Introduction
Brachytherapy with iodine-125 (125I) has been extensively used as a conservative treatment for uveal melanoma (UM). Surgical technique for correct placement of episcleral radioactive plaques (ERP) in UM cases with posterior choroidal location and/or small size can be difficult and inaccurate. In this study, the correct positioning of plaques was assessed by intra-operative ultrasound control.

Material and methods
This was a longitudinal, retrospective study of consecutive 20 patients with UM (small-medium size and/or posterior location) who received 125I brachytherapy. Location of plaques was adjusted by intra-operative ocular ultrasonography control. To perform ocular intra-operative ultrasonography, a 10 MHz probe was used to longitudinal and transverse bases in corresponding dummy plaques.

Results
The study included 8 males and 12 females, with a mean age of 66.3 years (SD = 14.53), 5 right eyes (RE) and 15 left eyes (LE). In ultrasound examination, 4 UMs were of mushroom morphology and the rest nodular. Means of the size of UM by ultrasound were (mm): Lb: 10.60 (SD = 2.24) × Tb: 9.88 (SD = 1.54) × H: 4.02 (SD = 1.44) (3 cases corresponding to small size of collaborative ocular melanoma study (COMS), and 17 cases to medium). The plaques used were between 14 and 20 mm in diameter, with an average distance between the edge of greater base of the tumor and the edge of plate of 2.44 mm (SD = 0.34). It was necessary to surgically reposition the plaque in 4 cases (20%).

Conclusions
Intra-operative ultrasound control improves the accuracy of radioactive plaque placement for the treatment of medium-small UMs in posterior location. Probably, this technique should be applied in all cases of brachytherapy, regardless of the isotope chosen and the location of tumor mass, in order to perfectly adjust therapeutic position.



中文翻译：

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葡萄膜黑色素瘤患者碘125近距离放射治疗斑块的术中眼部超声检查

简介
碘 125 (125I) 近距离放射治疗已被广泛用作葡萄膜黑色素瘤 (UM) 的保守治疗。在具有后脉络膜位置和/或小尺寸的 UM 病例中正确放置巩膜外放射性斑块 (ERP) 的手术技术可能很困难且不准确。在这项研究中，通过术中超声控制评估斑块的正确定位。

材料与方法
这是一项对连续 20 名接受 125I 近距离放射治疗的 UM（中小型和/或后部位置）患者进行的纵向回顾性研究。通过术中眼部超声控制调整斑块的位置。为了进行眼部术中超声检查，使用 10 MHz 探头对相应假斑块中的纵向和横向基底进行检查。

结果
该研究包括 8 名男性和 12 名女性，平均年龄为 66.3 岁（SD = 14.53），5 只右眼（RE）和 15 只左眼（LE）。超声检查发现4个UM呈蘑菇状，其余呈结节状。超声检查 UM 大小的平均值为（mm）：Lb：10.60（SD = 2.24）×Tb：9.88（SD = 1.54）×H：4.02（SD = 1.44）（3例对应于小尺寸协同眼部黑色素瘤研究（COMS），17 例中等）。使用的斑块直径在 14 至 20 mm 之间，肿瘤大基底边缘与板边缘之间的平均距离为 2.44 mm (SD = 0.34)。4 例 (20%) 需要手术重新定位斑块。

结论
术中超声控制提高了放射性斑块放置的准确性，用于治疗后部位置的中小型 UM。很可能，无论选择的同位素和肿瘤块的位置如何，这种技术都应该应用于所有近距离放射治疗的情况，以便完美地调整治疗位置。