Johannes T. Heverhagen PhD, Presenter: Nothing to Disclose

Hendrik von Tengg-Kobligk MD, Abstract Co-Author: Nothing to Disclose

Mohamed Abdel-Rahman MD, Abstract Co-Author: Nothing to Disclose

Elson L Craig MD, Abstract Co-Author: Nothing to Disclose

Fredrick H Davidorf MD, Abstract Co-Author: Nothing to Disclose

Michael Vinzenz Knopp MD, Abstract Co-Author: Nothing to Disclose

Guang Jia, Abstract Co-Author: Nothing to Disclose

Klaus T Baudendistel PhD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

To demonstrate the feasibility and potential clinical utility of dynamic contrast enhanced (DCE) MRI to assess ocular lesions using standard clinical MRI systems.

22 patients with ocular lesions and clinical suspicion of malignant melanomas, hemangiomas and, metastases underwent DCE-MRI using a Gd-chelate (Omniscan, Amersham, 0.1 mmol/kg, 0.6 mL/s). Studies were performed on 1.5T clinical systems (GE, Milwaukee, WI) using a fast 3D-SPGR sequence (TR: 6.9ms, TE: 2.5ms, FA: 25º, 12 slices, Acquisition time: 15s, 32 time points). A surface coil was placed above the eye in order to maximize the signal to noise ratio. Dynamic imaging data were post processed for qualitative and quantitative assessment including pharmacokinetic mapping for visualization. For objective data analysis, a blinded assessment was performed. Definite diagnosis was obtained by surgical enucleation with histological correlation in 9 patients with bulky tumors. After an initial comparative pilot evaluation, no pharmacological orbital muscle blockade was performed.

DCE-MRI was sucessfully performed and quantified in all cases. Malignant melanomas revealed a rapid and strong initial enhancement followed by a fast washout within active intratumoral regions which could be differentiated from intratumoral necrotic areas with contrast agent trapping. However, metastases did not reveal a different enhancemnet profile and could not be distinguished from malignant melanomas by DCE MRI alone. Even small ocular hemangiomas were destinctively delineated based on their rapid and strong enhancement during the dynamic series. The imaging based findings were in close agreement with histology when available. As expected, characteristic contrast enhancement patterns were established for different tissue including non-diseased areas.

DCE-MRI of ocular lesions is feasible on standard MR systems and appears to be a valuable diagnostic adjunct for supplementing morphologic information with the microvascular properties of intraocular tumors.

Heverhagen, J, von Tengg-Kobligk, H, Abdel-Rahman, M, Craig, E, Davidorf, F, Knopp, M, Jia, G, Baudendistel, K, et al, , Tumors of the Orbit: Assessment with Dynamic Contrast-enhanced MRI.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4407395.html