Performance of 68Ga-DOTA-SST PET/CT, Octreoscan SPECT/CT and 18F-FDG PET/CT in the Detection of Culprit Tumors Causing Osteomalacia: a Meta-analysis

Overview

Journal Nucl Med Commun

Specialty Nuclear Medicine

Date 2020 Jan 31

PMID 32000173

Citations 16

Authors

Yuanyuan Jiang

Guozhu Hou

Wuying Cheng

Affiliations

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Abstract

Objectives: The objective of this study was to assess and compare the performance of Ga-DOTA-conjugated-somatostatin-receptor-targeting-peptides (Ga-DOTA-SST) PET/CT, octreoscan-SPECT/CT and F-FDG-PET/CT in the detection of tumor-induced osteomalacia (TIO).

Methods: Relevant studies reporting the performance Ga-DOTA-SST PET/CT, octreoscan-SPECT/CT and F-FDG-PET/CT in TIO were identified by searching PubMed, EMBASE, and Web of Science (last updated June 2019). Two authors independently extracted the numbers of true and false positives, and true and false negatives. The pooled estimates on a per-patient basis were calculated with 95% confidence interval (CI) obtained using a random-effects model.

Results: Fourteen studies comprising 346 patients were included in this meta-analysis. The meta-analysis provided the following results on a per-patient analysis. The pooled sensitivities of both Ga-DOTA-SST PET/CT (90%, 95% CI 82-95%) and octreoscan-SPECT/CT (83%, 95% CI 75-89%) were found to be significantly higher (P < 0.005) than that of F-FDG PET/CT (67%, 95% CI 53-80%). There was no statistically significant difference between the sensitivity of Ga-DOTA-SST PET/CT and octreoscan-SPECT/CT (P = 0.161). Owing to the low number of articles with true negative findings, the pooled specificities were not calculated. A total of 287 tumors were identified in 287 patients according to the data the included studies offered. The majority of the tumors were located in the lower extremities (59.6%, 171/287), followed by craniofacial regions (24.0%, 69/287), torso (9.4%%, 27/287), and upper extremities (6.9%, 20/287).

Conclusion: This meta-analysis demonstrates that somatostatin receptor-based imaging modalities outperformed F-FDG PET/CT in the detection of TIO, with Ga-DOTA-SST PET/CT performing slightly better than octreoscan-SPECT/CT.

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References

Jagtap V, Sarathi V, Lila A, Malhotra G, Sankhe S, Bandgar T . Tumor-induced osteomalacia: a single center experience. Endocr Pract. 2010; 17(2):177-84. DOI: 10.4158/EP10151.OR. View

Lee Y, Lee J, Lee J, Lee H, Park B, Kim Y . Hepatocellular carcinoma: diagnostic performance of multidetector CT and MR imaging-a systematic review and meta-analysis. Radiology. 2015; 275(1):97-109. DOI: 10.1148/radiol.14140690. View

Carpenter T . Oncogenic osteomalacia--a complex dance of factors. N Engl J Med. 2003; 348(17):1705-8. DOI: 10.1056/NEJMe030037. View

Whiting P, Rutjes A, Westwood M, Mallett S, Deeks J, Reitsma J . QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med. 2011; 155(8):529-36. DOI: 10.7326/0003-4819-155-8-201110180-00009. View

Zhou J, Gou Z, Wu R, Yuan Y, Yu G, Zhao Y . Comparison of PSMA-PET/CT, choline-PET/CT, NaF-PET/CT, MRI, and bone scintigraphy in the diagnosis of bone metastases in patients with prostate cancer: a systematic review and meta-analysis. Skeletal Radiol. 2019; 48(12):1915-1924. DOI: 10.1007/s00256-019-03230-z. View

Okamiya T, Takahashi K, Kamada H, Hirato J, Motoi T, Fukumoto S . Oncogenic osteomalacia caused by an occult paranasal sinus tumor. Auris Nasus Larynx. 2015; 42(2):167-9. DOI: 10.1016/j.anl.2014.10.001. View

Florenzano P, Gafni R, Collins M . Tumor-induced osteomalacia. Bone Rep. 2017; 7:90-97. PMC: 5633085. DOI: 10.1016/j.bonr.2017.09.002. View

Ward L, Rauch F, White K, Filler G, Matzinger M, Letts M . Resolution of severe, adolescent-onset hypophosphatemic rickets following resection of an FGF-23-producing tumour of the distal ulna. Bone. 2004; 34(5):905-11. DOI: 10.1016/j.bone.2003.12.025. View

Clifton-Bligh R, Hofman M, Duncan E, Sim I, Darnell D, Clarkson A . Improving diagnosis of tumor-induced osteomalacia with Gallium-68 DOTATATE PET/CT. J Clin Endocrinol Metab. 2013; 98(2):687-94. DOI: 10.1210/jc.2012-3642. View

10.

