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Diffusion-weighted imaging (DWI) highlights SDHB-related tumours: A pilot study

Nicola Tufton1,2, Gemma White1, William M Drake1,2

  • 1Department of Endocrinology, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK.

Clinical Endocrinology
|April 2, 2019
PubMed
Abstract

Insights

Diffusion-weighted imaging (DWI) enhances MRI surveillance for SDHB mutation carriers, effectively detecting small phaeochromocytomas and paragangliomas (PPGLs) without radiation exposure.

Area of Science:

  • Radiology
  • Oncology
  • Genetics

Background:

  • Asymptomatic carriers of SDHB mutations require regular surveillance imaging.
  • MRI offers radiation-free imaging but its efficacy for detecting phaeochromocytoma and paraganglioma (PPGL) depends on specific sequences and radiologist expertise.
  • Diffusion-weighted imaging (DWI) shows promise in improving MRI's sensitivity for PPGL detection.

Purpose of the Study:

  • To evaluate the added value of diffusion-weighted imaging (DWI) in MRI-based surveillance for SDHB mutation carriers.
  • To demonstrate DWI's capability in identifying small PPGLs across various body locations.

Main Methods:

  • Expert radiologists reviewed MRI scans of 18 SDHB mutation carriers, focusing on DWI sequences.
  • High-signal areas on DWI were further analyzed using standard MRI sequences.
  • The study included 18 confirmed SDHB-related tumors and 12 presumed PGLs/metastatic deposits.

Main Results:

  • DWI successfully identified all 30 lesions, including small tumors ranging from 5 to 52 mm.
  • PPGLs were detected by DWI in the abdomen, adrenal gland, thorax, neck, and bladder.
  • DWI also highlighted other SDHB-related tumors (GIST, RCC) and metastatic deposits in the liver and bone.

Conclusions:

  • Preliminary data indicate DWI possesses high sensitivity for detecting small SDHB-related tumors.
  • Further validation in larger cohorts, including all SDH subunits, is warranted.
  • DWI could enhance the role of MRI in surveillance, providing reassurance without radiation risks.
Keywords:
DWIMRISDHimagingparagangliomasurveillance

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