Application of 68 Ga-DOTATATE PET/CT imaging combined with MRI in the diagnosis of tumor-induced osteomalacia / 中华核医学与分子影像杂志

ABSTRACT

Objective To evaluate the effect of 68 Ga-1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid-D-Phe1-Tyr3-Thr8-octreotide ( DOTATATE) PET/CT imaging combined with MRI on im-proving the diagnostic efficiency for tumor-induced osteomalacia (TIO). Methods From March 2012 to October 2018, 159 patients (89 males, 70 females; age 17-59 years) who were suspected with TIO and underwent both 99 Tcm-hydrazinonicotinamide-Tyr3-octreotide ( HYNIC-TOC ) SPECT imaging and 68 Ga-DOTATATE PET/CT imaging were recruited into this retrospective study. Lesions presenting abnormal in-creased focal uptake in any part of the body were suspected of culprit tumors, excluding those induced by fractures and inflammation. Based on the suspicious culprit lesions detected by 68 Ga-DOTATATE PET/CT imaging, 80 patients underwent corresponding MRI. The lesion presenting as the space-occupying nodule or mass with abnormal signal on MR image was diagnosed as the TIO culprit lesion. Compared with the results of pathological examination and clinical follow-up, the diagnostic efficiency of 99 Tcm-HYNIC-TOC SPECT imaging and 68 Ga-DOTATATE PET/CT imaging and the combination of 68 Ga-DOTATATE PET/CT imaging and MRI for TIO were analyzed. Results Of 159 patients, 135 were confirmed with TIO and 24 were with non-TIO. 99 Tcm-HYNIC-TOC SPECT imaging accurately diagnosed 92 TIO patients and 22 non-TIO pa-tients, with the sensitivity, specificity and accuracy of 68.1％(92/135), 91.7％(22/24) and 71.7％(114/159) respectively. 68 Ga-DOTATATE PET/CT imaging accurately diagnosed 134 TIO patients and 19 non-TIO patients, with the sensitivity, specificity and accuracy of 99.3％(134/135), 79.2％(19/24) and 96. 2％(153/159) respectively. A total of 74 TIO and 5 non-TIO patients were accurately diagnosed by 68Ga-DOTATATE PET/CT imaging combined with MRI, with the sensitivity, specificity and accuracy of 98.7％(74/75), 5/5 and 98.8％(79/80). Conclusion 68Ga-DOTATATE PET/CT imaging shows higher sensi-tivity than 99 Tcm-HYNIC-TOC SPECT imaging in diagnosing TIO, and the combination of 68 Ga-DOTATATE PET/CT imaging and MRI can improve the specificity and accuracy.