Effective detection of the tumors causing osteomalacia using [Tc-99m]-HYNIC-octreotide (99mTc-HYNIC-TOC) whole body scan

被引:48
作者
Jing, Hongli [1 ,2 ]
Li, Fang [1 ,2 ]
Zhuang, Hongming [3 ]
Wang, Zhenghua [1 ,2 ]
Tian, Jian [1 ,2 ]
Xing, Xiaoping [2 ,4 ]
Jin, Jin [2 ,5 ]
Zhong, Dingrong [2 ,6 ]
Zhang, Jingjing [1 ,2 ]
机构
[1] Chinese Acad Med Sci, Peking Union Med Coll Hosp, Dept Nucl Med, Beijing 100730, Peoples R China
[2] Peking Union Med Coll, Beijing 100730, Peoples R China
[3] Univ Penn, Perelman Sch Med, Childrens Hosp Philadelphia, Dept Radiol, Philadelphia, PA 19104 USA
[4] Chinese Acad Med Sci, Peking Union Med Coll Hosp, Dept Endocrinol, Beijing 100730, Peoples R China
[5] Chinese Acad Med Sci, Peking Union Med Coll Hosp, Dept Orthoped Surg, Beijing 100730, Peoples R China
[6] Chinese Acad Med Sci, Peking Union Med Coll Hosp, Dept Pathol, Beijing 100730, Peoples R China
关键词
Tumor induced osteomalacia (TIO); 99mTc-HYNIC-TOC; Ostreoscan; Hypophosphatemia; Oncogenic osteomalacia; RECEPTOR-POSITIVE TUMORS; POSITRON-EMISSION; ONCOGENIC OSTEOMALACIA; HYPOPHOSPHATEMIC OSTEOMALACIA; FDG PET/CT; LOCALIZATION; FIBROBLAST-GROWTH-FACTOR-23; INFECTION; DIAGNOSIS; PATIENT;
D O I
10.1016/j.ejrad.2013.04.006
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Purpose: Tumor-induced osteomalacia (TIO) is an endocrine disorder caused by tumors producing excessive fibroblast growth factor-23 (FGF-23). The causative tumors are generally small, slow-growing benign mesenchymal tumors. The only cure of the disease depends on resection of the tumors, which are extremely difficult to localize due to their small sizes and rare locations. Since these tumors are known to express somatostatin receptors, this research was undertaken to evaluate efficacy of [Tc-99m]-HYNIC-octreotide (99mTc-HYNIC-TOC) whole body imaging in this clinical setting Methods: Images of 99mTc-HYNIC-TOC scans and clinical chart from 183 patients with hypophosphatemia and clinically suspected TIO were retrospectively reviewed. The scan findings were compared to the results of histopathological examinations and clinical follow-ups. Results: Among 183 patients, 72 were confirmed to have TIO while 103 patients were found to have other causes of hypophosphatemia. The possibility of TIO could not be either diagnosed or excluded in the remaining 8 patients. For analytical purposes, these 8 patients who could neither be diagnosed nor excluded as having TIO were regarded as having the disease, bringing the total of TIO patients to 80. The 99mTc-HYNIC-TOC scan identified 69 tumors in 80 patients with TIO, which rendered a sensitivity of 86.3% (69/80). 99mTc-HYNIC-TOC scintigraphy excluded 102 patients without TIO with a specificity of 99.1% (102/103). The overall accuracy of 99mTc-HYNIC-TOC whole body scan in the localization of tumors responsible for osteomalacia is 93.4% (171/183). Conclusions: Whole body 99mTc-HYNIC-TOC imaging is effective in the localization of occult tumors causing TIO. (C) 2013 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:2028 / 2034
页数:7
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