed. Kaplan-Meier analysis, Cox proportional hazards model and linear models were used for calculations. RESULTS The median baseline tumour diameter was 10.0 mm (range, 3.0-20.0 mm), median tumour thickness 5.0 mm (range, 0.9-15.5 mm) and median gross tumour volume (GTV) 0.4 cm³ (range, 0.2-2.6 cm³). After a median follow-up of 32.0 months (range, 2.5-76.0 months), 7 patients (6.9%) underwent enucleation: 4 (4.0%) due to local recurrence and 3 (3.0%) due to radiation toxicities, and 6 patients (5.9%) revealed tumour persistence with a GTV exceeding 1.0 cm³. Of 20 patients (19.8%) who died, 8 (7.9%) were tumour-related deaths. Twelve patients (11.9%) suffered from distant metastasis. GTV showed an impact on all endpoints, and treatment delay was associated with reduced odds of eye preservation. CONCLUSION LINAC-based fSRS with static conformal beams combined with dynamic conformal arcs and discrete intensity-modulated radiotherapy results in a high tumour control rate. The tumour volume is the most robust physical prognostic marker for local control and disease progression. Avoiding treatment delay improves outcomes.
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Affiliation(s)
- Shanthala Sreenivasa
- Department of Radiation Oncology, Städtisches Klinikum Dessau, Brandenburg Medical School Theodor Fontane, Dessau, Germany
| | - Markus Wösle
- Department of Radiation Oncology, Städtisches Klinikum Dessau, Brandenburg Medical School Theodor Fontane, Dessau, Germany
| | - Yann Gager
- Department of Research and Development, PathoNext GmbH, Leipzig, Germany
| | - Dirk Vordermark
- Department of Radiation Oncology, Martin Luther Universität Halle-Wittenberg, Halle (Saale), Germany
| | - Luise Grajewski
- Department of Ophthalmology, Städtisches Klinikum Dessau, Brandenburg Medical School Theodor Fontane, Dessau, Germany
| | - Lothar Krause
- Department of Ophthalmology, Städtisches Klinikum Dessau, Brandenburg Medical School Theodor Fontane, Dessau, Germany
| | - I Frank Ciernik
- Department of Radiation Oncology, Städtisches Klinikum Dessau, Brandenburg Medical School Theodor Fontane, Dessau, Germany
- Department of Radiation Oncology, Martin Luther Universität Halle-Wittenberg, Halle (Saale), Germany
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13
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Hazazi A, AlShehah AA, Khan FR, Hakami MA, Almarshadi F, Abalkhail A, Nassar SA, Almasoudi HH, Ali AA, Abu-Alghayth MH, Kukreti N, Binshaya AS. From diagnosis to therapy: The transformative role of lncRNAs in eye cancer management. Pathol Res Pract 2024; 254:155081. [PMID: 38211388 DOI: 10.1016/j.prp.2023.155081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/29/2023] [Accepted: 12/30/2023] [Indexed: 01/13/2024]
Abstract
The genomic era has brought about a transformative shift in our comprehension of cancer, unveiling the intricate molecular landscape underlying disease development. Eye cancers (ECs), encompassing diverse malignancies affecting ocular tissues, pose distinctive challenges in diagnosis and management. Long non-coding RNAs (lncRNAs), an emerging category of non-coding RNAs, are pivotal actors in the genomic intricacies of eye cancers. LncRNAs have garnered recognition for their multifaceted roles in gene expression regulation and influence on many cellular processes. Many studies support that the lncRNAs have a role in developing various cancers. Recent investigations have pinpointed specific lncRNAs associated with ECs, including retinoblastoma and uveal melanoma. These lncRNAs exert control over critical pathways governing tumor initiation, progression, and metastasis, endowing them with the ability to function as evaluation, predictive, and therapeutic indicators. The article aims to synthesize the existing information concerning the functions of lncRNAs in ECs, elucidating their regulatory mechanisms and clinical significance. By delving into the lncRNAs' expanding relevance in the modulation of oncogenic and tumor-suppressive networks, we gain a deeper understanding of the molecular complexities intrinsic to these diseases. In our exploration of the genomic intricacies of ECs, lncRNAs introduce a fresh perspective, providing an opportunity to function as clinical and therapeutic indicators, and they also have therapeutic benefits that show promise for advancing the treatment of ECs. This comprehensive review bridges the intricate relationship between lncRNAs and ECs within the context of the genomic era.
