title: 68Ga-DOTATATE for Tumor Localization in Tumor-Induced Osteomalacia.
abstract: Phosphaturic mesenchymal tumors (PMTs) are small, typically difficult to localize, and express somatostatin receptors. Recent work suggests imaging studies using68Gallium (68Ga)-conjugated somatostatin peptide analogues, such as 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA)TATE, which enables somatostatin receptor imaging with positron emission tomography (PET), may be useful at identifying these tumors.
  
  
  
  Our objective was to evaluate the use of68Ga-DOTATATE PET/computed tomography (CT) for tumor localization in tumor-induced osteomalacia (TIO).
  
  
  
  This was a single-center prospective study of patients with TIO.
  
  
  
  The study was conducted at the National Institutes of Health Clinical Center between February 2014 and February 2015.
  
  
  
  Eleven subjects (six females, five males) with TIO were included.
  
  
  
  Subjects underwent68Ga-DOTATATE PET/CT in addition to111In-pentetreotide single-photon emission CT (Octreoscan- SPECT/CT) and fluorodeoxyglucose-PET/CT (18F FDG-PET/CT) scan.
  
  
  
  Localization of PMTs on the previously described imaging modalities were determined.
  
  
  
  The tumor was successfully localized in 6/11 (54.5%) subjects (one was metastatic). The tumor was identified by68Ga-DOTATATE in all six cases. Both Octreoscan-SPECT/CT and18F FDG-PET each identified the tumor in 4/6. In no cases was68Ga-DOTATATE the only imaging study to identify the tumor.
  
  
  
