Document Detail

New imaging approaches to phaeochromocytomas and paragangliomas.
MedLine Citation:
PMID:  19508681     Owner:  NLM     Status:  MEDLINE    
Formerly used concepts for phaeochromocytomas and paragangliomas have been challenged by recent discoveries that at least 24% of tumours are familial and thereby often multiple in various locations throughout the body. Furthermore, tumours are often malignant and perhaps more aggressive if associated with SDHB gene mutations. Some paragangliomas are clinically silent and may present only with dopamine hypersecretion. In the current era where CT and MRI are more commonly used, tumours are more often found as incidentalomas and MRI may be less specific for phaeochromocytoma and paraganglioma than previously thought. Because of unique tumour characteristics (e.g. the presence of cell membrane and intracellular vesicular norepinephrine transporters) these tumours were 'born' to be imaged by means of specific functional imaging approaches. Moreover, additional recent discoveries related to apoptosis, hypoxia, acidosis, anaerobic glycolysis and angiogenesis, often disturbed in tumour cells, open new options and challenges to specifically image phaeochromocytomas and paragangliomas and possibly link those results to their pathophysiology, genotypic alterations and metastatic potential. Functional imaging, especially represented by positron emission tomography (PET), offers an excellent approach by which tumour-specific processes can be detected, evaluated and seen in the context of tumour-specific behaviour and its genetic signature. In this review, we address the recent developments in new functional imaging modalities for phaeochromocytoma and paraganglioma and provide the reader with suggested imaging approaches in various phaeochromocytomas and paragangliomas of sympathetic origin. Current imaging algorithms of head and neck parasympathetic paragangliomas are not discussed. Finally, this review outlines some future perspectives of functional imaging of these tumours.
Bas Havekes; Kathryn King; Edwin W Lai; Johannes A Romijn; Eleonora P M Corssmit; Karel Pacak
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Intramural; Review     Date:  2009-06-08
Journal Detail:
Title:  Clinical endocrinology     Volume:  72     ISSN:  1365-2265     ISO Abbreviation:  Clin. Endocrinol. (Oxf)     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-05-07     Completed Date:  2010-08-25     Revised Date:  2013-06-02    
Medline Journal Info:
Nlm Unique ID:  0346653     Medline TA:  Clin Endocrinol (Oxf)     Country:  England    
Other Details:
Languages:  eng     Pagination:  137-45     Citation Subset:  IM    
Department of Internal Medicine, Division of Endocrinology, University Hospital Maastricht, Maastricht, The Netherlands.
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MeSH Terms
Magnetic Resonance Imaging / methods
Paraganglioma / diagnosis*,  radiography
Pheochromocytoma / diagnosis*,  radiography
Positron-Emission Tomography
Grant Support
Z01 HD008735-07/HD/NICHD NIH HHS
Comment In:
Clin Endocrinol (Oxf). 2010 Apr;72(4):568-9; author reply 569   [PMID:  19769625 ]

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