Uveal melanoma: evaluation of extrascleral extension using thin-section MR of the eye with surface coils.
OBJECTIVE
This study was done to evaluate the role of high-resolution magnetic resonance (MR) imaging with special surface coils in selecting the correct therapeutic approach (eye enucleation or follow-up) in patients with suspected extrascleral extension of uveal melanoma.


METHODS
This prospective study involved 12 patients with suspected extrascleral extension of uveal melanoma on orbital ultrasonography. All patients were studied with thin-section MR imaging of the eye using surface coils.


RESULTS
High-resolution MR imaging of the eye excluded extrascleral extension of disease in 8/12 patients: in 4/8 cases it revealed vascular ectasia and in the other 4/8 cases the linear hypointensity of the sclera was unbroken. Seven of these eight patients were followed up by ultrasound, which showed stability of melanoma for at least 2 years, while the last patient underwent enucleation, and the histological examination confirmed the MR diagnosis. In 4/12 patients, high-resolution MR suggested a diagnosis of extrascleral extension of melanoma, which was confirmed at histological examination after enucleation.


CONCLUSIONS
High-resolution MR imaging of the eye with surface coils allowed us to evaluate extrascleral extension of uveal melanoma and choose the correct therapeutic approach, avoiding unnecessary enucleation in 7/12 patients.
Dipartimento di Scienze Radiologiche, Istituto di Radiologia, Policlinico Agostino Gemelli, UCSC, Rome, Italy, tommaso.tartaglione@rm.unicatt.it.
Tommaso
T
Tartaglione
Monica Maria
MM
Pagliara
Mariacarmela
M
Sciandra
Carmela Grazia
CG
Caputo
Rosalinda
R
Calandrelli
Gina
G
Fabrizi
Simona
S
Gaudino
Maria Antonietta
MA
Blasi
Cesare
C
Colosimo
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000669:Amplifiers, Electronic; D004867:Equipment Design; D015353:Eye Enucleation; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000295:instrumentation; D008279:Magnetic Resonance Imaging / Q000295:instrumentation* / Q000379:methods; D008297:Male; D008545:Melanoma / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014604:Uveal Neoplasms / Q000473:pathology* / Q000601:surgery; D000098943:Uveal Melanoma