Effective detection of the tumors causing osteomalacia using [Tc-99m]-HYNIC-octreotide (99mTc-HYNIC-TOC) whole body scan
Effective detection of the tumors causing osteomalacia using [Tc-99m]-HYNIC-octreotide (99mTc-HYNIC-TOC) whole body scan
复制标题
使用[Tc-99m]-HYNIC-奥曲肽（99mTc-HYNIC-TOC）全身扫描有效检测引起骨软化的肿瘤
DOI：
10.1016/j.ejrad.2013.04.006
复制
发表时间：
2013-11-01
影响因子：
3.3
通讯作者：
Zhang, Jingjing
中科院分区：
文献类型：
--
作者：
Jing, Hongli;Li, Fang;Zhang, Jingjing
目的：肿瘤诱导的骨软化是一种由肿瘤过度分泌成纤维细胞生长因子-23(FGF23)引起的内分泌紊乱。引起肿瘤的通常是小的、生长缓慢的良性间充质肿瘤。这种疾病的唯一治疗方法是切除肿瘤，由于肿瘤体积小，位置罕见，定位极其困难。由于这些肿瘤都表达生长抑素受体，因此本研究评价了[~(99m)Tc]-HYNIC-奥曲肽(99mTC-HYNIC-TOC)全身显像的临床应用价值。方法：回顾分析183例低血磷症和临床疑似TIO患者的99mTC-HYNIC-TOC显像和临床资料。结果：183例患者中，72例确诊为低磷血症，103例为其他原因引起的低磷血症。其余8例患者均不能诊断或排除TIO的可能性。为了便于分析，这8名既不能诊断也不能排除为TIO的患者被视为患有该病，使TIO患者总数达到80人。99mTC-HYNIC-TOC显像发现80例TIO患者的69个肿瘤，其敏感性为86.3%(69/80)。99mTC-HYNIC-TOC显像排除102例无TIO患者，特异度为99.1%(102/103)。99mTC-HYNIC-TOC全身显像对引起骨软化的肿瘤定位的总准确率为93.4%(171/183)。结论：99mTC-HYNIC-TOC全身显像可有效地定位致骨软化的隐匿性肿瘤。(C)2013爱思唯尔爱尔兰有限公司。保留所有权利。
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 settingMethods: 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.