title: 68Ga DOTATATE PET/CT is an Accurate Imaging Modality in the Detection of Culprit Tumors Causing Osteomalacia.
abstract: OBJECTIVE
  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.
authors.affiliation: From 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.
authors.forename: Jingjing
authors.initials: J
authors.lastname: Zhang
authors.forename: Zhaohui
authors.initials: Z
authors.lastname: Zhu
authors.forename: Dingrong
authors.initials: D
authors.lastname: Zhong
authors.forename: Yonghong
authors.initials: Y
authors.lastname: Dang
authors.forename: Haiqun
authors.initials: H
authors.lastname: Xing
authors.forename: Yanrong
authors.initials: Y
authors.lastname: Du
authors.forename: Hongli
authors.initials: H
authors.lastname: Jing
authors.forename: Zhen
authors.initials: Z
authors.lastname: Qiao
authors.forename: Xiaoping
authors.initials: X
authors.lastname: Xing
authors.forename: Hongming
authors.initials: H
authors.lastname: Zhuang
authors.forename: Fang
authors.initials: F
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D000089703:Fibroblast Growth Factor-23; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009372:Neoplasms, Connective Tissue / Q000000981:diagnostic imaging*; D009942:Organometallic Compounds; D010018:Osteomalacia; D010257:Paraneoplastic Syndromes; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed
chemical_list: C000717427:FGF23 protein, human; D009942:Organometallic Compounds; D019275:Radiopharmaceuticals; D000089703:Fibroblast Growth Factor-23; C513399:gallium Ga 68 dotatate