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Mihai R, De Crea C, Guerin C, Torresan F, Agcaoglu O, Simescu R, Walz MK. Surgery for advanced adrenal malignant disease: recommendations based on European Society of Endocrine Surgeons consensus meeting. Br J Surg 2024; 111:znad266. [PMID: 38265812 PMCID: PMC10805373 DOI: 10.1093/bjs/znad266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 08/02/2023] [Indexed: 01/25/2024]
Affiliation(s)
- Radu Mihai
- Churchill Cancer Centre, Oxford University Hospital NHS Foundation Trust, Oxford, UK
| | - Carmela De Crea
- Centro di Ricerca in Chirurgia delle Ghiandole Endocrine e dell’Obesità, Università Cattolica del Sacro Cuore, Rome, Italy
- Endocrine Surgery Unit, Hospital Fatebenefratelli Isola Tiberina—Gemelli Isola, Rome, Italy
| | - Carole Guerin
- Department of Endocrine and Metabolic Surgery, Aix-Marseille University, Hôpital de La Conception, Marseille, France
| | - Francesca Torresan
- Endocrine Surgery Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Orhan Agcaoglu
- Department of General Surgery, Koc University School of Medicine, Istanbul, Turkey
| | - Razvan Simescu
- Department of General and Endocrine Surgery, Medlife-Humanitas Hospital, Cluj-Napoca, Romania
| | - Martin K Walz
- Department of Surgery and Minimally Invasive Surgery, Kliniken Essen-Mitte, Essen, Germany
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Orsini A, Ferretti S, Tamborino F, Cicchetti R, Ciavarella D, Seccia B, Basilico R, Colasante A, Marchioni M, Schips L. Mastering bladder paraganglioma for optimal treatment: a case report of robot-assisted surgery. Ther Adv Urol 2024; 16:17562872241249603. [PMID: 38779495 PMCID: PMC11110518 DOI: 10.1177/17562872241249603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 04/08/2024] [Indexed: 05/25/2024] Open
Abstract
Bladder paraganglioma is a rare neuroendocrine neoplasm, either functional or non-functional, arising from the urinary bladder. Functional variants present with catecholamine-related symptoms, while non-functional variants pose diagnostic challenges, mimicking urothelial carcinoma. Misdiagnosis risks underscore the importance of accurate identification for appropriate patient management. In this case, a 52-year-old man, diagnosed incidentally with hypertension and reported occasional post-micturition tachycardia, underwent abdominal ultrasound for known hepatic cyst follow-up, revealing an oval hypoechoic bladder mass. Initial consideration of bladder urothelial carcinoma prompted further investigation with contrast-enhanced CT scan and cystoscopy that confirmed extrinsic mass nature, and subsequent robotic-assisted partial cystectomy was performed. Histologically, the removed mass exhibited characteristic features of bladder paraganglioma. Postoperative recovery was uneventful, with resolution of post-micturition tachycardia at 1 month. Follow-up includes endocrinological evaluation and a 6-month CT scan. In conclusion, bladder paraganglioma should be considered in para-vesical mass differentials. This case highlights the importance of meticulous history collection, even in asymptomatic patients, the need for a multidisciplinary approach for accurate diagnosis and management of this rare condition, and the robotic approach as a viable option.