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Affiliation(s)
- Ali Hazazi
- Department of Pathology and Laboratory Medicine, Security Forces Hospital Program, Riyadh, Saudi Arabia; College of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Arabia
| | | | - Farhan R Khan
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Al-Quwayiyah, Shaqra University, Riyadh, Saudi Arabia
| | - Mohammed Ageeli Hakami
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Al-Quwayiyah, Shaqra University, Riyadh, Saudi Arabia
| | - Fahad Almarshadi
- Department of Public Health, College of Public Health and Health Informatics, University of Ha'il, Saudi Arabia
| | - Adil Abalkhail
- Department of Public Health, College of Public Health and Health Informatics, Qassim University, Qassim, Saudi Arabia
| | - Somia A Nassar
- Department of Medical Laboratory Sciences, College of Applied medical sciences, Prince Sattam bin Abdulaziz University, Alkharj 11942, Saudi Arabia; Department of Parasitology & Animal Diseases, National Research Centre, 33 Bohouth St., Dokki, Giza 12622, Egypt
| | - Hassan H Almasoudi
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Najran University, Najran 61441, Saudi Arabia
| | - Amer Al Ali
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, University of Bisha, P.O. Box 255, Bisha 67714, Saudi Arabia
| | - Mohammed H Abu-Alghayth
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, University of Bisha, P.O. Box 255, Bisha 67714, Saudi Arabia
| | - Neelima Kukreti
- School of Pharmacy, Graphic Era Hill University, Dehradun 248007, India
| | - Abdulkarim S Binshaya
- Department of Medical Laboratory Sciences, College of Applied medical sciences, Prince Sattam bin Abdulaziz University, Alkharj 11942, Saudi Arabia.
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14
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Miao Y, Jung H, Hsu D, Song J, Ni S, Ma D, Jian Y, Makita S, Yasuno Y, Sarunic MV, Stephenson KAJ, Paton K, Mammo Z, Ju MJ. Polarization-Diversity Optical Coherence Tomography Assessment of Choroidal Nevi. Invest Ophthalmol Vis Sci 2023; 64:6. [PMID: 37930688 PMCID: PMC10629548 DOI: 10.1167/iovs.64.14.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 10/09/2023] [Indexed: 11/07/2023] Open
Abstract
Purpose The purpose of this study was to demonstrate the utility of polarization-diversity optical coherence tomography (PD-OCT), a noninvasive imaging technique with melanin-specific contrast, in the quantitative and qualitative assessment of choroidal nevi. Methods Nevi were imaged with a custom-built 55-degree field-of-view (FOV) 400 kHz PD-OCT system. Imaging features on PD-OCT were compared to those on fundus photography, auto-fluorescence, ultrasound, and non-PD-OCT images. Lesions were manually segmented for size measurement and metrics for objective assessment of melanin distributions were calculated, including degree of polarization uniformity (DOPU), attenuation coefficient, and melanin occupancy rate (MOR). Results We imaged 17 patients (mean age = 69.5 years, range = 37-90) with 11 pigmented, 3 non-pigmented, and 3 mixed pigmentation nevi. Nevi with full margin acquisition had an average longest basal diameter of 5.1 mm (range = 2.99-8.72 mm) and average height of 0.72 mm (range = 0.37 mm-2.09 mm). PD-OCT provided clear contrast of choroidal melanin content, distribution, and delineation of nevus margins for melanotic nevi. Pigmented nevi were found to have lower DOPU, higher attenuation coefficient, and higher MOR than non-pigmented lesions. Melanin content on PD-OCT was consistent with pigmentation on fundus in 15 of 17 nevi (88%). Conclusions PD-OCT allows objective assessment of choroidal nevi melanin content and distribution. In addition, melanin-specific contrast by PD-OCT enables clear nevus margin delineation and may improve serial growth surveillance. Further investigation is needed to determine the clinical significance and prognostic value of melanin characterization by PD-OCT in the evaluation of choroidal nevi.
