July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Doppler-based angiography of retinoblastoma in diagnostic imaging of pediatric patients: clinical trials with a novel 1050nm OCT system
Author Affiliations & Notes
  • Oleg Nadiarnykh
    Physics, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
    VU MC, Amsterdam, Netherlands
  • Valentina Davidoiu
    Physics, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
  • Maximilian G. O. Gräfe
    Physics, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
  • Frank D Verbraak
    Vrije University Medical Center, Amsterdam, Netherlands
  • Machteld Bosscha
    Vrije University Medical Center, Amsterdam, Netherlands
  • Annette Moll
    Vrije University Medical Center, Amsterdam, Netherlands
  • Johannes De boer
    Physics, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
  • Footnotes
    Commercial Relationships   Oleg Nadiarnykh, None; Valentina Davidoiu, None; Maximilian Gräfe, None; Frank Verbraak, None; Machteld Bosscha, None; Annette Moll, None; Johannes De boer, Heidelberg Engineering (F), Vrije Universieit (P)
  • Footnotes
    Support  KIKA project # 111
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 5983. doi:
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      Oleg Nadiarnykh, Valentina Davidoiu, Maximilian G. O. Gräfe, Frank D Verbraak, Machteld Bosscha, Annette Moll, Johannes De boer; Doppler-based angiography of retinoblastoma in diagnostic imaging of pediatric patients: clinical trials with a novel 1050nm OCT system. Invest. Ophthalmol. Vis. Sci. 2018;59(9):5983.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Reliable differentiation in real time of the vital vs. benign tumor tissue is the main challenge for treatment of retinoblastoma (RB), a retinal malignancy occurring in infancy. Our ongoing observational clinical study uses the novel optical coherence tomography (OCT) imaging system specifically developed for pediatric retinoblastoma patients under anesthesia. We show for the first time angiography imaging of blood vasculature around RB tumors combined with 3D mapping of tissue structure at the 8-15 µm resolution with more diagnostic information.

Methods : The <4 year old RB patients were recruited over the period of 3 years from 15 annual cases in the Netherlands. The OCT imaging was done during the standard in-patient sessions.
OCT is a non-invasive optical modality yielding cross sectional images of tissue.The 3D visualization combined with angiographic capability is a powerful tool for assessment of various retinal abnormalities and effects from treatment. Our novel system with a handheld scanner and Doppler mode is implemented for children under inhalation anesthesia.

Results : We stress that only large structures are visible in a standard en-face view. 3D mapping of retinal morphology and blood vasculature with better contrast and resolution of Doppler OCT improves assessment offering more information for ambiguous cases. The angiographic image (1) composed from flow detection at every pixel of every B-scan shows clear difference between normal blood vessels in a healthy retina vs. the dense network of vessels within the tumor volume (top region), and absence of blood vessels in a stable benign mass (center, left). The two intensity-based B-scans taken along the orange lines are shown in fig.2 with segmentation lines for top surface and the RPE layer. A striking difference in tumor mass morphology is evident here.

Conclusions : We demonstrate the increased real-time diagnostic sensitivity for RB patients with the 3D morphology of retina at OCT resolution. We show Doppler-based angiography for the first time in pediatric RB patients as an additional imaging contrast in understanding and treating retinoblastoma.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

 

Angiography image from a patient with a previously treated RB tumor: excessive network of blood vessels in the recessed tumor volume (top); absence of blood vessels in a stable tumor mass diagnosed as benign (center, left). Scale bars: 0.25mm

Angiography image from a patient with a previously treated RB tumor: excessive network of blood vessels in the recessed tumor volume (top); absence of blood vessels in a stable tumor mass diagnosed as benign (center, left). Scale bars: 0.25mm

 

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