Hepatic Ultrasonography Compared with Computed Tomography and Magnetic Resonance Imaging at Diagnosis of Metastatic Uveal Melanoma

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Rantala , E S , Peltola , E , Helminen , H , Hernberg , M & Kivelä , T T 2020 , ' Hepatic Ultrasonography Compared with Computed Tomography and Magnetic Resonance Imaging at Diagnosis of Metastatic Uveal Melanoma ' , American Journal of Ophthalmology , vol. 216 , pp. 156-164 . https://doi.org/10.1016/j.ajo.2020.03.049

Title: Hepatic Ultrasonography Compared with Computed Tomography and Magnetic Resonance Imaging at Diagnosis of Metastatic Uveal Melanoma
Author: Rantala, Elina S.; Peltola, Erno; Helminen, Hanne; Hernberg, Micaela; Kivelä, Tero T.
Contributor: University of Helsinki, Department of Ophthalmology and Otorhinolaryngology
University of Helsinki, HUS Medical Imaging Center
University of Helsinki, Faculty of Medicine
University of Helsinki, HUS Comprehensive Cancer Center
University of Helsinki, Department of Ophthalmology and Otorhinolaryngology
Date: 2020-08-01
Language: eng
Number of pages: 9
Belongs to series: American Journal of Ophthalmology
ISSN: 0002-9394
URI: http://hdl.handle.net/10138/318855
Abstract: Purpose To evaluate the consistency of hepatic ultrasonography (US) with staging computed tomography (CT) and magnetic resonance imaging (MRI), to analyze why US was inconsistent with CT/MRI, and to compare CT/MRI. DESIGN Reliability analysis. METHODS Two hundred fifteen patients whose primary uveal melanoma was managed in the Helsinki University Hospital and who were diagnosed with hepatic metastases by US within 60 days of staging CT/MRI from January 1999 to December 2016, were included. Patients attended a real-life follow-up schedule including hepatic US, liver function tests (LFT), and a confirmatory CT/MRI. We evaluated the consistency of US with staging CT/MRI regarding the presence and number of metastases. RESULTS The enrolled patients underwent 215 US, 167 CT, and 69 MRI examinations, and 67% of them had biopsy-confirmed metastases. Screening was regular for 98% of the patients, and 66% were asymptomatic. US was fully consistent with CT/MRI in detecting metastases in 113 (53%) patients, in 63 (29%) CT/MRI showed more metastases, and in 16 (7%) less metastases than US. CT/MRI was inconsistent with US in 23 (11%) patients. The sensitivity of US in detecting metastases was 96% (95% confidence interval, 92-98). US failed to suggest metastases in 10 patients. LFT were abnormal in six of them, and a newly-detected hepatic lesion was present by US in four. CONCLUSIONS Hepatic US is a sensitive screening modality in detecting metastases in patients with primary uveal melanoma, if combined with LFT and in case of any new detected lesion, a confirmatory MRI.
Subject: 3122 Cancers
3125 Otorhinolaryngology, ophthalmology
COLLABORATIVE OCULAR MELANOMA
LIVER METASTASES
CHOROIDAL MELANOMA
MALIGNANT-MELANOMA
ABNORMALITIES
SURVEILLANCE
VALIDATION
GUIDELINES
MRI
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