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Detection Rate of Culprit Tumors Causing Osteomalacia Using Somatostatin Receptor PET/CT: Systematic Review and Meta-Analysis

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Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, CH-1011 Lausanne, Switzerland
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Clinic of Medical Oncology, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, CH-6500 Bellinzona, Switzerland
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Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, CH-1011 Lausanne, Switzerland
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Faculty of Biology and Medicine, University of Lausanne, CH-1005 Lausanne, Switzerland
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Clinic of Orthopaedics and Traumatology, Department of Surgery, Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale, CH-6900 Lugano, Switzerland
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Clinic of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, CH-6500 Bellinzona, Switzerland
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Faculty of Medicine, University of Zurich, CH-8091 Zurich, Switzerland
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Health Technology Assessment Unit, Academic Education Research and Innovation Area, General Directorate, Ente Ospedaliero Cantonale, CH-6500 Bellinzona, Switzerland
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Clinic of Orthopedics and Traumatology, Department of Surgery, Ospedale Regionale di Bellinzona, Ente Ospedaliero Cantonale, CH-6500 Bellinzona, Switzerland
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
These authors contributed equally to this work.
Diagnostics 2020, 10(1), 2; https://doi.org/10.3390/diagnostics10010002
Received: 28 November 2019 / Revised: 16 December 2019 / Accepted: 17 December 2019 / Published: 18 December 2019
(This article belongs to the Section Medical Imaging)
Background: Tumor-induced or oncogenic osteomalacia (TIO) is a rare paraneoplastic syndrome in which osteomalacia is a consequence of fibroblast growth factor 23 (FGF23) secretion by a mesenchymal tumor. The localization of the culprit lesion in patients with TIO is often challenging. Several studies have evaluated the detection rate (DR) of these tumors using somatostatin receptor positron emission tomography (SSTR-PET/CT). We aimed to summarize literature findings on this topic providing pooled estimates of DR. Methods: A comprehensive literature search by screening PubMed, Embase and Cochrane library electronic databases through August 2019 was performed. The pooled DR of culprit tumors using SSTR-PET/CT in patients with TIO was calculated using a random-effects statistical model. Results: Fourteen studies on the use of SSTR-PET/CT in detecting the culprit tumor in patients with TIO were included in the qualitative analysis. The pooled DR of SSTR-PET/CT on a per-patient-based analysis calculated using eleven studies (166 patients) was 87.6% (95% confidence interval (95% CI) 80.2–95.1%). Statistical heterogeneity among studies was detected (I-square = 63%), likely due to the use of different radiolabeled somatostatin analogues, as demonstrated by a subgroup analysis. Conclusions: Despite limited literature data due to the rarity of the disease, SSTR-PET/CT demonstrated a very high DR of culprit tumors in patients with TIO and it could be used as first-line imaging method for this indication. View Full-Text
Keywords: PET; osteomalacia; culprit tumor; somatostatin; detection rate; systematic review; meta-analysis PET; osteomalacia; culprit tumor; somatostatin; detection rate; systematic review; meta-analysis
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Meyer, M.; Nicod Lalonde, M.; Testart, N.; Jreige, M.; Kamani, C.; Boughdad, S.; Muoio, B.; Becce, F.; Schaefer, N.; Candrian, C.; Giovanella, L.; Prior, J.O.; Treglia, G.; Riegger, M. Detection Rate of Culprit Tumors Causing Osteomalacia Using Somatostatin Receptor PET/CT: Systematic Review and Meta-Analysis. Diagnostics 2020, 10, 2.

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