Echographic examination with new generation contrast agent of choroidal malignant melanomas: Acta Ophthalmologica Scandinavica 2005

Department of Ophthalmology, University Federico II, Naples, Italy.
Acta Ophthalmologica Scandinavica (Impact Factor: 1.85). 06/2005; 83(3):347-354. DOI: 10.1111/j.1600-0420.2005.00428.x

ABSTRACT To determine the efficacy of echography with new generation contrast agents in visualizing vascularization of choroidal malignant melanomas.
An echographic contrast medium consisting of phospholipidic microbubbles filled with sulphur hexafluoride (Sonovue) was used to visualize microcirculation in 25 cases of choroidal lesions already diagnosed with standardized echography (21 choroidal malignant melanomas, four disciform lesions).
In untreated malignant melanomas contrast agent echography revealed the presence of a dense microcirculation inside the mass. In one case vitreal seeding of the contrast agent was detectable before enucleation and histological examination revealed the presence of tumoral cells. In 12 cases treated with transpupillary thermotherapy, contrast agent echographic evaluation showed heavy regression of microcirculation after 1 week, confirmed in one case by histology, and a reduction of 70-80% in dimensions after 6 months (which appeared to have stabilized at subsequent examinations). In four cases treated with proton beam brachytherapy 2 years prior to our examination, contrast agent echography showed the absence of a microvascular network and the presence of large vessels and blood lakes. In four cases of disciform lesion, deep and superficial retina-associated vascularization was observed, with a weak spread of contrast agent inside the lesion.
Live representation with good resolution of choroidal malignant melanoma microcirculation was obtained.

  • [Show abstract] [Hide abstract]
    ABSTRACT: PURPOSE: To evaluate the use of in vivo imaging of rabbit model of choroidal melanoma using high-frequency contrast-enhanced ultrasound (HF-CE-US) with two-dimensional (2D) or three-dimensional (3D) modes and to correlate the sonographic findings with histopathologic characteristics. METHODS: Five New Zealand white rabbits, which were immunosuppressed with daily cyclosporin A (CsA), were inoculated into their right eyes with aliquots of 1.5×10(6)/50 μl of 92.1 human uveal melanoma cells cultured in RPMI. At week 4, the tumour-bearing eyes were imaged using high-frequency ultrasound (HF-US) with microbubble contrast agent to determine the 2D tumour size and relative blood volume and by 3D mode to determine tumour volume. Histologic tumour burden was quantified in enucleated eyes by ImageJ software, and mean vascular density (MVD) was determined by counting vascular channels in periodic acid Schiff (PAS) without haematoxylin sections. RESULTS: Using HF-CE-US, melanomas were visualised as relatively hyperechoic regions in the images. The correlation coefficients of sonographic size and volume compared with histologic area were 0.72 and 0.70, respectively. The sonographic tumour relative blood volume correlated with the histologic tumour vascularity (r(2)=0.92, p=0.04). CONCLUSIONS: There is a positive correlation between in vivo sonographic tumour volume/size and histologic tumour size in our rabbit choroidal melanoma model. HF-CE-US corresponds to MVD and blood volume.
    The British journal of ophthalmology 05/2013; 97(7). DOI:10.1136/bjophthalmol-2013-303343 · 2.81 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Purpose: To assess three-dimensional echography image quality and multiplanar imaging for the visualization of vitreoretinal and choroidal diseases. Methods: In an observational cross-sectional study, 20 eyes of 20 patients presenting different vitreoretinal and choroidal pathologies have been evaluated with three-dimensional ultrasonography (3DUS). Results: Of the 20 eyes, an epiretinal membrane was present in 2 eyes, diabetic macular edema in 6, a macular hole in 2, a myopic posterior detachment in 2, myopic peripapillary detachment of the pigment epithelium in 1, choroidal melanoma in 4, optic nerve glioma in 1 case, carotidocavernous fistula in 1 and an intravitreal dislocation of an intraocular lens in 1 eye. 3DUS was effective in wide-field representation of the vitreoretinal interface during macular edema, in good-quality visualization of the dislocated intraocular lens and in calculating the volume of choroidal melanoma. No advantages were found in other evaluated cases if compared with the already existing imaging techniques. Conclusions: One of the main advantages of 3DUS was the possibility to obtain a wide-field representation of spatial relationships between the lesions and the surrounding ocular structures.
    Ophthalmologica 01/2009; 223(3):183-187. DOI:10.1159/000197931 · 1.87 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To analyze the application significance of ultrasound contrast agent in identification and diagnosis of ocular spaceoccupying lesions, and mainly analyze its advantages and problems. Thirty-two representative literatures about the application of ultrasound contrast agent in diagnosis of spaceoccupying lesions at home and abroad were collected after focused on sorting the literature reporting the application of ultrasound contrast diagnostic technology in the diagnosis and identification of ocular spaceoccupying lesions in recent years. Its advantages and problems were retrospectively analyzed, and reasonable assessment on existing problems was made and possible solutions to the problems were proposed. As a new imaging diagnostic technique, the contrast-enhanced ultrasound, which can enhance the display of tumor microcirculation vessels and improve the tumor's ultrasound diagnostic capability, was analyzed. Through sorting and comprehensively analyzing the collected literatures, the positive rate of ocular spaceoccupying lesion diagnosis could be significantly improved with ultrasound contrast technology. Thus, the vascular perfusion in normal tissues and lesions was reflected objectively. According to the lesion's perfusion characteristics of the contrast agent plus with the performance features of two-dimensional ultrasound, the ocular spaceoccupying lesions can be accurately diagnosed, and this could provide clinicians with reliable research basis in this field. Ultrasound contrast examination is a new testing method, and ultrasound contrast agent can significantly enhance the ultrasonic detection signal, clearly show the blood perfusion in vessels and tissues, increase the image contrast resolution, and improve the lesion's detection capability in the microcirculation perfusion level, especially its important value in the diagnosis of ocular tumor.
    08/2011; 4(4):337-42. DOI:10.3980/j.issn.2222-3959.2011.04.02