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Indian J Nucl Med. 2019 Jul-Sep;34(3):188-193. doi: 10.4103/ijnm.IJNM_14_19.

Ga-68 DOTATATE Positron Emission Tomography-Computed Tomography Imaging in Oncogenic Osteomalacia: Experience from a Tertiary Level Hospital in South India.

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1
Department of Nuclear Medicine, Christian Medical College, Vellore, Tamil Nadu, India.

Abstract

Aim:

Utility of Ga68 DOTATATE PETCT imaging to localise cause for oncogenic osteomalacia (OOM).

Materials and Methods:

Retrospective analysis between March 2015 to March 2018 of all patients with a clinical diagnosis (based on a combination of clinical history, hypophosphatemia and elevated FGF-23 values) of OOM who underwent Ga-68 DOTATATE PET/CT.

Results:

Total of 27 patients had undergone Ga-68 DOTATATE PET/CT imaging in our centre from March 2015 to March 2018. Of these 16 patients with clinically suspected oncogenic osteomalacia were included in our study. Age range 18-61 years of which 12 were males. Total of 13 (81.25%) patients were found to be positive on imaging for a possible mesenchymal tumour. Most common site of tumour was the lower limb (76%). Most common presenting symptom was bone pain (81%) followed by muscle weakness (19%). Overall, 10 patients underwent surgery, all of whose biopsy was reported as phosphaturic mesenchymal tumour. During the three month follow up, serum phosphorous measured in 15/16, post-surgical/ medical treatment had normalised in all except two patients who had undergone only medical therapy with neutral phosphate. Fall in FGF-23 was more pronounced in surgically treated patients as compared to those who received medical treatment.

Conclusion:

Ga68-DOTATE PET/CT is a useful investigatory modality for localizing cause for oncogenic osteomalacia.

KEYWORDS:

Fibroblast growth factor-23; Ga-68 DOTATATE positron-emission tomography-computed tomography; oncogenic osteomalacia; phosphaturic mesenchymal tumor

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