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Gadolinium-DTPA-enhanced MRI of intraocular tumors
1Department of Diagnostic Radiology, Aachen University of Technology, West Germany.
Abstract:
The value of gadolinium-enhanced MRI in 30 patients with intraocular lesions has been evaluated. Seventeen patients had a uveal melanoma, two a ciliary body melanoma, three had uveal metastases, one lymphoma, four had senile macula degenerations, and three uveal nevi. Twelve of 17 patients with melanoma were followed up by MRI after ruthenium plaque therapy on 2-4 occasions. Melanomas showed high precontrast signal intensities and only a slight enhancement after intravenous Gd-DTPA was given. After ruthenium plaque therapy precontrast signal intensities (SI) decreased while a moderate signal increase on postcontrast scans was noted. Scars or tumor residues were better delineated on enhanced images. All other tumors than melanotic melanomas showed low SI on precontrast scans and a high signal increase after Gd-DTPA administration. Small amelanotic tumors were better delineated on postcontrast scans. In addition Gd-DTPA-enhanced MRI allowed differentiation between tumor and hemorrhage. No signal increase after Gd-DTPA application was seen in subretinal or vitreous hemorrhages of varying ages.
Insights
Gadolinium-enhanced MRI effectively differentiates intraocular tumors like melanoma and metastases from other lesions. Post-treatment imaging aids in monitoring melanoma response to ruthenium plaque therapy.
Area of Science:
- Ophthalmology
- Radiology
- Oncology
Background:
- Intraocular lesions present diagnostic challenges.
- Magnetic Resonance Imaging (MRI) is a valuable tool for ocular imaging.
- Gadolinium contrast agents enhance MRI visualization.
Purpose of the Study:
- To evaluate the utility of gadolinium-enhanced MRI in diagnosing various intraocular lesions.
- To assess the role of enhanced MRI in monitoring uveal melanoma post-treatment.
Main Methods:
- Retrospective analysis of 30 patients with intraocular lesions.
- MRI scans performed before and after intravenous gadolinium-based contrast agent (Gd-DTPA).
- Specific focus on 17 patients with uveal melanoma undergoing ruthenium plaque therapy.
Main Results:
- Melanomas showed high precontrast signals with slight enhancement; post-therapy scans revealed decreased signal intensity and moderate enhancement, improving delineation of scars/residues.
- Amelanotic tumors demonstrated low precontrast signals and significant post-contrast enhancement, aiding visualization.
- Enhanced MRI differentiated tumors from hemorrhages, which showed no signal increase.
Conclusions:
- Gadolinium-enhanced MRI is valuable for diagnosing and characterizing intraocular tumors.
- Enhanced MRI facilitates monitoring of uveal melanoma treatment response.
- The technique aids in distinguishing neoplastic lesions from non-neoplastic conditions like hemorrhage.