68Ga DOTATATE PET/CT is an Accurate Imaging Modality in the Detection of Culprit Tumors Causing Osteomalacia
Jingjing Zhang1, Zhaohui Zhu, Dingrong Zhong
1From 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.
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.
Insights
Gallium-68 DOTATATE PET/CT accurately detects tumors causing tumor-induced osteomalacia (TIO). This imaging is crucial for identifying the small, hard-to-find tumors responsible for TIO, enabling curative surgical treatment.
Area of Science:
- Endocrinology
- Nuclear Medicine
- Oncology
Background:
- Tumor-induced osteomalacia (TIO) results from tumors producing fibroblast growth factor-23 (FGF-23).
- Locating these small mesenchymal tumors is challenging with conventional imaging.
- Surgical resection is the only cure for TIO.
Purpose of the Study:
- To evaluate the diagnostic efficacy of Gallium-68 DOTATATE Positron Emission Tomography/Computed Tomography ((68)Ga DOTATATE PET/CT) for detecting TIO-causing tumors.
- To assess the accuracy of (68)Ga DOTATATE PET/CT in identifying tumors responsible for TIO.
Main Methods:
- Retrospective review of clinical data and (68)Ga DOTATATE PET/CT scans from 54 patients with suspected TIO.
- Comparison of imaging findings with histopathological results and clinical follow-up.
- Analysis of sensitivity, specificity, and overall accuracy of the imaging modality.
Main Results:
- (68)Ga DOTATATE PET/CT showed a 100% sensitivity and 90.9% specificity in detecting TIO-causing tumors.
- Overall accuracy for tumor detection was 97.7%.
- Patients with confirmed tumors via PET/CT and subsequent surgery experienced prompt symptom resolution and normalized phosphate levels.
Conclusions:
- (68)Ga DOTATATE PET/CT is a highly accurate imaging technique for diagnosing TIO.
- This modality aids in identifying the elusive tumors responsible for TIO, facilitating timely and curative surgical intervention.
More Related Videos
13:16Computed Tomography and Optical Imaging of Osteogenesis-angiogenesis Coupling to Assess Integration of Cranial Bone Autografts and Allografts
Published on: December 22, 2015
12:23Multi-modal Imaging of Angiogenesis in a Nude Rat Model of Breast Cancer Bone Metastasis Using Magnetic Resonance Imaging, Volumetric Computed Tomography and Ultrasound
Published on: August 14, 2012
Related Concept Videos
01:13Radiological Investigation III: Pulmonary Angiogram and PET Scan
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...
01:30Radiological Investigation I: X-ray and CT