Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C1835664 (TOC)
 2,763 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Tumor-induced osteomalacia (TIO) is a paraneoplastic syndrome characterized by renal phosphate wasting, hypophosphatemia and low calcitriol levels as well as clinical symptoms like diffuse bone and muscle pain, fatigue fractures or increased fracture risk. Conventional imaging methods, however, often fail to detect the small tumors. Lately, tumor localization clearly improved by somatostatin-receptor (SSTR) imaging, such as octreotide scintigraphy or octreotide SPECT/CT. However, recent studies revealed that still a large number of tumors remained undetected by octreotide imaging. Hence, studies focused on different SSTR imaging methods such as 68Ga DOTA-NOC, 68Ga DOTA-TOC and 68Ga DOTA-TATE PET/CT with promising first results. Studies comparing different SSTR imaging methods for tumor localization in TIO are rare and thus little is known about diagnostic alternatives once a particular method failed to detect a tumor in patients with TIO. Here, we report the data of 5 consecutive patients suffering from TIO, who underwent both 111Indium-octreotide scintigraphy (111In-OCT) SPECT/CT as well as 68Ga DOTA-TATE PET/CT for tumor detection. While 111In-OCT SPECT/CT allowed tumor detection in only 1 of 5 patients, 68Ga DOTA-TATE PET/CT was able to localize the tumor in all patients. Afterwards, anatomical imaging of the region of interest was performed with CT and MRI. Thus, successful surgical resection of the tumor was achieved in all patients. Serum phosphate levels returned to normal and all patients reported relief of symptoms within weeks. Moreover, an iliac crest biopsy was obtained from every patient and revealed marked osteomalacia in all cases. Follow-up DXA revealed an increase in BMD of up to 34.5% 1-year postoperative, indicating remineralization. No recurrence was observed. In conclusion our data indicates that 68Ga DOTA-TATE PET/CT is an effective and promising diagnostic tool in the diagnosis of TIO, even in patients in whom 111In-OCT prior failed to detect a tumor.
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PMID:68Ga DOTA-TATE PET/CT allows tumor localization in patients with tumor-induced osteomalacia but negative 111In-octreotide SPECT/CT. 2476 33

Purpose: Peptide receptor radionuclide therapy (PRRT) with 177Lu-labelled somatostatin analogues in patients with somatostatin-receptor expressing tumors is often performed using administration protocols prescribing a 30 minutes infusion time. The most often used method of infusion is the gravity method, by which the complete dose is effectively administered exponentially. However, there is no evidence to explicitly support an infusion time of 30 minutes. This study aims to investigate the safety of an infusion time of less than 5 minutes. Methods: A cohort study was performed, examining the biochemical and clinical toxicity after PRRT when using a fast infusion protocol with a maximum infusion time of 5 minutes. Data on patient characteristics, laboratory tests, follow-up visits and pre- and post-treatment imaging using 68Ga-DOTA-TOC PET/CT from patients treated with PRRT at the University Medical Center Utrecht (UMC Utrecht) were collected. All patients receiving PRRT using the fast-infusion protocol were included. If no laboratory or clinical follow-up was available, patients were excluded. In addition, a laboratory experiment was performed, simulating the standard-infusion protocol using the gravity method. Results: 31 patients were included, who were treated using the fast infusion protocol. Clinical toxicity mainly consisted of grade 1/2 fatigue (87.1%) and grade 1 nausea and/or vomiting (67.7%) during follow-up. No acute or long term clinical toxicity possibly related to the fast infusion protocol was reported. Grade 3/4 hematological toxicity occurred after PRRT in one patient (3.2%). No grade 3/4 renal toxicity occurred. The laboratory experiment showed that when using the gravity method for infusion, half of the activity is infused after 3.5 minutes, and 95% is infused within 15 minutes. Conclusion: A faster infusion of PRRT using an infusion time of less than 5 minutes is safe and feasible in clinical practice.
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PMID:A rapid and safe infusion protocol for lutetium-177 peptide receptor radionuclide therapy. 3324 81