Kaneuchi Y, Hakozaki M, Yamada H, Hasegawa O, Tajino T, Konno S . Missed causative tumors in diagnosing tumor-induced osteomalacia with (18)F-FDG PET/CT: a potential pitfall of standard-field imaging. Hell J Nucl Med. 2016; 19(1):46-8. DOI: 10.1967/s002449910337. View

11.

S Jain A, Shelley S, Muthukrishnan I, Kalal S, Amalachandran J, Chandran S . Diagnostic importance of contrast enhanced (18)F-fluorodeoxyglucose positron emission computed tomography in patients with tumor induced osteomalacia: Our experience. Indian J Nucl Med. 2016; 31(1):14-9. PMC: 4746834. DOI: 10.4103/0972-3919.172344. View

12.

Fukumoto S, Yamashita T . Fibroblast growth factor 23 in oncogenic osteomalacia and X-linked hypophosphatemia. N Engl J Med. 2003; 349(5):505-6; author reply 505-6. View

13.

de Beur S, Streeten E, Civelek A, McCarthy E, Uribe L, Marx S . Localisation of mesenchymal tumours by somatostatin receptor imaging. Lancet. 2002; 359(9308):761-3. DOI: 10.1016/s0140-6736(02)07846-7. View

14.

Jiang Y, Xia W, Xing X, Silva B, Li M, Wang O . Tumor-induced osteomalacia: an important cause of adult-onset hypophosphatemic osteomalacia in China: Report of 39 cases and review of the literature. J Bone Miner Res. 2012; 27(9):1967-75. DOI: 10.1002/jbmr.1642. View

15.

Hofman M, Lau W, Hicks R . Somatostatin receptor imaging with 68Ga DOTATATE PET/CT: clinical utility, normal patterns, pearls, and pitfalls in interpretation. Radiographics. 2015; 35(2):500-16. DOI: 10.1148/rg.352140164. View

16.

Satyaraddi A, Cherian K, Shetty S, Kapoor N, Jebasingh F, Cherian V . Musculoskeletal oncogenic osteomalacia-An experience from a single centre in South India. J Orthop. 2017; 14(1):184-188. PMC: 5222952. DOI: 10.1016/j.jor.2016.12.010. View

17.

Jing H, Li F, Zhuang H, Wang Z, Tian J, Xing X . Effective detection of the tumors causing osteomalacia using [Tc-99m]-HYNIC-octreotide (99mTc-HYNIC-TOC) whole body scan. Eur J Radiol. 2013; 82(11):2028-34. DOI: 10.1016/j.ejrad.2013.04.006. View

18.

Zhang S, Wang L, Wang T, Xing H, Huo L, Li F . [Value of Ga-DOTA-TATE Positron Emission Tomography/Computed Tomography in the Localization of Culprit Tumors Causing Osteomalacia with Negative Tc-HYNIC-TOC Single Photo Emission Computed Tomography]. Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2019; 40(6):757-764. DOI: 10.3881/j.issn.1000-503X.10693. View

19.

Folpe A, Fanburg-Smith J, Billings S, Bisceglia M, Bertoni F, Cho J . Most osteomalacia-associated mesenchymal tumors are a single histopathologic entity: an analysis of 32 cases and a comprehensive review of the literature. Am J Surg Pathol. 2004; 28(1):1-30. DOI: 10.1097/00000478-200401000-00001. View

20.

Wu W, Wang C, Ruan J, Chen F, Li N, Chen F . A case report of phosphaturic mesenchymal tumor-induced osteomalacia. Medicine (Baltimore). 2018; 96(51):e9470. PMC: 5758288. DOI: 10.1097/MD.0000000000009470. View