Ultrahigh field magnetic resonance and colour Doppler real-time fusion imaging of the orbit--a hybrid tool for assessment of choroidal melanoma.

OBJECTIVES: A combination of magnetic resonance images with real-time high-resolution ultrasound known as fusion imaging may improve ophthalmologic examination. This study was undertaken to evaluate the feasibility of orbital high-field magnetic resonance and real-time colour Doppler ultrasound image fusion and navigation.

METHODS: This case study, performed between April and June 2013, included one healthy man (age, 47 years) and two patients (one woman, 57 years; one man, 67 years) with choroidal melanomas. All cases underwent 7.0-T magnetic resonance imaging using a custom-made ocular imaging surface coil. The Digital Imaging and Communications in Medicine volume data set was then loaded into the ultrasound system for manual registration of the live ultrasound image and fusion imaging examination.

RESULTS: Data registration, matching and then volume navigation were feasible in all cases. Fusion imaging provided real-time imaging capabilities and high tissue contrast of choroidal tumour and optic nerve. It also allowed adding a real-time colour Doppler signal on magnetic resonance images for assessment of vasculature of tumour and retrobulbar structures.

CONCLUSIONS: The combination of orbital high-field magnetic resonance and colour Doppler ultrasound image fusion and navigation is feasible. Multimodal fusion imaging promises to foster assessment and monitoring of choroidal melanoma and optic nerve disorders.

KEY POINTS: • Orbital magnetic resonance and colour Doppler ultrasound real-time fusion imaging is feasible • Fusion imaging combines the spatial and temporal resolution advantages of each modality • Magnetic resonance and ultrasound fusion imaging improves assessment of choroidal melanoma vascularisation.