Angiogenesis has an essential role in the de novo evolution of choroidal melanoma as well as choroidal nevus transformation into melanoma. Differentiating early-stage melanoma from nevus is of high clinical importance; thus, imaging techniques that provide objective information regarding tumor microvasculature structures could aid accurate early detection. Herein, we investigated the feasibility of quantitative high-definition microvessel imaging (qHDMI) for differentiation of choroidal tumors in humans. This new ultrasound-based technique encompasses a series of morphological filtering and vessel enhancement techniques, enabling the visualization of tumor microvessels as small as 150 microns and extracting vessel morphological features as new tumor biomarkers. Distributional differences between the malignant melanomas and benign nevi were tested on 37 patients with choroidal tumors using a non-parametric Wilcoxon rank-sum test, and statistical significance was declared for biomarkers withp-values < 0.05. The ocular oncology diagnosis was choroidal melanoma (malignant) in 21 and choroidal nevus (benign) in 15 patients. The mean thickness of benign and malignant masses was 1.70 ± 0.40 mm and 3.81 ± 2.63 mm, respectively. Six HDMI biomarkers, including number of vessel segments (p= 0.003), number of branch points (p= 0.003), vessel density (p= 0.03), maximum tortuosity (p= 0.001), microvessel fractal dimension (p= 0.002), and maximum diameter (p= 0.003) exhibited significant distributional differences between the two groups. Contrast-free HDMI provided noninvasive imaging and quantification of microvessels of choroidal tumors. The results of this pilot study indicate the potential use of qHDMI as a complementary tool for characterization of small ocular tumors and early detection of choroidal melanoma.
血管生成在脉络膜黑色素瘤的新生演化以及脉络膜痣向黑色素瘤转化过程中具有关键作用。区分早期黑色素瘤与痣具有重要的临床意义；因此，能够提供肿瘤微血管结构客观信息的成像技术有助于实现精准的早期检测。本研究探讨了定量高清微血管成像技术用于人类脉络膜肿瘤鉴别的可行性。这项基于超声的新型技术整合了一系列形态学滤波和血管增强技术，可清晰显示小至150微米的肿瘤微血管，并提取血管形态特征作为新型肿瘤生物标志物。通过对37例脉络膜肿瘤患者采用非参数Wilcoxon秩和检验，分析恶性黑色素瘤与良性痣的分布差异，将p值<0.05的生物标志物定义为具有统计学显著性。眼科肿瘤学诊断结果显示：21例为脉络膜黑色素瘤（恶性），15例为脉络膜痣（良性）。良性与恶性肿物的平均厚度分别为1.70±0.40毫米和3.81±2.63毫米。六项HDMI生物标志物在两组间呈现显著分布差异，包括血管段数量（p=0.003）、分支点数量（p=0.003）、血管密度（p=0.03）、最大迂曲度（p=0.001）、微血管分形维度（p=0.002）及最大直径（p=0.003）。无造影剂HDMI技术实现了脉络膜肿瘤微血管的无创成像与定量分析。这项初步研究结果表明，qHDMI有望成为小型眼部肿瘤特征化描述及脉络膜黑色素瘤早期检测的辅助工具。
肿瘤(癌症)患者之家