Jingjing Zhang1, Zhaohui Zhu, Dingrong Zhong, Yonghong Dang, Haiqun Xing, Yanrong Du, Hongli Jing, Zhen Qiao, Xiaoping Xing, Hongming Zhuang, Fang Li. 1. From the *Departments of Nuclear Medicine, †Department of Pathology, ‡Department of Endocrinology Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China; and §Department of Radiology, The Children's Hospital of Philadelphia University of Pennsylvania Perelman School of Medicine Philadelphia, PA.
Abstract
OBJECTIVES: Tumor-induced osteomalacia (TIO) is generally caused by small benign mesenchymal tumors producing fibroblast growth factor-23 (FGF-23). The only curative therapy of the disease is resection of the causative tumors. However, these tumors are extremely difficult to detect using conventional imaging modalities. This research was undertaken to evaluate efficacy of (68)Ga DOTATATE PET/CT in this clinical setting. METHODS: Images of (68)Ga DOTATATE PET/CT and clinical charts from 54 patients with clinically suspected TIO were retrospectively reviewed. The image findings were compared with the results of histopathological examinations and clinical follow-ups. RESULTS: (68)Ga DOTATATE PET/CT scans were positive in 44 patients, among which, 33 had surgery to remove the lesions. Postsurgical pathological examination confirmed causative tumors in 32 patients whose symptoms diminished promptly, and the serum phosphate levels became normal, which confirmed the diagnoses of TIO. Eleven patients with positive (68)Ga DOTATATE PET/CT did not have surgery. These 11 patients continued to have symptoms and hypophosphatemia but were not included in the final analysis because of lack of evidence to confirm or exclude TIO. Ten patients had negative (68)Ga DOTATATE PET/CT scans. All of these10 patients responded to conservative therapy and had normal serum phosphate levels in the follow-up, which excluded TIO. Therefore, the (68)Ga DOTATATE PET/CT imaging had a sensitivity of 100% (32/32) and a specificity of 90.9% (10/11). The overall accuracy of (68)Ga DOTATATE PET/CT scan in the detection of tumors responsible for osteomalacia is 97.7% (42/43). CONCLUSIONS: (68)Ga DOTATATE PET/CT scan is an accurate imaging modality in the detection of tumors causing TIO.
OBJECTIVES: Tumor-induced osteomalacia (TIO) is generally caused by small benign mesenchymal tumors producing fibroblast growth factor-23 (FGF-23). The only curative therapy of the disease is resection of the causative tumors. However, these tumors are extremely difficult to detect using conventional imaging modalities. This research was undertaken to evaluate efficacy of (68)Ga DOTATATE PET/CT in this clinical setting. METHODS: Images of (68)Ga DOTATATE PET/CT and clinical charts from 54 patients with clinically suspected TIO were retrospectively reviewed. The image findings were compared with the results of histopathological examinations and clinical follow-ups. RESULTS: (68)Ga DOTATATE PET/CT scans were positive in 44 patients, among which, 33 had surgery to remove the lesions. Postsurgical pathological examination confirmed causative tumors in 32 patients whose symptoms diminished promptly, and the serum phosphate levels became normal, which confirmed the diagnoses of TIO. Eleven patients with positive (68)Ga DOTATATE PET/CT did not have surgery. These 11 patients continued to have symptoms and hypophosphatemia but were not included in the final analysis because of lack of evidence to confirm or exclude TIO. Ten patients had negative (68)Ga DOTATATE PET/CT scans. All of these10 patients responded to conservative therapy and had normal serum phosphate levels in the follow-up, which excluded TIO. Therefore, the (68)Ga DOTATATE PET/CT imaging had a sensitivity of 100% (32/32) and a specificity of 90.9% (10/11). The overall accuracy of (68)Ga DOTATATE PET/CT scan in the detection of tumors responsible for osteomalacia is 97.7% (42/43). CONCLUSIONS: (68)Ga DOTATATE PET/CT scan is an accurate imaging modality in the detection of tumors causing TIO.
Authors: G González; R Baudrand; M F Sepúlveda; N Vucetich; F J Guarda; P Villanueva; O Contreras; A Villa; F Salech; L Toro; L Michea; P Florenzano Journal: Osteoporos Int Date: 2017-03-25 Impact factor: 4.507
Authors: Diala El-Maouche; Samira M Sadowski; Georgios Z Papadakis; Lori Guthrie; Candice Cottle-Delisle; Roxanne Merkel; Corina Millo; Clara C Chen; Electron Kebebew; Michael T Collins Journal: J Clin Endocrinol Metab Date: 2016-08-17 Impact factor: 5.958
Authors: Carlo Scognamiglio Renner Araujo; Luciana Parente Costa Seguro; Paulo Schiavom Duarte; Carlos Alberto Buchpiguel; Rosa Maria Rodrigues Pereira Journal: Nucl Med Mol Imaging Date: 2019-11-14