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Affiliation(s)
- Yusi Miao
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Hoyoung Jung
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Destiny Hsu
- School of Engineering Science, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Jun Song
- School of Biomedical Engineering, University of British Columbia, Vancouver, British Columbia, Canada
| | - Shuibin Ni
- Case Eye Institute, Oregon Health & Science University, Portland, Oregon, United States
| | - Da Ma
- Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States
| | - Yifan Jian
- Case Eye Institute, Oregon Health & Science University, Portland, Oregon, United States
| | - Shuichi Makita
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Yoshiaki Yasuno
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Marinko V. Sarunic
- School of Engineering Science, Simon Fraser University, Burnaby, British Columbia, Canada
- Department of Medical Physics and Biomedical Engineering, University College London, London, England, United Kingdom
- Institute of Ophthalmology, University College London, London, England, United Kingdom
| | - Kirk A. J. Stephenson
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Katherine Paton
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Zaid Mammo
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Myeong Jin Ju
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada
- School of Biomedical Engineering, University of British Columbia, Vancouver, British Columbia, Canada
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15
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Terradas M, Gonzalez-Abuin N, García-Mulero S, Viana-Errasti J, Aiza G, Piulats JM, Brunet J, Capellá G, Valle L. MBD4-associated neoplasia syndrome: screening of cases with suggestive phenotypes. Eur J Hum Genet 2023; 31:1185-1189. [PMID: 37402954 PMCID: PMC10545785 DOI: 10.1038/s41431-023-01418-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 06/05/2023] [Accepted: 06/19/2023] [Indexed: 07/06/2023] Open
Abstract
Germline mutations in MBD4, which, like MUTYH and NTHL1, encodes a glycosylase of the DNA based excision repair system, cause an autosomal recessive syndrome characterised by increased risk of acute myeloid leukaemia, gastrointestinal polyposis, colorectal cancer (CRC) and, to a lesser extent, uveal melanoma and schwannomas. To better define the phenotypic spectrum and tumour molecular features associated with biallelic MBD4-associated cancer predisposition, and study if heterozygous variants are associated with gastrointestinal tumour predisposition, we evaluated germline MBD4 status in 728 patients with CRC, polyposis, and other suggestive phenotypes (TCGA and in-house cohorts). Eight CRC patients carried rare homozygous or heterozygous germline variants in MBD4. The information gathered on mode of inheritance, variant nature, functional effect of the variant, and tumour mutational characteristics suggested that none of the patients included in the study had an MBD4-associated hereditary syndrome and that the heterozygous variants identified were not associated with the disease.
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Affiliation(s)
- Mariona Terradas
- Hereditary Cancer Programme, Catalan Institute of Oncology; Oncobell Programme, IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Noemi Gonzalez-Abuin
- Hereditary Cancer Programme, Catalan Institute of Oncology; Oncobell Programme, IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
| | - Sandra García-Mulero
- Cancer Immunotherapy (CIT) Group-iPROCURE, Catalan Institute of Oncology; Oncobell Programme, IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
- Unit of Biomarkers and Susceptibility, Oncology Data Analytics Programme (ODAP), Catalan Institute of Oncology; Oncobell Programme, IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
| | - Julen Viana-Errasti
- Hereditary Cancer Programme, Catalan Institute of Oncology; Oncobell Programme, IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
| | - Gemma Aiza
- Hereditary Cancer Programme, Catalan Institute of Oncology; Oncobell Programme, IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
| | - Josep M Piulats
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Cancer Immunotherapy (CIT) Group-iPROCURE, Catalan Institute of Oncology; Oncobell Programme, IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
- Medical Oncology Department, Catalan Institute of Oncology, Hospitalet de Llobregat, Barcelona, Spain
| | - Joan Brunet
- Hereditary Cancer Programme, Catalan Institute of Oncology; Oncobell Programme, IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Catalan Institute of Oncology, IDIBGi, Girona, Spain
| | - Gabriel Capellá
- Hereditary Cancer Programme, Catalan Institute of Oncology; Oncobell Programme, IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Laura Valle
- Hereditary Cancer Programme, Catalan Institute of Oncology; Oncobell Programme, IDIBELL, Hospitalet de Llobregat, Barcelona, Spain.
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain.
