Magnetic resonance spectroscopy of paragangliomas: new insights into in vivo metabolomics
- Arthur Varoquaux1⇑,
- Yann le Fur2,
- Alessio Imperiale3,4,
- Antony Reyre1,
- Marion Montava5,
- Nicolas Fakhry6,
- Izzie-Jacques Namer3,4,
- Guy Moulin1,
- Karel Pacak7,
- Maxime Guye1,2 and
- David Taïeb8,9,10⇑
- 1Department of Medical Imaging, La Timone University Hospital, Aix‐Marseille University, Marseille, France
2CNRS, CRMBM UMR 7339, Aix‐Marseille University, 13385 Marseille, France
3Department of Biophysics and Nuclear Medicine, University Hospitals of Strasbourg, Strasbourg, France
4ICube, UMR 7357, Faculty of Medicine, University of Strasbourg/CNRS and FMTS, Strasbourg, France
5Department of Otorhinolaryngology–Head and Neck Surgery, North Hospital, Aix-Marseille University, Marseille, France
6Department of Otorhinolaryngology–Head and Neck Surgery, La Timone University Hospital, Aix-Marseille University, Marseille, France
7Program in Reproductive and Adult Endocrinology, <ce:italic>Eunice Kennedy Shriver</ce:italic> National Institute of Child Health and Human Development (NICHD), National Institutes of Health, Bethesda, Maryland 20892, USA
8Department of Nuclear Medicine, La Timone University Hospital, Aix‐Marseille University, Marseille, France
9Biophysics and Nuclear Medicine, European Center for Research in Medical Imaging, La Timone University Hospital, Aix‐Marseille University, 264, Rue Saint‐Pierre, 13385 Marseille, France
10INSERM, UMR1068, Institut Paoli‐Calmettes, Marseille Cancerology Research Center, Marseille, France
- Correspondence should be addressed to D Taïeb; or A Varoquaux Emails: david.taieb{at}ap-hm.fr or DamienArthur.VAROQUAUX{at}ap-hm.fr)
Abstract
Paragangliomas (PGLs) can be associated with mutations in genes of the tricarboxylic acid (TCA) cycle. Succinate dehydrogenase (SDHx) mutations are the prime examples of genetically determined TCA cycle defects with accumulation of succinate. Succinate, which acts as an oncometabolite, can be detected by ex vivo metabolomics approaches. The aim of this study was to evaluate the potential role of proton magnetic resonance (MR) spectroscopy (1H-MRS) for identifying SDHx-related PGLs in vivo and noninvasively. Eight patients were prospectively evaluated with single voxel 1H-MRS. MR spectra from eight tumors (four SDHx-related PGLs, two sporadic PGLs, one cervical schwannoma, and one cervical neurofibroma) were acquired and interpreted qualitatively. Compared to other tumors, a succinate resonance peak was detected only in SDHx-related tumor patients. Spectra quality was considered good in three cases, medium in two cases, poor in two cases, and uninterpretable in the latter case. Smaller lesions had lower spectra quality compared to larger lesions. Jugular PGLs also exhibited a poorer spectra quality compared to other locations. 1H-MRS has always been challenging in terms of its technical requisites. This is even more true for the evaluation of head and neck tumors. However, 1H-MRS might be added to the classical MR sequences for metabolomic characterization of PGLs. In vivo detection of succinate might guide genetic testing, characterize SDHx variants of unknown significance (in the absence of available tumor sample), and even optimize a selection of appropriate therapies.
- Revision received 17 June 2015
- Accepted 23 June 2015
- Made available online as an Accepted Preprint 26 June 2015
- © 2015 Society for Endocrinology
