Multimodal Imaging in Choroidal Metastasis

Abstract

Background: Choroidal metastasis represent the most common malignant intraocular tumours. Objectives: To detect the structural and vascular features of choroidal metastasis by multimodal imaging. Methods: Sixteen eyes of 16 patients with choroidal metastasis were enrolled in this prospective study. The multimodal imaging was performed in all patients: fluorescein angiography, indocyanine green angiography, enhanced depth imaging optical coherence tomography (EDI-OCT), OCT angiography (OCTA) and ultrasonography. Results: The choroidal metastasis were located in the macula region in 9 eyes (57%) and in the extramacular region in 7 eyes (43%). EDI-OCT showed a mean thickness of 950 ± 246 µm, a smooth anterior tumour surface in 5 eyes (31%) and a lumpy bumpy appearance in 11 eyes (69%). The most frequent EDI-OCT features were represented by choriocapillaris thinning (100%), shaggy photoreceptors (82%), subretinal fluid with speckles (69%), subretinal lipofuscin pigment (6%), absence of drusen (100%), optical shadowing (94%), low internal optical reflectivity (75%) and retinal pigment epithelium alterations (43%). OCTA revealed an absence of intratumoral vascular network in all cases.

Multimodal imaging features of choroidal metastasis of non-small-cell lung cancer: a case report

“…Indocyanine green angiography can delineate a broader border of CM that is otherwise not visible on clinical examination, whereas fluorescein angiography can distinguish CM from choroidal melanoma based on the absence of dual circulation. 6,7 Our patient demonstrated classical findings of CM on MRI; the CM appears as a well-defined mass iso-to hyper-intense on T1-weighted images and hypointense on T2-weighted images. High-resolution MRI may differentiate CM from primary ocular tumor.…”

Multimodal imaging features of choroidal metastasis of non-small-cell lung cancer: a case report

“…Indocyanine green angiography can delineate a broader border of CM that is otherwise not visible on clinical examination, whereas fluorescein angiography can distinguish CM from choroidal melanoma based on the absence of dual circulation. 6,7 Our patient demonstrated classical findings of CM on MRI; the CM appears as a well-defined mass iso-to hyper-intense on T1-weighted images and hypointense on T2-weighted images. High-resolution MRI may differentiate CM from primary ocular tumor.…”

Choroidal metastases from thoracic cancer: a retrospective study on clinical characteristics and treatment efficacy

“…While CM is typically associated with systemic cancer spread, it may also represent the initial symptom of an unknown primary tumor or the first sign of recurrence in a previously diagnosed primary cancer. The clinical diagnosis of CM primarily depends on the patient’s medical history, clinical presentation, indirect ophthalmoscopic examination, and multimodal imaging techniques ( 9 ). In cases where patients present with ocular symptoms but lack a known tumor history, comprehensive systemic cancer screening, in collaboration with relevant specialties, is essential.…”

Clinical and Multimodal Imaging Study to Differentiate Amelanotic Choroidal Lesions

“…With the introduction of multimodal imaging, various studies have shown the utility of retinal imagining to differentiate these conditions simulating amelanotic choroidal lesions. However, these studies are very few and limited to case reports and short case series [1,2,5,[8][9][10]13]. Considering the limitations of tumor biopsy (inadequate sampling, false negatives, and need for expert skills), we aimed to study the various clinical and multimodal imaging clues to differentiate these three lesions simulating amelanotic choroidal lesions.…”

Multimodal imaging features of choroidal metastasis of non-small-cell lung cancer: a case report

“…Indocyanine green angiography can delineate a broader border of CM that is otherwise not visible on clinical examination, whereas fluorescein angiography can distinguish CM from choroidal melanoma based on the absence of dual circulation. 6,7 Our patient demonstrated classical findings of CM on MRI; the CM appears as a well-defined mass iso-to hyper-intense on T1-weighted images and hypointense on T2-weighted images. High-resolution MRI may differentiate CM from primary ocular tumor.…”

Choroidal metastases from thoracic cancer: a retrospective study on clinical characteristics and treatment efficacy

“…While CM is typically associated with systemic cancer spread, it may also represent the initial symptom of an unknown primary tumor or the first sign of recurrence in a previously diagnosed primary cancer. The clinical diagnosis of CM primarily depends on the patient’s medical history, clinical presentation, indirect ophthalmoscopic examination, and multimodal imaging techniques ( 9 ). In cases where patients present with ocular symptoms but lack a known tumor history, comprehensive systemic cancer screening, in collaboration with relevant specialties, is essential.…”

Clinical and Multimodal Imaging Study to Differentiate Amelanotic Choroidal Lesions

“…With the introduction of multimodal imaging, various studies have shown the utility of retinal imagining to differentiate these conditions simulating amelanotic choroidal lesions. However, these studies are very few and limited to case reports and short case series [1,2,5,[8][9][10]13]. Considering the limitations of tumor biopsy (inadequate sampling, false negatives, and need for expert skills), we aimed to study the various clinical and multimodal imaging clues to differentiate these three lesions simulating amelanotic choroidal lesions.…”

Multimodal imaging features of choroidal metastasis of non-small-cell lung cancer: a case report

“…Indocyanine green angiography can delineate a broader border of CM that is otherwise not visible on clinical examination, whereas fluorescein angiography can distinguish CM from choroidal melanoma based on the absence of dual circulation. 6,7 Our patient demonstrated classical findings of CM on MRI; the CM appears as a well-defined mass iso-to hyper-intense on T1-weighted images and hypointense on T2-weighted images. High-resolution MRI may differentiate CM from primary ocular tumor.…”

Choroidal metastases from thoracic cancer: a retrospective study on clinical characteristics and treatment efficacy

“…While CM is typically associated with systemic cancer spread, it may also represent the initial symptom of an unknown primary tumor or the first sign of recurrence in a previously diagnosed primary cancer. The clinical diagnosis of CM primarily depends on the patient’s medical history, clinical presentation, indirect ophthalmoscopic examination, and multimodal imaging techniques ( 9 ). In cases where patients present with ocular symptoms but lack a known tumor history, comprehensive systemic cancer screening, in collaboration with relevant specialties, is essential.…”

Clinical and Multimodal Imaging Study to Differentiate Amelanotic Choroidal Lesions

“…With the introduction of multimodal imaging, various studies have shown the utility of retinal imagining to differentiate these conditions simulating amelanotic choroidal lesions. However, these studies are very few and limited to case reports and short case series [1,2,5,[8][9][10]13]. Considering the limitations of tumor biopsy (inadequate sampling, false negatives, and need for expert skills), we aimed to study the various clinical and multimodal imaging clues to differentiate these three lesions simulating amelanotic choroidal lesions.…”