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1.
Clin Nucl Med ; 40(8): 642-6, 2015 Aug.
Article in English | MEDLINE | ID: mdl-26053726

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.


Subject(s)
Multimodal Imaging , Neoplasms, Connective Tissue/diagnostic imaging , Organometallic Compounds , Positron-Emission Tomography , Radiopharmaceuticals , Tomography, X-Ray Computed , Adult , Aged , Female , Fibroblast Growth Factor-23 , Humans , Male , Middle Aged , Osteomalacia , Paraneoplastic Syndromes
2.
Clin Nucl Med ; 38(11): 922-4, 2013 Nov.
Article in English | MEDLINE | ID: mdl-24089059

ABSTRACT

Most osteomalacia-causing tumors are small, benign mesenchymal neoplasms, which are commonly located in the extremities or craniofacial regions. An 18-year-old male patient with suspicion of tumor-induced osteomalacia underwent (99m)Tc-HYNIC-TOC scintigraphy to search potential culprit tumor. The images showed a large activity in the region of the left kidney. The lesion was resected and a clear cell renal cell carcinoma was found. One year after the left nephrectomy, the patient was tumor-free without symptoms of osteomalacia.


Subject(s)
Carcinoma, Renal Cell/complications , Carcinoma, Renal Cell/diagnostic imaging , Kidney Neoplasms/complications , Kidney Neoplasms/diagnostic imaging , Octreotide/analogs & derivatives , Organotechnetium Compounds , Osteomalacia/diagnostic imaging , Osteomalacia/etiology , Adolescent , Humans , Male , Radionuclide Imaging
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