Papathomas, Thomas, Tzortzakakis, Antonios, Sun, Na, Erlmeier, Franziska, Feuchtinger, Annette, Trpkov, Kiril, Bazarova, Alina, Arvanitis, Alexandros, Wang, Wanzhong, Bozoky, Bela, Kokaraki, Georgia, Axelsson, Rimma and Walch, Axel (2020). In Situ Metabolomics Expands the Spectrum of Renal Tumours Positive on Tc-99(m)-sestamibi Single Photon Emission Computed Tomography/Computed Tomography Examination. Eur. Urol. Open Sci., 22. S. 88 - 97. AMSTERDAM: ELSEVIER. ISSN 2666-1683

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Abstract

Background: Definite noninvasive characterisation of renal tumours positive on Tc-99m-sestamibi single photon emission computed tomography/computed tomography (SPECT/CT) examination including renal oncocytomas (ROs), hybrid oncocytic chromophobe tumours (HOCTs), and chromophobe renal cell carcinoma (chRCC) is currently not feasible. Objective: To investigate whether combined Tc-99m-sestamibi SPECT/CT and in situ metabolomic profiling can accurately characterise renal tumours exhibiting Tc-99m-sestamibi uptake. Design, setting, and participants: A tissue microarray analysis of 33 tumour samples from 28 patients was used to investigate whether their in situ metabolomic status correlates with their features on Tc-99m-sestamibi SPECT/CT examination. In order to validate emerging data, an independent cohort comprising 117 tumours was subjected to matrix-assisted laser desorption/ionisation mass spectrometry imaging (MALDI MSI). Outcome measurements and statistical analysis: MALDI MSI data analysis and image generation were facilitated by FlexImaging v. 4.2, while k-means analysis by SCiLS Lab software followed by R-package CARRoT analysis was used for assessing the highest predictive power in the differential of RO versus chRCC. Heatmap-based clustering, sparse partial least-squares discriminant analysis, and volcano plots were created with MetaboAnalyst 3.0. Results and limitations: We identified a discriminatory metabolomic signature for Tc-99m-sestamibi SPECT/CT-positive Birt-Hogg-Dube-associated HOCTs versus other renal oncocytic tumours. Metabolomic differences were also evident between Tc-99m-sestamibi-positive and Tc-99m-sestamibi-negative chRCCs, prompting additional expert review; two of three Tc-99m-sestamibi-positive chRCCs were reclassified as low-grade oncocytic tumours (LOTs). Differences were identified between distal-derived tumours from those of proximal tubule origin, including differences between ROs and chRCCs. Conclusions: The current study expands the spectrum of Tc-99m-sestamibi SPECT/CT-positive renal tumours, encompassing ROs, HOCTs, LOTs, and chRCCs, and supports the feasibility of in situ metabolomic profiling in the diagnostics and classification of renal tumours. Patient summary: For preoperative evaluation of solid renal tumours, Tc-99m-sestamibi single photon emission computed tomography/computed tomography (SPECT/CT) is a novel examination method. To increase diagnostic accuracy, we propose that Tc-99m-sestamibi-positive renal tumours should be biopsied and followed by a combined histometabolomic analysis. (C) 2020 The Authors. Published by Elsevier B.V. on behalf of European Association of Urology.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Papathomas, ThomasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tzortzakakis, AntoniosUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sun, NaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Erlmeier, FranziskaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Feuchtinger, AnnetteUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Trpkov, KirilUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bazarova, AlinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Arvanitis, AlexandrosUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wang, WanzhongUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bozoky, BelaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kokaraki, GeorgiaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Axelsson, RimmaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Walch, AxelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-309583
DOI: 10.1016/j.euros.2020.11.001
Journal or Publication Title: Eur. Urol. Open Sci.
Volume: 22
Page Range: S. 88 - 97
Date: 2020
Publisher: ELSEVIER
Place of Publication: AMSTERDAM
ISSN: 2666-1683
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
MOLECULAR CHARACTERIZATION; INTRATUMOR HETEROGENEITY; CELL; METABOLITES; ONCOCYTOMA; CARCINOMAMultiple languages
Urology & NephrologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/30958

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