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16
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Jaarsma-Coes MG, Klaassen L, Marinkovic M, Luyten GPM, Vu THK, Ferreira TA, Beenakker JWM. Magnetic Resonance Imaging in the Clinical Care for Uveal Melanoma Patients-A Systematic Review from an Ophthalmic Perspective. Cancers (Basel) 2023; 15:cancers15112995. [PMID: 37296958 DOI: 10.3390/cancers15112995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 05/24/2023] [Accepted: 05/26/2023] [Indexed: 06/12/2023] Open
Abstract
Conversely to most tumour types, magnetic resonance imaging (MRI) was rarely used for eye tumours. As recent technical advances have increased ocular MRI's diagnostic value, various clinical applications have been proposed. This systematic review provides an overview of the current status of MRI in the clinical care of uveal melanoma (UM) patients, the most common eye tumour in adults. In total, 158 articles were included. Two- and three-dimensional anatomical scans and functional scans, which assess the tumour micro-biology, can be obtained in routine clinical setting. The radiological characteristics of the most common intra-ocular masses have been described extensively, enabling MRI to contribute to diagnoses. Additionally, MRI's ability to non-invasively probe the tissue's biological properties enables early detection of therapy response and potentially differentiates between high- and low-risk UM. MRI-based tumour dimensions are generally in agreement with conventional ultrasound (median absolute difference 0.5 mm), but MRI is considered more accurate in a subgroup of anteriorly located tumours. Although multiple studies propose that MRI's 3D tumour visualisation can improve therapy planning, an evaluation of its clinical benefit is lacking. In conclusion, MRI is a complementary imaging modality for UM of which the clinical benefit has been shown by multiple studies.
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Affiliation(s)
- Myriam G Jaarsma-Coes
- Department of Ophthalmology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
- Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Lisa Klaassen
- Department of Ophthalmology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
- Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
- Department of Radiation Oncology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Marina Marinkovic
- Department of Ophthalmology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Gregorius P M Luyten
- Department of Ophthalmology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - T H Khanh Vu
- Department of Ophthalmology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Teresa A Ferreira
- Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Jan-Willem M Beenakker
- Department of Ophthalmology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
- Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
- Department of Radiation Oncology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
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17
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Kadakia A, Zhang J, Yao X, Zhou Q, Heiferman MJ. Ultrasound in ocular oncology: Technical advances, clinical applications, and limitations. Exp Biol Med (Maywood) 2023; 248:371-379. [PMID: 37212384 PMCID: PMC10281622 DOI: 10.1177/15353702231169539] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2023] Open
Abstract
Due to its accessibility and ability for real-time image acquisition of ocular structures, ultrasound has high utility in the visualization of the eye, especially in ocular oncology. In this minireview, we summarize the technical rationale and applications of ultrasound modalities, A-scan, B-scan, high-frequency ultrasound biomicroscopy (UBM), and Doppler measurement. A-scan ultrasound uses a transducer of 7-11 MHz, making it useful for determining the echogenicity of ocular tumors (7-8 MHz) and measuring the axial length of the eye (10-11 MHz). B-scan ultrasound operates at 10-20 MHz, which can be used for measuring posterior ocular tumors while UBM operates at 40-100 MHz to evaluate anterior ocular structures. Doppler ultrasonography allows for the detection of tumor vascularization. While ultrasonography has numerous clinical applications due to its favorable penetration compared with optical coherence tomography, it is still limited by its relatively lower resolution. Ultrasound also requires an experienced sonographer due to the need for accurate probe localization to areas of interest.
