Diagnostic efficiency of 68 Ga-DOTANOC PET/CT in patients with suspected tumour-induced osteomalacia
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MOLECULAR IMAGING
Diagnostic efficiency of 68Ga-DOTANOC PET/CT in patients with suspected tumour-induced osteomalacia Qiao He 1 & Bing Zhang 1 & Linqi Zhang 2 & Zhifeng Chen 1 & Xinchong Shi 1 & Chang Yi 1 & Xiaoyan Wang 1 & Xiangsong Zhang 1 Received: 9 July 2020 / Revised: 27 August 2020 / Accepted: 23 September 2020 # European Society of Radiology 2020
Abstract Objectives Currently, the main challenge in tumour-induced osteomalacia (TIO) is the difficulty in locating culprit tumours for definitive diagnosis and surgical therapy. Herein, we retrospectively evaluate the efficiency of 68Ga-DOTANOC PET/CT in the localisation and diagnosis of TIO, and compared with 18F-FDG. Methods Twenty-four consecutive patients with hypophosphataemic osteomalacia (HO) and suspicion of TIO who were referred to our centre for 68Ga-DOTANOC PET/CT scanning were retrospectively reviewed. The images were evaluated qualitatively as well as semi-quantitatively, and imaging results were compared with the final diagnoses. Results Among the total of 21 patients who were included in the final analyses, 17 were diagnosed with TIO, while four were proven to have other causes of HO. 68Ga-DOTANOC PET/CT produced positive results in 16 of the 17 patients with TIO, representing a sensitivity of 94.1%. Moreover, the 68Ga-DOTANOC PET/CT results were negative in 3 of the 4 patients without TIO, representing a specificity of 75.0%. The overall accuracy of 68Ga-DOTANOC PET/CT in locating the tumours responsible for TIO is 90.5%. In particular, 68Ga-DOTANOC PET/CT detected the culprit tumours in 4 out of 10 patients with negative results on previous 18F-FDG PET/CT and showed a significantly higher T/M ratio of tumours than 18F-FDG PET/CT in the same patients (n = 10; 4.76 ± 3.08 vs 1.95 ± 1.33, p < 0.05). Conclusions 68Ga-DOTANOC PET/CT is an accurate imaging modality in the localisation of tumours for TIO. It is superior to 18 F-FDG PET/CT and may be useful in the differential diagnosis of HO. Key Points • TIO should be considered a possible cause for patients diagnosed with HO, which usually needs to be differentiated from other aetiologies. • 68Ga-DOTANOC PET/CT is an accurate imaging modality in locating culprit tumours for TIO, superior to 18F-FDG PET/CT. Keywords Oncogenic osteomalacia . 68Ga-DOTANOC . PET/CT . Mesenchymoma
Abbreviations F-FDG 68 Ga-DOTANOC 99m Tc-HYNIC-TOC 18
Qiao He and Bing Zhang contributed equally to this work. * Linqi Zhang [email protected] * Xiangsong Zhang [email protected] 1
2
Department of Nuclear Medicine, the First Affiliated Hospital of Sun Yat-sen University, 58# Zhongshan Er Road, Guangzhou 510080, Guangdong Province, People’s Republic of China Department of Nuclear Medicine, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou 510095, People’s Republic of China
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