Mark Alan Rosen MD, PhD, Presenter: Nothing to Disclose

Katherine Nathanson, Abstract Co-Author: Nothing to Disclose

Lauren Fishbein, Abstract Co-Author: Nothing to Disclose

Laurie A. Loevner MD, Abstract Co-Author: Nothing to Disclose

Shana Merrill, Abstract Co-Author: Nothing to Disclose

Debbie Cohen, Abstract Co-Author: Nothing to Disclose

To evaluate the potential for rapid full-body MRI to identify occult tumors in asymptomatic subjects with SDHB gene mutations, a population at risk for pheochromocytoma/paraganglioma (PCC-PGL)

Asymptomatic and previously unaffected SDHB gene mutation carriers underwent full-body MRI scanning of the neck, chest, abdomen, and pelvis (NCAP) using a modified rapid full body imaging sequence. Scanning was performed on a 1.5 Tesla imaging unit (Espree©, Siemens, Erlangen, GE) equipped with continuous table movement (CTM) software for rapid large volume imaging. Imaging included four axial sequences (T2 HASTE, T2 HASTE with fat suppression, and T1 DIXON chemical shift imaging before and after gadolinium administration) from the skull base through the pelvis, supplemented with step-table diffusion weighted imaging. Positive findings were correlated with pathological data.

Twenty previously unaffected SDHB carrier subjects underwent a total of 22 whole body MRI examinations. Single solid masses were identified in 6 subjects, for an overall positive screen rate of 6/22, or 27%. In 5/6 positive cases (PPV=83%), pathology confirmed presence of a paraganglioma (N=3) or another clinically significant tumor (N=2). Two retroperitoneal paraganglioma were identified, 2.3 and 5.4 cm, respectively. The larger lesion demonstrated vascular invasion and increased mitotic activity. One para-urethral paraganglioma (1.5 cm) was also identified. Pathology in the remaining two positive cases included a 2 cm typical carcinoid tumor in the lung and an 8 cm unclassified RCC. In one false positive case, a 1.8 cm retrocrural mass demonstrated indeterminate results on endoscopic FNA.

Rapid full-body MRI scanning using continuous moving table techniques is feasible as a screening study in patients at risk for tumors in various locations. Application to an asymptomatic population of SDHB mutation carriers can readily demonstrate clinically significant tumors.

Rapid full-body MRI allows for clinical evaluation of the neck, chest, abdomen, and pelvis and demonstrates clinically relevant findings in a high percentage of SDHB mutation carriers.

Rosen, M, Nathanson, K, Fishbein, L, Loevner, L, Merrill, S, Cohen, D, Pilot Study to Evaluate the Use of Full-body MRI for Tumor Detection in Asymptomatic Subjects with Succinate Dehydrogenase B (SDHB) Gene Mutations.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14017698.html