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Ga-68 DOTATOC PET/CT-Guided Biopsy and Cryoablation with Autoradiography of Biopsy Specimen for Treatment of Tumor-Induced Osteomalacia

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Abstract

Tumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome caused by small benign tumors of mesenchymal origin also known as phosphaturic mesenchymal tumors mixed connective tissue variant. Excellent prognosis is expected with eradication of the culprit tumor. These small tumors are notoriously difficult to localize with conventional imaging studies; this often leads to an extensive work up and prolonged morbidity. We report a patient with clinical diagnosis of TIO whose culprit tumor was localized with Ga-68 DOTATOC PET/CT and MRI. Biopsy and cryoablation were performed under Ga-68 DOTATOC PET/CT guidance. Autoradiography of the biopsy specimen was performed and showed in situ correlation between Ga-68 DOTATOC uptake and histopathology with millimeter resolution.

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Acknowledgments

This research was funded in part through the NIH/NCI Cancer Center Support Grant P30 CA008748. 68Ga-DOTATOC was provided by Memorial Sloan Kettering Cancer Center institutional protocol 14-226 “68Ga-DOTATOC for imaging of Neuroendocrine tumors: Expanded access trial.” Quantitative autobiography of biopsy specimen was made available by Memorial Sloan Kettering Cancer Center institutional protocol 12-072 “Evaluation and Improvement of PET Accuracy for Tumor Targeting Using Autoradiography and Pathology Tests of Biospecimens from Patients Undergoing PET/CT Guided Biopsy.” Special thanks to Mr. Lawrence T. Dauer, PhD, from Department of Medical Physics, Memorial Sloan Kettering Cancer Center for guidance about the operator dose.

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Authors and Affiliations

  1. Interventional Radiology Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, M276C, New York, NY, 10065, USA

    Majid Maybody

  2. Molecular Imaging and Therapy Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Ravinder K. Grewal & Jorge A. Carrasquillo

  3. Orthopedic Surgical Oncology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    John H. Healey

  4. Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Cristina R. Antonescu

  5. Department of Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Louise Fanchon & Assen Kirov

  6. Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Sinchun Hwang

  7. Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Azeez Farooki

Authors
  1. Majid Maybody
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  2. Ravinder K. Grewal
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  3. John H. Healey
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  4. Cristina R. Antonescu
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  5. Louise Fanchon
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  6. Sinchun Hwang
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  7. Jorge A. Carrasquillo
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  8. Assen Kirov
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  9. Azeez Farooki
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Correspondence to Majid Maybody.

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

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All procedures performed were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained for all procedures.

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Maybody, M., Grewal, R.K., Healey, J.H. et al. Ga-68 DOTATOC PET/CT-Guided Biopsy and Cryoablation with Autoradiography of Biopsy Specimen for Treatment of Tumor-Induced Osteomalacia. Cardiovasc Intervent Radiol 39, 1352–1357 (2016). https://doi.org/10.1007/s00270-016-1350-1

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  • DOI: https://doi.org/10.1007/s00270-016-1350-1

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