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Affiliation(s)
- Angelo Orsini
- Department of Urology, SS Annunziata Hospital, ‘G. D’Annunzio’ University of Chieti, Via dei Vestini, Chieti, Italy
| | - Simone Ferretti
- Department of Medical, Oral and Biotechnological Sciences, ‘G. d’Annunzio’ University of Chieti, Urology Unit, Chieti, Italy
| | - Flavia Tamborino
- Department of Medical, Oral and Biotechnological Sciences, ‘G. d’Annunzio’ University of Chieti, Urology Unit, Chieti, Italy
| | - Rossella Cicchetti
- Department of Medical, Oral and Biotechnological Sciences, ‘G. d’Annunzio’ University of Chieti, Urology Unit, Chieti, Italy
| | - Davide Ciavarella
- Department of Medical, Oral and Biotechnological Sciences, ‘G. d’Annunzio’ University of Chieti, Urology Unit, Chieti, Italy
| | - Barbara Seccia
- Department of Neuroscience, Imaging and Clinical Sciences, ‘G. d’Annunzio’ University of Chieti, Chieti, Italy
| | - Raffaella Basilico
- Department of Medical, Oral and Biotechnological Sciences, ‘G. d’Annunzio’ University of Chieti, Radiology Unit, Chieti, Italy
| | | | - Michele Marchioni
- Department of Urology, SS Annunziata Hospital, ‘G. D’Annunzio’ University of Chieti, Via dei Vestini, Chieti 66100, Italy
| | - Luigi Schips
- Department of Medical, Oral and Biotechnological Sciences, ‘G. d’Annunzio’ University of Chieti, Urology Unit, Chieti, Italy
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Romero ÁB, Furtado FS, Sertic M, Goiffon RJ, Mahmood U, Catalano OA. Abdominal Positron Emission Tomography/Magnetic Resonance Imaging. Magn Reson Imaging Clin N Am 2023; 31:579-589. [PMID: 37741642 DOI: 10.1016/j.mric.2023.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/25/2023]
Abstract
Hybrid positron emission tomography (PET)/magnetic resonance imaging (MRI) is highly suited for abdominal pathologies. A precise co-registration of anatomic and metabolic data is possible thanks to the simultaneous acquisition, leading to accurate imaging. The literature shows that PET/MRI is at least as good as PET/CT and even superior for some indications, such as primary hepatic tumors, distant metastasis evaluation, and inflammatory bowel disease. PET/MRI allows whole-body staging in a single session, improving health care efficiency and patient comfort.
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Affiliation(s)
- Álvaro Badenes Romero
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Athinoula A Martinos Center for Biomedical Imaging, Harvard Medical School, Charlestown, MA, USA; Department of Nuclear Medicine, Joan XXIII Hospital, Tarragona, Spain
| | - Felipe S Furtado
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Athinoula A Martinos Center for Biomedical Imaging, Harvard Medical School, Charlestown, MA, USA
| | - Madaleine Sertic
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Reece J Goiffon
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Umar Mahmood
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Onofrio A Catalano
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Athinoula A Martinos Center for Biomedical Imaging, Harvard Medical School, Charlestown, MA, USA.
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Marcus C, Subramaniam RM. Paragangliomas and Pheochromocytomas: Positron Emission Tomography/Computed Tomography Diagnosis and Therapy. PET Clin 2023; 18:233-242. [PMID: 36585340 DOI: 10.1016/j.cpet.2022.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Molecular imaging evaluation of pheochromocytomas and paragangliomas depends on multiple factors, such as localized versus metastatic disease, the genetic, and biochemical profile of tumors. Positron emission tomography/computed tomography (PET/CT) imaging of these tumors outperforms Meta-Iodo-Benzyl-Guanidine (MIBG) scintigraphy in most cases. A few PET radiotracers have been studied in evaluating these patients with somatostatin receptor PET imaging and have shown superior performance compared with other agents in most of these patients. 18F-fluorodeoxyglucose PET/CT imaging is useful in select patients, such as those with succinate dehydrogenase complex subunit B-associated disease. Treatment strategy depends on multiple factors and necessitates a multidisciplinary approach.
