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Correlation of histological findings from a large ciliochoroidal melanoma with CT perfusion and 3T MRI dynamic enhancement studies
Authors Pulido JS, Campeau NG, Klotz E, Primak AN, Saba O, Gunduz Kaan, Cantrill H, Salomão D, McCollough CH
Published 6 June 2008 Volume 2008:2(2) Pages 275—281
Jose S Pulido1, Norbert G Campeau2, Ernst Klotz3, Andrew N Primak2, Osama Saba3, Kaan Gunduz1, Herbert Cantrill5, Diva Salomão1,4, Cynthia H McCollough2
1Department of Ophthalmology; 2Department of Radiology; 3Siemens Medical Solutions, Malvern, PA, USA; 4Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN, USA; 5VitreoRetinal Surgery, Minneapolis, MN, USA
Background: The initial use of a 64-slice computed tomography (CT) scanner for obtaining quantitative perfusion data from a large ciliochoroidal melanoma, and correlation with 3T magnetic resonance imaging (MRI) dynamic enhancement and tumor histology.
Methods: The CT perfusion scan was performed using 80 kVp, 250 mA and 1-sec rotation time for 40 sec. The analysis was performed using commercial perfusion analysis software with a prototype 3-dimensional motion correction tool. Dynamic contrast-enhanced 3-Tesla MRI measured the kinetics of enhancement to estimate the vascular permeability. The time-dependent enhancement patterns were obtained using the average signal intensity using Functool analysis software. The involved globe was enucleated and microscopic evaluation of the tumor was performed.
Results: The perfusion parameters blood flow, blood volume and permeability surface area product in the affected eye determined by CT perfusion analysis were 118 ml/100 ml/min, 11.3 ml/100 ml and 48 ml/100 ml/min. Dynamic MRI enhancement showed maximal intensity increase of 111%. The neoplasm was a ciliochoroidal spindle cell melanoma which was mitotically active (13 mitoses/40 hpf). Vascular loops and arcades were present throughout the tumor. The patient developed metastases within 9 months of presentation.
Conclusion: Quantitative CT perfusion analysis of ocular tumors is feasible with motion correction software.
Keywords: ciliochoroidal melanoma, CT perfusion imaging, MR enhancement imaging, tumor blood volume, tumor blood flow, tumor permeability
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