Comparison of Magnetic Resonance Imaging-Based and Conventional Measurements for Proton Beam Therapy of Uveal Melanoma.

Autor:	Jaarsma-Coes MG; Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands; Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands., Ferreira TA; Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands., Marinkovic M; Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands., Vu THK; Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands., van Vught L; Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands; Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands., van Haren GR; Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands., Rodrigues MF; HollandPTC, Delft, The Netherlands; Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands., Klaver YLB; HollandPTC, Delft, The Netherlands; Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands., Verbist BM; Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands; HollandPTC, Delft, The Netherlands., Luyten GPM; Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands., Rasch CRN; HollandPTC, Delft, The Netherlands; Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands., Beenakker JM; Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands; Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands; Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: j.w.m.beenakker@lumc.nl.
Jazyk:	angličtina
Zdroj:	Ophthalmology. Retina [Ophthalmol Retina] 2023 Feb; Vol. 7 (2), pp. 178-188. Date of Electronic Publication: 2022 Jul 13.
DOI:	10.1016/j.oret.2022.06.019
Abstrakt:	Objective: Conventionally, ocular proton therapy (PT) is planned using measurements obtained by an ophthalmologist using ultrasound, fundoscopy, biometry, and intraoperative assessments. Owing to the recent advances in magnetic resonance imaging (MRI) of uveal melanoma (UM), it is possible to acquire high-resolution 3-dimensional images of the eye, providing the opportunity to incorporate MRI in ocular PT planning. In this study, we described how these measurements can be obtained using MRI, compared the MRI-based measurements with conventional ophthalmic measurements, and identified potential pitfalls for both modalities. Design: Cross-sectional study. Subjects: Data from 23 consecutive patients with UM treated with PT were retrospectively evaluated. Methods: Magnetic resonance imaging-based measurements of axial length, tumor height and basal diameter, and marker-tumor distances were compared with the conventional ophthalmic measurements, and discrepancies were evaluated in a multidisciplinary setting. Main Outcome Measures: Tumor prominence and basal diameters on MRI and ultrasound, axial length on MRI and biometry, tumor-marker distances on MRI and measured intraoperatively. Results: The mean absolute differences of the tumor height and basal diameter measurements between ultrasound and MRI were 0.57 mm and 1.44 mm, respectively. Larger absolute differences in height and basal diameter were observed when the full tumor extent was not visible on ultrasound (0.92 mm and 1.67 mm, respectively) compared with when the full tumor extent was visible (0.44 mm and 1.15 mm, respectively). When the full tumor was not visible on ultrasound, MRI was considered more reliable. Tumor-marker distances measured using MRI and intraoperative techniques differed < 1 mm in 55% of the markers. For anteriorly located and mushroom-shaped tumors (25% of the markers), MRI provided more accurate measurements. In flat UM (15% of the markers), however, it was difficult to delineate the tumor on MRI. The mean absolute difference in axial length between optical biometry and MRI was 0.50 mm. The presence of the tumor was found to influence optical biometry in 15 of 22 patients; the remaining patients showed a better agreement (0.30 mm). Magnetic resonance imaging-based biometry was considered more reliable in patients with UM. Conclusions: Magnetic resonance imaging allowed for the 3-dimensional assessment of the tumor and surrounding tissue. In specific patients, it provided a more reliable measurement of axial length, tumor dimensions, and marker-tumor distances and could contribute to a more accurate treatment planning. Nevertheless, a combined evaluation remains advised, especially for flat UM. (Copyright © 2022 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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