Ultrasonographic and angiographic follow-up of primary choroidal malignant melanoma after proton beam irradiation therapy.
The aim of this study is to evaluate the reliability of the ultrasonographic and angiographic follow-up of primary choroidal malignant melanoma (PCMM) after proton beam irradiation therapy in a series of 14 patients. All patients underwent standardized A and B scan ultrasonography, fluorescein and indocyanine green videoangiography (FV, ICGV) before and after treatment with proton beam irradiation. The follow-up was carried out at 1, 3, 5, 8 months and then every 6 months. The mean follow-up was 26 months (range 6-46 months). The thickness of the tumors was demonstrated to be decreased and the internal reflectivity to be enhanced in 12 out of 14 cases from 8 months after treatment till the end of the follow-up period. In 2 eyes which were enucleated 5 months after treatment, histopathology confirmed that medium-low internal reflectivity corresponded to several areas of high cellularity and cellular mitosis. FV and ICGV were impossible because of opacities of dioptric media in 2 cases. From 8 months after treatment till the end of the follow-up period, in all the examined patients, FV demonstrated large hypofluorescent zones of the lesions which represented the destruction of the vascular tree of the tumor. From 8 months after treatment till the end of the follow-up period, ICGV demonstrated hypofluorescence of the lesions in 8 cases; mild hyperfluorescence and zones of colorant staining were present in late angiograms in 2 cases. The results of our study seem to confirm the reliability of standardized A and B scan ultrasonography in the follow-up of PCMM treated with proton beam irradiation; if ultrasonography is used together with FV and ICGV, the reliability of this combination is surely higher.
Romani
A
A
Section of Ophthalmology, Neurosciences Department of Pisa University, Italy.
Baldeschi
L
L
Genovesi-Ebert
F
F
Gremigni
E
E
Ragone
M C
MC
Rizzo
S
S
Nardi
M
M
D000368:Aged; D000369:Aged, 80 and over; D002830:Choroid Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000532:radiotherapy*; D004396:Coloring Agents; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D007089:Image Enhancement; D007208:Indocyanine Green; D008545:Melanoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000532:radiotherapy*; D008875:Middle Aged; D008938:Mitosis; D011522:Protons; D015203:Reproducibility of Results; D014463:Ultrasonography; D014741:Video Recording
D004396:Coloring Agents; D011522:Protons; D007208:Indocyanine Green