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Pixel Intensity to Estimate Choroidal Tumor Thickness Using 2-Dimensional Ultra-Widefield Images
Michael D Yu1, Michael Heiferman1, Edward Korot1
1Ocular Oncology Service, Byers Eye Institute, Stanford University, Palo Alto, California.
JAMA Ophthalmology
|February 6, 2025
Summary
Tumor thickness in melanocytic choroidal lesions (MCLs) can now be estimated using Optomap ultra-widefield images. This novel technique correlates pixel intensity difference (PID) with tumor thickness, offering a rapid alternative to B-scan ultrasonography.
Area of Science:
- Ophthalmology
- Medical Imaging
- Oncology
Background:
- Tumor thickness is a critical risk factor for malignant transformation of choroidal nevi into melanoma.
- Accurate tumor thickness evaluation typically requires B-scan ultrasonography, which is not always available in non-specialty clinics.
- Melanocytic choroidal lesions (MCLs) are often first diagnosed in settings lacking specialized equipment.
Purpose of the Study:
- To introduce a novel technique for estimating MCL thickness using only Optomap ultra-widefield (UWF) images.
- To assess the potential for rapid and reliable thickness estimation without B-scan ultrasonography.
- To investigate the correlation between MCL thickness and pixel intensity on UWF images.
Main Methods:
- A retrospective analysis of 138 MCLs was conducted.
- Quantitative correlation between B-scan ultrasonographic thickness and green-channel (GC) Optomap UWF image pixel intensity difference (PID) was investigated.
- Linear regression analysis was used to correlate PID with ultrasonographic tumor thickness.
Main Results:
- A strong correlation was found between ultrasonographic tumor thickness and PID (R² = 0.823, P < .001).
- Mean PID increased significantly with increasing mean tumor thickness across different lesion size strata (P < .001).
- The developed regression model demonstrated good performance in estimating tumor thickness.
Conclusions:
- Green-channel derived lesion intensity from UWF Optomap images correlates well with ultrasonographic tumor thickness.
- This study demonstrates a viable technique for rapid and reliable estimation of MCL tumor thickness using UWF images.
- The technique offers a valuable alternative for settings where B-scan ultrasonography is unavailable.
