Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica ›› 2018, Vol. 40 ›› Issue (6): 757-764.doi: 10.3881/j.issn.1000-503X.10693

• Original Articles • Previous Articles     Next Articles

Value of 68Ga-DOTA-TATE Positron Emission Tomography/Computed Tomography in the Localization of Culprit Tumors Causing Osteomalacia with Negative 99mTc-HYNIC-TOC Single Photo Emission Computed Tomography

ZHANG Shu1,2,WANG Ling1,2,WANG Tong1,2,XING Haiqun1,2,HUO Li1,2,LI Fang1,2()   

  1. 1Department of Nuclear Medicine, ,Beijing 100730,China
    2Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine,PUMC Hospital,CAMS and PUMC,Beijing 100730,China
  • Received:2018-07-11 Online:2018-12-20 Published:2019-01-03
  • Supported by:
    Supported by the National Natural Sciences Foundation of China(81671722)

Abstract:

Objective To analyze 68Ga-DOTA-TATE positron emission tomography/computed tomography (PET/CT) imaging features of tumor-indud osteomalacia (TIO) patients with negative 99mTc-HYNIC-TOC single photo emission computed tomography (SPECT) findings and to investigate the value of 68Ga-DOTA-TATE PET/CT in accurate localization of culprit tumors.
Methods We retrospectively analyzed 68Ga-DOTA-TATE PET/CT imaging features including location,size,density,the maximum and mean standardized uptake value in 37 TIO patients with negative 99mTc-HYNIC-TOC SPECT findings.
Results Totally 37 solitary TIO tumors,including 35 phosphaturic mesenchymal tumors and 2 spindle cell tumors confirmed by pathological examinations,were detected via 68Ga-DOTA-TATE PET/CT scans in the included 37 cases. These 37 TIO tumors showed obviously increased activities,with an maximum standardized uptake value of 7.2±4.3 and mean standardized uptake value of 4.3±2.4. The average maximum diameter was (1.9±0.7) cm. The majority of the tumors occurred in the lower extremities (19/37),followed by the trunk (11/37),maxillary/mandibular bone (5/37),and upper extremities (2/37). In addition,24 bone lesions were located in long bones of lower extremities (13/24),most of which demonstrated eccentric growth (8/13). Osteolytic changes (14/24) were observed mainly in the lesions via the corresponding CT imaging;meanwhile,sclerotic changes presented in nine cases. Of the 13 soft-tissue lesions,the majority (10/13) showed well-circumscribed isodense or hypodense nodules on the CT images,with spot calcification in one lesion located in the pleura.
Conclusions 68Ga-DOTA-TATE PET/CT scans can detect the TIO culprit tumors miss-diagnosed by 99mTc-HYNIC-TOC SPECT. Somatostatin-receptors highly expressed lesions with focal osteolytic or osteosclerotic change in bone and isodense or hypodense nodules in soft tissue will favor the diagnosis of TIO tumors.

Key words: tumor-induced osteomalacia, phosphaturic mesenchymal tumor, single photo emission computed tomography, positron emission tomography, computed tomography

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