MRI in Diagnosing Solid Tumors of the Eye and Orbit

PRIMARY OBJECTIVES:

I. To determine the feasibility of DCE-MRI (dynamic contrast enhanced magnetic resonance imaging) as non-invasive imaging tool to image contrast enhancement in ocular and orbital tumors.

II. To compare contrast enhancement and its distribution within orbital tissue. III. To assess potential differences in contrast enhancement which help to characterize malignant lesions as well as discriminate these from benign tissue.

IV. To compare image characteristics between clinical high field end ex-vivo ultra high field magnetic resonance (MR) imaging.

V. To correlate imaging findings with obtained histology by comparing contrast enhancement parameters, e.g. maximum signal intensity, to histology characteristics, e.g. vascular density.

OUTLINE:

Patients undergo DCE-MRI.

After completion of study treatment, patients are followed up every 6 months for up to 5 years.

Inclusion criteria

• The patient has an orbital mass which needs further diagnostic evaluation before treatment or for monitoring
• Able to give informed consent
• Return for follow-up visits

Exclusion criteria

• Patients with a lesion < 2 mm
• The patient should not participate in this study is any of the following applies to the patient: the patients has a pacemaker, metallic cardiac valve(s), magnetic material such as surgical clips, implanted electronic infusion pumps or any other condition that would interfere with the MRI, the patient has a stent somewhere in the body, the patient has a history of allergic reaction to any metals, contrast agents, x-ray dyes, the patient has claustrophobia
• Patients cannot be pregnant and prisoners will not be considered for the study
• Exposure to gadolinium-based contrast agents increases the risk for nephrogenic systemic fibrosis (NSF) in patients with acute or severe renal dysfunction; therefore, patients with the following conditions are excluded from the study:

• Acute or chronic severe renal insufficiency (glomerular filtration rate < 30 mL/min/1.73 m^2)
• Acute renal dysfunction due to the hepato-renal syndrome or in the perioperative liver transplantation period
• In order to identify subjects at risk for the development of NSF, the American College of Radiology (http://acr.org) recommends obtaining a medical history and a glomerular filtration rate (GFR) assessment within six weeks of MR imaging in the following patients:

• Renal disease (including solitary kidney, renal transplant, renal tumor)
• Age > 60
• History of hypertension
• History of diabetes
• History of severe hepatic disease/liver transplant/pending liver transplant
• All subjects providing written informed consent will complete the subject history and screening form prior to MR imaging; the form will be reviewed to determine whether the subject is at risk as defined above and the availability of an estimated glomerular filtration rate (eGFR) within six weeks of anticipated MR imaging; an eGFR result greater than six weeks prior to the MRI imaging date will be repeated and evaluated for renal function; subjects with an eGFR of < 30 mL/min/1.73 m^2 will be excluded from the study