68Ga-DOTATATE for tumor localization in tumor-induced osteomalacia

Diala El-Maouche, Samira M. Sadowski, Georgios Z. Papadakis, Lori Guthrie, Candice Cottle-Delisle, Roxanne Merkel, Corina Millo, Clara C. Chen, Electron Kebebew, Michael T. Collins

Research output: Contribution to journalArticlepeer-review

68 Scopus citations


Context: Phosphaturic mesenchymal tumors (PMTs) are small, typically difficult to localize, and express somatostatin receptors. Recent work suggests imaging studies using 68Gallium (68Ga)-conjugated somatostatin peptide analogues, such as 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA)TATE, which enables somatostatin receptor imaging with positron emission tomography (PET), may be useful at identifying these tumors. Objective: Our objective was to evaluate the use of 68Ga-DOTATATE PET/computed tomography (CT) for tumor localization in tumor-induced osteomalacia (TIO). Design: This was a single-center prospective study of patients with TIO. Setting: The study was conducted at the National Institutes of Health Clinical Center between February 2014 and February 2015. Subjects: Eleven subjects (six females, five males) with TIO were included. Intervention: Subjects underwent 68Ga-DOTATATE PET/CT in addition to 111In-pentetreotide singlephoton emission CT (Octreoscan-SPECT/CT) and fluorodeoxyglucose-PET/CT (18F FDG-PET/CT) scan. Main Outcome Measures: Localization of PMTs on the previously described imaging modalities were determined. Results: The tumor was successfully localized in 6/11 (54.5%) subjects (one was metastatic). The tumor was identified by 68Ga-DOTATATE in all six cases. Both Octreoscan-SPECT/CT and 18F FDG-PET each identified the tumor in 4/6. In no cases was 68Ga-DOTATATE the only imaging study to identify the tumor. Conclusions: In this first prospective study comparing 68Ga-DOTATATE PET/CT to OctreoscanSPECT/CT and 18F FDG-PET in TIO localization, 68Ga-DOTATATE PET/CT demonstrated the greatest sensitivity and specificity, suggesting that it may be the best single study for localization of PMTs in TIO.

Original languageEnglish (US)
Pages (from-to)3575-3581
Number of pages7
JournalJournal of Clinical Endocrinology and Metabolism
Issue number10
StatePublished - Oct 2016

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical


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