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Affiliation(s)
- Charles Marcus
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology and Radiological Sciences, Emory University School of Medicine, 1364 Clifton Road Northeast, 1st Floor #E163, Atlanta, GA 30322, USA.
| | - Rathan M Subramaniam
- Department of Medicine, Otago Medical School, University of Otago, 1st Floor, Dunedin Hospital, 201 Great King Street, Dunedin 9016, New Zealand; Duke University Medical Center, Department of Radiology, 2301 Erwin Road, Box 3808, Durham, NC 27710, USA
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Furtado FS, Mercaldo ND, Vahle T, Benkert T, Bradley WR, Ratanaprasatporn L, Seethamraju RT, Harisinghani MG, Lee S, Suarez-Weiss K, Umutlu L, Catana C, Pomykala KL, Domachevsky L, Bernstine H, Groshar D, Rosen BR, Catalano OA. Simultaneous multislice diffusion-weighted imaging versus standard diffusion-weighted imaging in whole-body PET/MRI. Eur Radiol 2023; 33:2536-2547. [PMID: 36460925 DOI: 10.1007/s00330-022-09275-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 10/20/2022] [Accepted: 10/26/2022] [Indexed: 12/04/2022]
Abstract
OBJECTIVE To compare standard (STD-DWI) single-shot echo-planar imaging DWI and simultaneous multislice (SMS) DWI during whole-body positron emission tomography (PET)/MRI regarding acquisition time, image quality, and lesion detection. METHODS Eighty-three adults (47 females, 57%), median age of 64 years (IQR 52-71), were prospectively enrolled from August 2018 to March 2020. Inclusion criteria were (a) abdominal or pelvic tumors and (b) PET/MRI referral from a clinician. Patients were excluded if whole-body acquisition of STD-DWI and SMS-DWI sequences was not completed. The evaluated sequences were axial STD-DWI at b-values 50-400-800 s/mm2 and the apparent diffusion coefficient (ADC), and axial SMS-DWI at b-values 50-300-800 s/mm2 and ADC, acquired with a 3-T PET/MRI scanner. Three radiologists rated each sequence's quality on a five-point scale. Lesion detection was quantified using the anatomic MRI sequences and PET as the reference standard. Regression models were constructed to quantify the association between all imaging outcomes/scores and sequence type. RESULTS The median whole-body STD-DWI acquisition time was 14.8 min (IQR 14.1-16.0) versus 7.0 min (IQR 6.7-7.2) for whole-body SMS-DWI, p < 0.001. SMS-DWI image quality scores were higher than STD-DWI in the abdomen (OR 5.31, 95% CI 2.76-10.22, p < 0.001), but lower in the cervicothoracic junction (OR 0.21, 95% CI 0.10-0.43, p < 0.001). There was no significant difference in the chest, mediastinum, pelvis, and rectum. STD-DWI detected 276/352 (78%) lesions while SMS-DWI located 296/352 (84%, OR 1.46, 95% CI 1.02-2.07, p = 0.038). CONCLUSIONS In cancer staging and restaging, SMS-DWI abbreviates acquisition while maintaining or improving the diagnostic yield in most anatomic regions. KEY POINTS • Simultaneous multislice diffusion-weighted imaging enables faster whole-body image acquisition. • Simultaneous multislice diffusion-weighted imaging maintains or improves image quality when compared to single-shot echo-planar diffusion-weighted imaging in most anatomical regions. • Simultaneous multislice diffusion-weighted imaging leads to superior lesion detection.