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Affiliation(s)
- Arya Kadakia
- Department of Ophthalmology and Visual
Sciences, Illinois Eye and Ear Infirmary, University of Illinois Chicago, Chicago, IL 60612,
USA
| | - Junhang Zhang
- Department of Biomedical Engineering, Viterbi
School of Engineering, University of Southern California, Los Angeles, CA 90089, USA
| | - Xincheng Yao
- Department of Ophthalmology and Visual
Sciences, Illinois Eye and Ear Infirmary, University of Illinois Chicago, Chicago, IL 60612,
USA
- Department of Biomedical Engineering,
University of Illinois Chicago, Chicago, IL 60607, USA
| | - Qifa Zhou
- Department of Biomedical Engineering, Viterbi
School of Engineering, University of Southern California, Los Angeles, CA 90089, USA
| | - Michael J Heiferman
- Department of Ophthalmology and Visual
Sciences, Illinois Eye and Ear Infirmary, University of Illinois Chicago, Chicago, IL 60612,
USA
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18
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Elfalah M, AlRyalat SA, Abu-Yaghi NE, Mohammad M, AlNawiaseh I, Rayyan D, Albliwi M, Elfalah M, AlSarairah F, Yousef YA. The Impact of Color Vision Deficiency on the Capability of Ophthalmologists to Diagnose Benign and Malignant Choroidal Tumors. J Clin Med 2023; 12:jcm12072744. [PMID: 37048826 PMCID: PMC10094880 DOI: 10.3390/jcm12072744] [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: 01/17/2023] [Revised: 02/14/2023] [Accepted: 02/24/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Color vision deficiency (CVD) is an under-reported problem among medical personnel, and its impact is still not well characterized. We aim to assess the impact of CVD among ophthalmologists on the accuracy of diagnosing different benign and malignant choroidal lesions. METHODS This is a cross-sectional study conducted on ophthalmologists. We used a web-based survey to collect responses through professional ophthalmology society social media. The survey included a set of five images for normal fundus, choroidal nevus, circumscribed choroidal hemangioma, choroidal metastasis, and choroidal melanoma, wherein each image simulated the three main types of CVD: protanopia, deuteranopia, and tritanopia, in addition to a non-simulated image. RESULTS Forty-one participants were included, with a mean age of 40 (±9.2) years. They were 28 (68%) men and 13 (32%) women. Participants showed significantly low accuracy for definite diagnosis for circumscribed choroidal hemangioma, nevus, melanoma, and metastasis when the images simulated protanopia and deuteranopia, but not tritanopia. Nevertheless, participants maintained the capability to recognize the nature of the lesions for both simulated and non-simulated images if they were benign or malignant, thereby ensuring immediate referral for specialized care. The exception was with simulated choroidal nevi images, wherein participants incorrectly assigned simulated protanopia and deuteranopia nevi images to malignant lesions. CONCLUSION Protanopia and deuteranopia affected the accuracy of diagnosing several choroidal lesions; however, ophthalmologists with those two simulated CVDs were still able to discriminate between benign and malignant tumors.
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Affiliation(s)
- Mutasem Elfalah
- Division of Ophthalmology, Department of Special Surgery, School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Saif Aldeen AlRyalat
- Division of Ophthalmology, Department of Special Surgery, School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Nakhleh E Abu-Yaghi
- Division of Ophthalmology, Department of Special Surgery, School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Mona Mohammad
- Department of Surgery (Ophthalmology), King Hussein Cancer Center, Amman 11941, Jordan
| | - Ibrahim AlNawiaseh
- Department of Surgery (Ophthalmology), King Hussein Cancer Center, Amman 11941, Jordan
| | - Deema Rayyan
- Division of Ophthalmology, Department of Special Surgery, School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Moath Albliwi
- Department of Surgery (Ophthalmology), King Hussein Cancer Center, Amman 11941, Jordan
| | - Mohammad Elfalah
- Division of Ophthalmology, Department of Special Surgery, School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Fawaz AlSarairah
- Ophthalmology Department, Faculty of Medicine, Mutah University, Mutah 61710, Jordan
| | - Yacoub A Yousef
- Department of Surgery (Ophthalmology), King Hussein Cancer Center, Amman 11941, Jordan
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Quan B, Liu X, Zhao S, Chen X, Zhang X, Chen Z. Detecting Early Ocular Choroidal Melanoma Using Ultrasound Localization Microscopy. Bioengineering (Basel) 2023; 10:bioengineering10040428. [PMID: 37106615 PMCID: PMC10136200 DOI: 10.3390/bioengineering10040428] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/15/2023] [Accepted: 03/23/2023] [Indexed: 03/30/2023] Open
Abstract
Ocular choroidal melanoma (OCM) is the most common ocular primary malignant tumor in adults, and there is an increasing emphasis on its early detection and treatment worldwide. The main obstacle in early detection of OCM is its overlapping clinical features with benign choroidal nevus. Thus, we propose ultrasound localization microscopy (ULM) based on the image deconvolution algorithm to assist the diagnosis of small OCM in early stages. Furthermore, we develop ultrasound (US) plane wave imaging based on three-frame difference algorithm to guide the placement of the probe on the field of view. A high-frequency Verasonics Vantage system and an L22-14v linear array transducer were used to perform experiments on both custom-made modules in vitro and a SD rat with ocular choroidal melanoma in vivo. The results demonstrate that our proposed deconvolution method implement more robust microbubble (MB) localization, reconstruction of microvasculature network in a finer grid and more precise flow velocity estimation. The excellent performance of US plane wave imaging was successfully validated on the flow phantom and in an in vivo OCM model. In the future, the super-resolution ULM, a critical complementary imaging modality, can provide doctors with conclusive suggestions for early diagnosis of OCM, which is significant for the treatment and prognosis of patients.
