Magnetic resonance spectroscopy of paragangliomas: new insights into in vivo metabolomics.
Fiche publication
Date publication
juin 2015
Auteurs
Membres identifiés du Cancéropôle Est :
Pr NAMER Izzie-Jacques
Tous les auteurs :
Varoquaux A, Le Fur Y, Imperiale A, Reyre A, Montava M, Fakhry N, Namer IJ, Moulin G, Pacak K, Guye M, Taieb D
Lien Pubmed
Résumé
OBJECTIVE: Paragangliomas (PGLs) can be associated with mutations in genes of the tricarboxylic acid (TCA) cycle. Succinate dehydrogenase mutations (SDHx) 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 MR spectroscopy (167 H-MRS) for identifying SDHx-related PGLs in vivo and non-invasively. METHODS: Eight patients were prospectively evaluated with single voxel 168 H-MRS. MR spectra from 8 tumors (4 SDHx-related PGLs, 2 sporadic PGLs, 1 cervical schwannoma, and 1 cervical neurofibroma) were acquired and interpreted qualitatively. RESULTS: Compared to other tumors, a succinate resonance peak was detected only in SDHx72 related tumor patients. Spectra quality was considered good in 3 cases, medium in 2 cases, poor in 2 cases, and uninterpretable in the latter case. Smaller lesions had lower spectra quality compared to larger lesions. Jugular PGLs also exihibited a poorer spectra quality compared to other locations. CONCLUSIONS: 176 H-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, 177 H-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.
Référence
Endocr Relat Cancer. 2015 Jun 26. pii: ERC-15-0246.