ArticleMolecular imaging and biology2026
Diagnostic Performance of Somatostatin Receptor-directed PET/CT for Tumor-induced Osteomalacia.
Article in Molecular imaging and biology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
aimTo evaluate the efficacy of somatostatin receptor (SSTR)-directed PET/CT in localizing phosphaturic mesenchymal tumors (PMT) in patients with suspected tumor-induced osteomalacia (TIO) and to explore relationships between imaging parameters and biochemical markers.
methodsThis retrospective analysis included 20 patients with suspected TIO, undergoing SSTR-directed PET/CT. Imaging findings and laboratory markers were assessed. SSTR-positive tumors were resected, while patients without detectable tumor, but persistent renal phosphate wasting, continued on medical treatment. Follow-up assessments included laboratory values and clinical examinations.
resultsPMT were detected on PET in 12 patients (60%), were resected, and confirmed immunohistochemically. Phosphorus levels (r = 0.26; p = 0.03), tubular reabsorption of phosphate (TRP; r = 0.77; p < 0.01) and tubular maximum of phosphate reabsorption over GFR (TmP/GFR; r = 0.44; p = 0.07) were lower in patients with detected PMT compared to those without. Elevation of fibroblast growth factor 23 (FGF23) was not significantly higher in PMT positive vs negative patients (253% vs 134% above the upper limit of normal; p = 0.97). Total lesion uptake (TLU) negatively correlated with TmP/GFR (r = -0.71; p = 0.03). A maximum standardized uptake value (SUVmax) threshold of 7.6 differentiated PMT from bone fractures (83% sensitivity; 100% specificity). Post-resection follow-up confirmed clinical cure in all cases.
conclusionIn SSTR-directed PET/CT, a distinction between PMT and bone fracture may be possible with a SUVmax threshold of 7.6. The integration of PET derived TLU, along with TmP/GFR may improve diagnosis and treatment planning for TIO.
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