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Affiliation(s)
- Felipe S Furtado
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Harvard Medical School, 149 13th Street, Charlestown, MA, 02129, USA
| | - Nathaniel D Mercaldo
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA
| | - Thomas Vahle
- MR Application Predevelopment, Siemens Healthcare GmbH, Allee am Roethelheimpark 2, 91052, Erlangen, Germany
| | - Thomas Benkert
- MR Application Predevelopment, Siemens Healthcare GmbH, Allee am Roethelheimpark 2, 91052, Erlangen, Germany
| | - William R Bradley
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA
| | - Lisa Ratanaprasatporn
- Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA, 02115, USA
| | - Ravi Teja Seethamraju
- Athinoula A. Martinos Center for Biomedical Imaging, Harvard Medical School, 149 13th Street, Charlestown, MA, 02129, USA
- MR Collaborations, Siemens Medical Solutions USA, Inc., 30 Jonathan Ln, Malden, MA, 02148, USA
| | - Mukesh G Harisinghani
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA
| | - Susanna Lee
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA
| | - Krista Suarez-Weiss
- Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA, 02115, USA
| | - Lale Umutlu
- Universitätsmedizin Essen, Hufelandstraße 55, 45147, Essen, Germany
| | - Ciprian Catana
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Harvard Medical School, 149 13th Street, Charlestown, MA, 02129, USA
| | | | - Liran Domachevsky
- Sheba Medical Center, Derech Sheba 2, Ramat Gan, Israel
- Tel Aviv University, 6997801, Tel Aviv-Yafo, Israel
| | - Hanna Bernstine
- Tel Aviv University, 6997801, Tel Aviv-Yafo, Israel
- Assuta Medical Center, HaBarzel 20 St, Ramat Hahayal, Tel Aviv, Israel
| | - David Groshar
- Tel Aviv University, 6997801, Tel Aviv-Yafo, Israel
- Assuta Medical Center, HaBarzel 20 St, Ramat Hahayal, Tel Aviv, Israel
| | - Bruse R Rosen
- Athinoula A. Martinos Center for Biomedical Imaging, Harvard Medical School, 149 13th Street, Charlestown, MA, 02129, USA
| | - Onofrio Antonio Catalano
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA.
- Athinoula A. Martinos Center for Biomedical Imaging, Harvard Medical School, 149 13th Street, Charlestown, MA, 02129, USA.
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Lollert A, Miederer M, Russo A, Staatz G. [Pheochromocytoma and paraganglioma during childhood and adolescence]. RADIOLOGIE (HEIDELBERG, GERMANY) 2022; 62:1043-1049. [PMID: 35948798 DOI: 10.1007/s00117-022-01048-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/05/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Pheochromocytoma and paraganglioma belong to the group of rare catecholamine-producing tumours during childhood and adolescence. They occur most frequently in patients with tumour predisposition syndromes. Imaging is essential to assess tumour stage and to plan therapy initiation. OBJECTIVE The aim of this review is a summary of the most important characteristics of the aforementioned tumour entities with a special focus on imaging. In particular, magnetic resonance imaging (MRI) as well as nuclear medicine techniques are presented. MATERIALS AND METHODS Diagnostic methods in patients with pheochromocytoma and paraganglioma are presented based on the literature and own case reports. RESULTS The radiologic modality of choice for the staging of catecholamine-producing tumours during childhood and adolescence is MRI, due to the lack of ionizing radiation and high soft tissue contrast. In addition, 123-I-meta-iodo-benzyl-guanidine (MIBG) scintigraphy and positron emission tomography/computer tomography (PET/CT) are performed. Whole-body MRI is particularly important as a screening tool in patients with a tumour predisposition syndrome. CONCLUSIONS Radiologic imaging and nuclear medicine techniques are important for the assessment of disease stage and therapy planning in patients with catecholamine-producing tumours. Detection of metastatic disease is essential, as there are no known histopathologic markers, which can predict the metastatic potential of the tumours.
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Affiliation(s)
- André Lollert
- Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie, Sektion Kinderradiologie, Universitätsmedizin der Johannes Gutenberg-Universität, Langenbeckstr. 1, 55131, Mainz, Deutschland.
| | - Matthias Miederer
- Klinik und Poliklinik für Nuklearmedizin, Universitätsmedizin der Johannes Gutenberg-Universität, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - Alexandra Russo
- Zentrum für Kinder- und Jugendmedizin, Universitätsmedizin der Johannes Gutenberg-Universität, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - Gundula Staatz
- Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie, Sektion Kinderradiologie, Universitätsmedizin der Johannes Gutenberg-Universität, Langenbeckstr. 1, 55131, Mainz, Deutschland
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