  In this first prospective study comparing68Ga-DOTATATE PET/CT to Octreoscan-SPECT/CT and18F FDG-PET in TIO localization,68Ga-DOTATATE PET/CT demonstrated the greatest sensitivity and specificity, suggesting that it may be the best single study for localization of PMTs in TIO.
authors.affiliation: Division of Endocrinology (D.E.-M.), Diabetes and Metabolism, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida; Skeletal Clinical Studies Unit (D.E.-M., L.G., M.T.C.), Craniofacial and Skeletal Diseases Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland; Thoracic and Endocrine Surgery (S.M.S.), University Hospitals of Geneva, Geneva, Switzerland; The Endocrine Oncology Branch (S.M.S., C.C.-D., R.M., E.K.), National Cancer Institute, National Institutes of Health, Bethesda, Maryland; Positron Emission Tomography Department (G.Z.P., C.M.), Warren Grant Magnusson Clinical Center, National Institutes of Health, Bethesda, Maryland; Nuclear Medicine Division (C.C.C.), Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, Maryland.
authors.forename: Diala
authors.initials: D
authors.lastname: El-Maouche
authors.affiliation: Division of Endocrinology (D.E.-M.), Diabetes and Metabolism, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida; Skeletal Clinical Studies Unit (D.E.-M., L.G., M.T.C.), Craniofacial and Skeletal Diseases Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland; Thoracic and Endocrine Surgery (S.M.S.), University Hospitals of Geneva, Geneva, Switzerland; The Endocrine Oncology Branch (S.M.S., C.C.-D., R.M., E.K.), National Cancer Institute, National Institutes of Health, Bethesda, Maryland; Positron Emission Tomography Department (G.Z.P., C.M.), Warren Grant Magnusson Clinical Center, National Institutes of Health, Bethesda, Maryland; Nuclear Medicine Division (C.C.C.), Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, Maryland.
authors.forename: Samira M
authors.initials: SM
authors.lastname: Sadowski
authors.affiliation: Division of Endocrinology (D.E.-M.), Diabetes and Metabolism, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida; Skeletal Clinical Studies Unit (D.E.-M., L.G., M.T.C.), Craniofacial and Skeletal Diseases Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland; Thoracic and Endocrine Surgery (S.M.S.), University Hospitals of Geneva, Geneva, Switzerland; The Endocrine Oncology Branch (S.M.S., C.C.-D., R.M., E.K.), National Cancer Institute, National Institutes of Health, Bethesda, Maryland; Positron Emission Tomography Department (G.Z.P., C.M.), Warren Grant Magnusson Clinical Center, National Institutes of Health, Bethesda, Maryland; Nuclear Medicine Division (C.C.C.), Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, Maryland.
authors.forename: Georgios Z
authors.initials: GZ
authors.lastname: Papadakis
authors.affiliation: Division of Endocrinology (D.E.-M.), Diabetes and Metabolism, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida; Skeletal Clinical Studies Unit (D.E.-M., L.G., M.T.C.), Craniofacial and Skeletal Diseases Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland; Thoracic and Endocrine Surgery (S.M.S.), University Hospitals of Geneva, Geneva, Switzerland; The Endocrine Oncology Branch (S.M.S., C.C.-D., R.M., E.K.), National Cancer Institute, National Institutes of Health, Bethesda, Maryland; Positron Emission Tomography Department (G.Z.P., C.M.), Warren Grant Magnusson Clinical Center, National Institutes of Health, Bethesda, Maryland; Nuclear Medicine Division (C.C.C.), Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, Maryland.
authors.forename: Lori
authors.initials: L
authors.lastname: Guthrie
authors.affiliation: Division of Endocrinology (D.E.-M.), Diabetes and Metabolism, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida; Skeletal Clinical Studies Unit (D.E.-M., L.G., M.T.C.), Craniofacial and Skeletal Diseases Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland; Thoracic and Endocrine Surgery (S.M.S.), University Hospitals of Geneva, Geneva, Switzerland; The Endocrine Oncology Branch (S.M.S., C.C.-D., R.M., E.K.), National Cancer Institute, National Institutes of Health, Bethesda, Maryland; Positron Emission Tomography Department (G.Z.P., C.M.), Warren Grant Magnusson Clinical Center, National Institutes of Health, Bethesda, Maryland; Nuclear Medicine Division (C.C.C.), Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, Maryland.
authors.forename: Candice
authors.initials: C
authors.lastname: Cottle-Delisle
authors.affiliation: Division of Endocrinology (D.E.-M.), Diabetes and Metabolism, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida; Skeletal Clinical Studies Unit (D.E.-M., L.G., M.T.C.), Craniofacial and Skeletal Diseases Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland; Thoracic and Endocrine Surgery (S.M.S.), University Hospitals of Geneva, Geneva, Switzerland; The Endocrine Oncology Branch (S.M.S., C.C.-D., R.M., E.K.), National Cancer Institute, National Institutes of Health, Bethesda, Maryland; Positron Emission Tomography Department (G.Z.P., C.M.), Warren Grant Magnusson Clinical Center, National Institutes of Health, Bethesda, Maryland; Nuclear Medicine Division (C.C.C.), Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, Maryland.
authors.forename: Roxanne
authors.initials: R
authors.lastname: Merkel
authors.affiliation: Division of Endocrinology (D.E.-M.), Diabetes and Metabolism, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida; Skeletal Clinical Studies Unit (D.E.-M., L.G., M.T.C.), Craniofacial and Skeletal Diseases Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland; Thoracic and Endocrine Surgery (S.M.S.), University Hospitals of Geneva, Geneva, Switzerland; The Endocrine Oncology Branch (S.M.S., C.C.-D., R.M., E.K.), National Cancer Institute, National Institutes of Health, Bethesda, Maryland; Positron Emission Tomography Department (G.Z.P., C.M.), Warren Grant Magnusson Clinical Center, National Institutes of Health, Bethesda, Maryland; Nuclear Medicine Division (C.C.C.), Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, Maryland.
authors.forename: Corina
authors.initials: C
authors.lastname: Millo
authors.affiliation: Division of Endocrinology (D.E.-M.), Diabetes and Metabolism, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida; Skeletal Clinical Studies Unit (D.E.-M., L.G., M.T.C.), Craniofacial and Skeletal Diseases Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland; Thoracic and Endocrine Surgery (S.M.S.), University Hospitals of Geneva, Geneva, Switzerland; The Endocrine Oncology Branch (S.M.S., C.C.-D., R.M., E.K.), National Cancer Institute, National Institutes of Health, Bethesda, Maryland; Positron Emission Tomography Department (G.Z.P., C.M.), Warren Grant Magnusson Clinical Center, National Institutes of Health, Bethesda, Maryland; Nuclear Medicine Division (C.C.C.), Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, Maryland.
authors.forename: Clara C
authors.initials: CC
authors.lastname: Chen
authors.affiliation: Division of Endocrinology (D.E.-M.), Diabetes and Metabolism, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida; Skeletal Clinical Studies Unit (D.E.-M., L.G., M.T.C.), Craniofacial and Skeletal Diseases Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland; Thoracic and Endocrine Surgery (S.M.S.), University Hospitals of Geneva, Geneva, Switzerland; The Endocrine Oncology Branch (S.M.S., C.C.-D., R.M., E.K.), National Cancer Institute, National Institutes of Health, Bethesda, Maryland; Positron Emission Tomography Department (G.Z.P., C.M.), Warren Grant Magnusson Clinical Center, National Institutes of Health, Bethesda, Maryland; Nuclear Medicine Division (C.C.C.), Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, Maryland.
authors.forename: Electron
authors.initials: E
authors.lastname: Kebebew
authors.affiliation: Division of Endocrinology (D.E.-M.), Diabetes and Metabolism, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida; Skeletal Clinical Studies Unit (D.E.-M., L.G., M.T.C.), Craniofacial and Skeletal Diseases Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland; Thoracic and Endocrine Surgery (S.M.S.), University Hospitals of Geneva, Geneva, Switzerland; The Endocrine Oncology Branch (S.M.S., C.C.-D., R.M., E.K.), National Cancer Institute, National Institutes of Health, Bethesda, Maryland; Positron Emission Tomography Department (G.Z.P., C.M.), Warren Grant Magnusson Clinical Center, National Institutes of Health, Bethesda, Maryland; Nuclear Medicine Division (C.C.C.), Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, Maryland.
authors.forename: Michael T
authors.initials: MT
authors.lastname: Collins
mesh_terms: D000293:Adolescent; D000328:Adult; D000080027:Cyclams; D005260:Female; D019788:Fluorodeoxyglucose F18; D005710:Gallium Radioisotopes; D006571:Heterocyclic Compounds; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009362:Neoplasm Metastasis / Q000000981:diagnostic imaging; D009369:Neoplasms / Q000000981:diagnostic imaging*; D009372:Neoplasms, Connective Tissue / Q000000981:diagnostic imaging*; D010018:Osteomalacia; D010257:Paraneoplastic Syndromes; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D017481:Receptors, Somatostatin / Q000378:metabolism*; D013004:Somatostatin / Q000031:analogs & derivatives*; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D055815:Young Adult
chemical_list: D000080027:Cyclams; D005710:Gallium Radioisotopes; D006571:Heterocyclic Compounds; D019275:Radiopharmaceuticals; D017481:Receptors, Somatostatin; D019788:Fluorodeoxyglucose F18; D013004:Somatostatin; C038072:cyclen; C081788:pentetreotide