Diagnostic performance of 68Ga-DOTATOC PET/CT in tumor-induced osteomalacia

Ayako Kato, Yuji Nakamoto, Takayoshi Ishimori, Nobuyuki Hayakawa, Masashi Ueda, Takashi Temma, Kohei Sano, Yoichi Shimizu, Tsuneo Saga, Kaori Togashi

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: Tumor-induced osteomalacia (TIO) is caused by typically small tumors that secrete fibroblast growth factor 23 (FGF23). As tumor resection is the only effective treatment for TIO, it is important to detect the culprit tumor. We aimed to assess the utility of 68Gallium-DOTA-D-Phe(1)-Tyr(3)-octreotide (68Ga-DOTATOC) PET/CT in TIO and the correlation between biochemical parameters and the PET/CT results. Methods: Thirty-five patients with clinically suspected TIO who had undergone 68Ga-DOTATOC PET/CT were retrospectively analyzed. 68Ga-DOTATOC PET/CT results were compared with biochemical parameters and the final diagnosis, including histopathology. Results: 68Ga-DOTATOC PET/CT detected focal uptake consistent with TIO in 21/35 patients, one of which was considered false positive. In 16 patients, the cause of osteomalacia was confirmed histologically as phosphaturic mesenchymal tumor (n = 15) or fibrous dysplasia (n = 1). The other four patients were judged clinically as true positive by subsequent MRI and the clinical course. Overall, the detection rate of 68Ga-DOTATOC PET/CT was 57% (20/35). Median tumor maximum standardized uptake value (SUVmax) was 6.9 (range 1.5–37.7). There was no significant difference in serum intact FGF23 level between DOTATOC-positive and DOTATOC-negative cases, and no significant correlation was observed between intact FGF23 level and tumor SUVmax. Conclusions: 68Ga-DOTATOC PET/CT was clinically useful in detecting culprit tumors and subsequent patient management in TIO.

Original languageEnglish
Pages (from-to)397-405
Number of pages9
JournalAnnals of nuclear medicine
Volume35
Issue number3
DOIs
Publication statusPublished - Mar 2021

Keywords

  • Fibroblast growth factor 23
  • Ga-DOTATOC
  • Positron emission tomography
  • Tumor-induced osteomalacia

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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