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Sensitivity of Magnetic Resonance Imaging in Detection of Choroidal Metastases.

Authors :
Yu MD
Miller S
Ghoraba H
Sabage LE
Fischbein NJ
Mruthyunjaya P
Source :
Ocular oncology and pathology [Ocul Oncol Pathol] 2024 Jun; Vol. 10 (2), pp. 80-87. Date of Electronic Publication: 2024 Feb 20.
Publication Year :
2024

Abstract

Introduction: The objective of this study was to determine the sensitivity of brain magnetic resonance imaging (MRI) in the detection of choroidal metastasis (CM) from systemic primary cancers.<br />Methods: A retrospective chart review identified patients with clinically confirmed CM seen on the Oncology Service (Byers Eye Institute) between January 2018 and March 2022. Patients had an MRI brain and/or orbits performed within 3 months of CM diagnosis. Evaluation of CM detection by MRI was then divided into two parts: an initial "standard read," where determination of CM detection was based solely on the original radiology report, to reflect real-world performance, and a subsequent "dedicated read," for which a board-certified neuroradiologist, blinded to the laterality and location of the CM, reevaluated the studies to provide an objective "gold standard" interpretation regarding the radiographic detection of CM.<br />Results: The study included 42 eyes of 40 patients with confirmed CM. On standard read, MRI detection of CM occurred in 21 of 42 eyes (50%), with no significant difference between MRI brain and orbit protocols ( p = 0.249). Features associated with improved detection were increased tumor basal diameter ( p < 0.001) and ultrasonographic tumor thickness ( p = 0.003). On dedicated read, MRI detection of CM improved to 26 of 33 eyes (76%; limited to eyes with full complement of pre- and post-gadolinium sequences). Post-gadolinium 3D fluid-attenuated inversion recovery (FLAIR) sequence with fat suppression was the most sensitive (88%) for CM detection. 42% and 58% of lesions were visualized using conventional pre-gadolinium T1- and T2-weighted imaging, respectively.<br />Conclusions: MRI sensitivity to detect CM improved from 50% to 76% with focused reinterpretation. Increased utilization of the post-gadolinium 3D FLAIR sequence and increased ocular scrutiny in cancer patients undergoing brain imaging may facilitate earlier diagnosis of CM.<br />Competing Interests: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.<br /> (© 2024 The Author(s). Published by S. Karger AG, Basel.)

Details

Language :
English
ISSN :
2296-4681
Volume :
10
Issue :
2
Database :
MEDLINE
Journal :
Ocular oncology and pathology
Publication Type :
Academic Journal
Accession number :
38882019
Full Text :
https://doi.org/10.1159/000537949