Usefulness of 68Ga-DOTATOC PET/CT to localize the culprit tumor inducing osteomalacia
Open Access
- 19 January 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in Scientific Reports
- Vol. 11 (1), 1-7
- https://doi.org/10.1038/s41598-021-81491-2
Abstract
Tumor-induced osteomalacia (TIO) is an uncommon paraneoplastic syndrome presenting with sustained hypophosphatemia. Treatment of choice is removal of the tumor causing the TIO, but identification of the culprit tumor by routine imaging is challenging. This study aimed to assess the usefulness of somatostatin receptor imaging, called 68Ga-DOTATOC PET/CT, in the management of patients with TIO. Twelve patients who were suspected of having TIO underwent 68Ga-DOTATOC PET/CT. Lesion detectability and maximum standardized uptake value (SUVmax) were determined and retrospectively compared with the clinical/imaging surveillance and histopathologic diagnosis. The median duration of suspected TIO with hypophosphatemia was 7.8 years (range 2.1–21.0). Conventional radiologic and/or nuclear medicine images failed to identify the culprit tumors. However, 68Ga-DOTATOC PET/CT scans showed that 8 of the 12 patients had positive lesions, suggesting the presence of focal culprit tumors. The SUVmax of positive tumors was 1.9–45.7 (median: 11.5). Six skeletal lesions and two extra-skeletal lesions were identified. Seven of the lesions were pathologically confirmed as potential culprits of TIO. Hypophosphatemia was resolved in five patients who underwent lesion excision. The 68Ga-DOTATOC PET/CT is a useful whole-body imaging modality for the detection of causative tumors in patients with suspected TIO.Funding Information
- Ministry of Health
This publication has 37 references indexed in Scilit:
- Successful Localization of Residual Culprit Tumor in a Case of Tumor-Induced Osteomalacia Using 68Ga-DOTANOC PET/CTClinical Nuclear Medicine, 2013
- Bone scintigraphic patterns in patients of tumor induced osteomalaciaIndian Journal of Nuclear Medicine, 2013
- Tumor-induced osteomalacia: An important cause of adult-onset hypophosphatemic osteomalacia in China: Report of 39 cases and review of the literatureJournal of Bone and Mineral Research, 2012
- Approach to the Hypophosphatemic PatientJournal of Clinical Endocrinology & Metabolism, 2012
- Linear nevus sebaceous syndrome with hypophosphatemic rickets with elevated FGF-23Pediatric Nephrology, 2011
- Curative surgical treatment after inefficient long-acting somatostatin analogues therapy of a tumor-induced osteomalaciaLa Presse Médicale, 2011
- Procedure guidelines for PET/CT tumour imaging with 68Ga-DOTA-conjugated peptides: 68Ga-DOTA-TOC, 68Ga-DOTA-NOC, 68Ga-DOTA-TATEEuropean Journal of Nuclear Medicine and Molecular Imaging, 2010
- Giant cell tumour of soft tissue causing oncogenic osteomalacia: report demonstrating the use of octreotide scintigraphy in tumour localizationClinical Radiology, 2008
- Most Osteomalacia-associated Mesenchymal Tumors Are a Single Histopathologic EntityThe American Journal of Surgical Pathology, 2004
- Autosomal dominant hypophosphatemic rickets is linked to chromosome 12p13.JCI Insight, 1997