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. 2008 Jul;22(7):948-52.
doi: 10.1038/sj.eye.6702783. Epub 2007 Mar 16.

Demonstrating circulation in vasculogenic mimicry patterns of uveal melanoma by confocal indocyanine green angiography

S Frenkel  1 , I Barzel, J Levy, A Y Lin, D-U Bartsch, D Majumdar, R Folberg, J Pe'er
Affiliations

Demonstrating circulation in vasculogenic mimicry patterns of uveal melanoma by confocal indocyanine green angiography

S Frenkel et al. Eye (Lond). 2008 Jul.

Abstract

Purpose: Vasculogenic mimicry patterns, formed by highly invasive melanoma cells, connect to endothelial cell-lined blood vessels and contain fluid in vitroand in vivo. This study was designed to determine if fluid leaks into vasculogenic mimicry patterns without circulation, or if fluid circulates in and clears from these patterns.

Methods: Indocyanine green (ICG) laser scanning confocal angiography (Heidelberg Retinal Angiograph (HRA); Heidelberg Engineering, Heidelberg, Germany) was performed on nine patients with posterior choroidal melanoma in an institutional setting. Blood was drawn before the ICG injection and from the contralateral arm of the ICG injection site and 1 min after the injection. Outcome measures include time to first filling of retinal vessels and vasculogenic mimicry patterns and the time at which no fluorescence could be detected by the HRA instrument. After fluorescence was no longer detected in vessels or patterns, the tubes containing the patient's blood was imaged by the Heidelberg HRA.

Results: Looping vasculogenic mimicry patterns were detected focally in five patients within 30 s after injection and were detectable up to 12 min post-injection. Blood drawn before ICG injection did not autofluoresce but ICG-containing blood pooled in the tube continued to fluoresce at 1-month post-injection.

Conclusions: Vasculogenic mimicry patterns are not part of the endothelial cell-lined vascular system and fluid enters these patterns through leakage. The rapid infusion of ICG into these patterns after injection and the disappearance of fluorescence detectable by the Heidelberg HRA suggest that fluid circulates in these patterns and does not accumulate as a stagnant pool.

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Figures

Figure 1
Figure 1
Vasculogenic mimicry loops are shown within a posterior choroidal melanoma (arrow) in this 20° x 20° confocal ICG image taken at 4:27 minutes after ICG injection.
Figure 2
Figure 2
A 10° x 10° confocal ICG image of the same tumor from Figure 1 taken at 11:08 minutes after the ICG injection. No fluorescence is visible within the vasculogenic mimicry loops (arrow).
Figure 3
Figure 3
Blood was drawn from the patient 1 minute before and after the ICG injection. A 30° x 30° confocal ICG image taken was taken with the HRA at 11:54 minutes after the ICG injection under the same condition as the angiogram. Blood drawn before the ICG injection (arrow) does not fluoresce. Blood drawn after the injection, positioned to the right of the non-fluorescent tube, continued to fluoresce for 4 weeks after the injection. In the insert, the outline of the tube that contains blood that did not fluoresce is traced in white.
See this image and copyright information in PMC

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