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Affiliation(s)
- Biao Quan
- The College of Mechanical and Electrical Engineering, Central South University, Changsha 410083, China
| | - Xiangdong Liu
- The College of Mechanical and Electrical Engineering, Central South University, Changsha 410083, China
| | - Shuang Zhao
- The Department of Dermatology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Xiang Chen
- The Department of Dermatology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Xuan Zhang
- The Department of Ophthalmology, Xiangya Hospital, Central South University, Changsha 410008, China
- Correspondence: (X.Z.); (Z.C.)
| | - Zeyu Chen
- The College of Mechanical and Electrical Engineering, Central South University, Changsha 410083, China
- Correspondence: (X.Z.); (Z.C.)
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20
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Soliman N, Mamdouh D, Elkordi A. Choroidal Melanoma: A Mini Review. MEDICINES (BASEL, SWITZERLAND) 2023; 10:medicines10010011. [PMID: 36662495 PMCID: PMC9863301 DOI: 10.3390/medicines10010011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/18/2022] [Accepted: 12/27/2022] [Indexed: 01/09/2023]
Abstract
Choroidal melanoma is a rare malignant tumour, yet it is the most common primary intra-ocular neoplasm and second on the list of top ten most malignant melanoma sites in the body. Clinical presentation can be non-specific and includes photopsia, floaters, progressive visual field loss, and blurry vision. The tumour is quite often diagnosed clinically during fundus examination; however, the most valued diagnostic tests are A- and B-scan ultrasonography (US). Several factors affect prognosis, including the patient's age, tumour size, histological features, and presence of metastases. Still, with primary treatment and tight surveillance, around 50% of choroidal melanoma patients metastasise.
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Affiliation(s)
- Noha Soliman
- UCL Institute of Ophthalmology, London EC1V 9EL, UK
- National Institute for Health Research Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust, UCL Institute of Ophthalmology, London EC1V 2PD, UK
- Royal College of Surgeons in Ireland, Medical University of Bahrain, Muharraq P.O. Box 15503, Bahrain
- Correspondence:
| | - Diaa Mamdouh
- Faculty of Medicine, Kuwait University, Kuwait City P.O. Box 24923, Kuwait
- Sheikh Jaber Al Ahmad Al Jaber Al Sabah Hospital, Kuwait City, Kuwait
| | - Aisha Elkordi
- Royal College of Surgeons in Ireland, Medical University of Bahrain, Muharraq P.O. Box 15503, Bahrain
- King Hamed University Hospital, Muharraq P.O Box 24343, Bahrain
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21
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Huang G, Li Q, Li L, Wang E. Development of novel polymeric nanoagents and their potential in cancer diagnosis and therapy runing title: Polymeric nanoagents for cancer theranostics. Front Chem 2022; 10:1097205. [PMID: 36590281 PMCID: PMC9800913 DOI: 10.3389/fchem.2022.1097205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022] Open
Abstract
Cancer has been one of the leading factors of death around the world. Cancer patients usually have low 5-year survival rates and poor life quality requiring substantial improvement. In clinic, the presenting diagnostic strategies lack sensitivity with only a small proportion of patients can be accurately identified. For diagnosed patients, most of them are at the advanced stages thus being delayed to receive treatment. Therefore, it is eager to investigate and develop highly effective and accurate techniques for cancer early diagnosis and individualized therapy. Various nanoplatforms are emerging as imaging agents and drug carriers for cancer theranostics recently. Novel polymeric nanoagents, as a potent exemplar, have extraordinary merits, such as good stability, high biosafety and high drug loading efficacy, showing the great prospect for cancer early diagnosis and precise treatment. Herein, we review the recent advances in novel polymeric nanoagents and elucidate their synthesis procedures. We further introduce the applications of novel polymeric nanoagents in cancer diagnosis, treatment, and theranostics, as well as associated challenges and prospects in this field.
