Correlation of the ICG-angiographical Presence of Complex Microcirculation Patterns With the Regression Rate of Uveal Melanomas Following Brachytherapy

Abstract

Abstract: : Purpose:The post irradiation regression rate of uveal melanomas is a prognostically significant factor for the development of metastases. Other factors are complex microcirculation patterns which are also imageable with confocal indocyanine-green-angiography (ICGA). Purpose of our study was to evaluate a possible correlation of networks in the ICGA and the tumor regression rate following brachytherapy. Methods:We compared post irradiation regression rates (in percent) in 20 patients at one year after brachytherapy with the presence of complex microcirculation patterns identified in the preoperative ICGA. With Ru-106 were irradiated 10 patients and with I-125 were irradiated 10 patients. Results:The preoperative mean maximum apical tumor height was 5.2 mm (SD: 1.5 mm; Ru-106 group: 5.7 mm (SD: 1.0 mm); I-125 group: 5.0 mm (SD: 1.9 mm)). In 11 (55 %) patients we found complex microcirculation patterns in the preoperative ICGA. The mean regression rate in tumors with complex microcirculation patterns was 51.3 % (SD: 14.7 %) and in tumors without complex microcirculation patterns 28.0 % (SD: 16.4 %). The difference between both groups was statistically significant (p = 0.003, Mann-Whitney -Test) Conclusion:The postirradiation regression rate was statistically significantly faster in those tumors with complex microcirculation patterns in the preoperative ICG. Our observation emphasizes a correlation between networks in the ICGA and its prognostic significance for developing metastases.

Keywords: 610 tumors • 464 melanoma • 430 imaging/image analysis: clinical