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22
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Klaassen L, Jaarsma-Coes MG, Verbist BM, Vu TK, Marinkovic M, Rasch CR, Luyten GP, Beenakker JWM. Automatic Three-Dimensional Magnetic Resonance-based measurements of tumour prominence and basal diameter for treatment planning of uveal melanoma. Phys Imaging Radiat Oncol 2022; 24:102-110. [PMID: 36386446 PMCID: PMC9649381 DOI: 10.1016/j.phro.2022.11.001] [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: 08/15/2022] [Revised: 10/31/2022] [Accepted: 11/01/2022] [Indexed: 11/07/2022] Open
Abstract
Background and Purpose Three-dimensional (3D) Magnetic Resonance Imaging (MRI) is increasingly used to complement conventional two-dimensional ultrasound in the assessment of tumour dimension measurement of uveal melanoma. However, the lack of definitions of the 3D measurements of these tumour dimensions hinders further adaptation of MRI in ocular radiotherapy planning. In this study, we composed 3D MR-based definitions of tumour prominence and basal diameter and compared them to conventional ultrasound. Materials and methods Tumours were delineated on 3DT2 and contrast-enhanced 3DT1 (T1gd) MRI for 25 patients. 3D definitions of tumour prominence and diameter were composed and evaluated automatically on the T1gd and T2 contours. Automatic T1gd measurements were compared to manual MRI measurements, to automatic T2 measurements and to manual ultrasound measurements. Results Prominence measurements were similar for all modalities (median absolute difference 0.3 mm). Automatic T1gd diameter measurements were generally larger than manual MRI, automatic T2 and manual ultrasound measurements (median absolute differences of 0.5, 1.6 and 1.1 mm respectively), mainly due to difficulty defining the axis of the largest diameter. Largest differences between ultrasound and MRI for both prominence and diameter were found in anteriorly located tumours (up to 1.6 and 4.5 mm respectively), for which the tumour extent could not entirely be visualized with ultrasound. Conclusions The proposed 3D definitions for tumour prominence and diameter agreed well with ultrasound measurements for tumours for which the extent was visible on ultrasound. 3D MRI measurements generally provided larger diameter measurements than ultrasound. In anteriorly located tumours, the MRI measurements were considered more accurate than conventional ultrasound.
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Affiliation(s)
- Lisa Klaassen
- Leiden University Medical Center, Department of Ophthalmology, PO Box 9600, 2300 RC Leiden, the Netherlands
- Leiden University Medical Center, Department of Radiology, PO Box 9600, 2300 RC Leiden, the Netherlands
- Leiden University Medical Center, Department of Radiation Oncology, PO Box 9600, 2300 RC Leiden, the Netherlands
| | - Myriam G. Jaarsma-Coes
- Leiden University Medical Center, Department of Ophthalmology, PO Box 9600, 2300 RC Leiden, the Netherlands
- Leiden University Medical Center, Department of Radiology, PO Box 9600, 2300 RC Leiden, the Netherlands
| | - Berit M. Verbist
- Leiden University Medical Center, Department of Radiology, PO Box 9600, 2300 RC Leiden, the Netherlands
- Holland Particle Therapy Center, PO Box 110, 2600 AC Delft, the Netherlands
| | - T.H. Khanh Vu
- Leiden University Medical Center, Department of Ophthalmology, PO Box 9600, 2300 RC Leiden, the Netherlands
| | - Marina Marinkovic
- Leiden University Medical Center, Department of Ophthalmology, PO Box 9600, 2300 RC Leiden, the Netherlands
| | - Coen R.N. Rasch
- Leiden University Medical Center, Department of Radiation Oncology, PO Box 9600, 2300 RC Leiden, the Netherlands
- Holland Particle Therapy Center, PO Box 110, 2600 AC Delft, the Netherlands
| | - Gregorius P.M. Luyten
- Leiden University Medical Center, Department of Ophthalmology, PO Box 9600, 2300 RC Leiden, the Netherlands
| | - Jan-Willem M. Beenakker
- Leiden University Medical Center, Department of Ophthalmology, PO Box 9600, 2300 RC Leiden, the Netherlands
- Leiden University Medical Center, Department of Radiology, PO Box 9600, 2300 RC Leiden, the Netherlands
- Leiden University Medical Center, Department of Radiation Oncology, PO Box 9600, 2300 RC Leiden, the Netherlands
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