Diagnostic performance and impact on patient management of [68Ga]Ga-DOTA-TOC PET/CT in colorectal neuroendocrine tumors derived from hindgut

Delabie, Pierre; Baudin, Éric; Hentic, Olivia; Afchain, Pauline; Rusu, Timofei; Montravers, F.

doi:10.1097/md.0000000000031512

Cited by 2 publications

(2 citation statements)

References 39 publications

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“…Despite advancements in understanding the disease, diagnosing and treating TIO remains challenging due to the variable size and distribution of the causative tumor in the body, which even advanced imaging techniques may fail to detect 11 . Ariadne Bosman reported that the tumor was found on physical examination in 32.4% of cases.…”

Section: Discussionmentioning

confidence: 99%

Unusual presentation of tumor‐induced osteomalacia mismanaged due to misdiagnosis: A literature review based on a case report

Fatollahzadeh,

Meybodi,

Pajavand

et al. 2024

Clinical Case Reports

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Key Clinical MessageTumor‐induced osteomalacia is a rare but potentially serious disease with nonspecific misguiding manifestations that can result in a wrong diagnosis and being treated for rheumatologic or other similar diseases. In patients with unexpected fractures, resistant musculoskeletal pains, and hypophosphatemia, this diagnosis should be considered by the physicians and approached through a complete history taking, physical exam laboratory, and radiologic evaluation to give the opportunity of on‐time treatment to the patient.AbstractTumor‐induced osteomalacia (TIO) is an uncommon mesenchymal tumor that results in disproportionate phosphorus excretion, primarily leading to bone‐related symptoms. Laboratory, imaging, and histopathological evaluation can confirm this pathologic condition. In this case, we present the history and subsequent clinical parts of a 50‐year‐old woman who presented with an unusual presentation of generalized musculoskeletal pains and a right ankle mass. Her disease was diagnosed with multidisciplinary evaluation and was approached by a surgical treatment. The patient was treated with total resection of the tumor, which led to complete resolution of musculoskeletal and metabolic abnormalities, which were resolved following total tumor resection. TIO is a paraneoplastic disease that results in abnormal secretion of phosphatonins, particularly fibroblast growth factor 23 (FGF23). This can cause hypophosphatemia, hyperparathyroidism, lower bone density, and increased risk of pathologic fractures. These tumors are mostly cured by surgical ± radiotherapy. The present study aims to provide insight into the fact that a TIO diagnosis is not always straightforward. However, in suspicious cases such as unexplained hypophosphatemia, it should be considered to prevent delayed diagnosis of the progressive pathology. The earlier treatment can prevent several complications and reduce the risk of mortality.

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Section: Discussionmentioning

confidence: 99%

Unusual presentation of tumor‐induced osteomalacia mismanaged due to misdiagnosis: A literature review based on a case report

Fatollahzadeh,

Meybodi,

Pajavand

et al. 2024

Clinical Case Reports

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“…European Medicines Agency 2022 ; Fourquet et al 2021 ) and [ 68 Ga]Ga-DOTATOC (EMA. European Medicines Agency 2018a ; Delabie et al 2022 ; Moreau et al 2022 ) already used in clinical routine.…”

Section: Discussionmentioning

confidence: 99%

Fully automated radiolabeling of [68Ga]Ga-EMP100 targeting c-MET for PET-CT clinical imaging

Rusu,

Delion,

Pirot

et al. 2023

EJNMMI radiopharm. chem.

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Background c-MET is a transmembrane receptor involved in many biological processes and contributes to cell proliferation and migration during cancer invasion process. Its expression is measured by immunehistochemistry on tissue biopsy in clinic, although this technique has its limitations. PET-CT could allow in vivo mapping of lesions expressing c-MET, providing whole-body detection. A number of radiopharmaceuticals are under development for this purpose but are not yet in routine clinical use. EMP100 is a cyclic oligopeptide bound to a DOTA chelator, with nanomolar affinity for c-MET. The aim of this project was to develop an automated method for radiolabelling the radiopharmaceutical [68Ga]Ga-EMP100. Results The main results showed an optimal pH range between 3.25 and 3.75 for the complexation reaction and a stabilisation of the temperature at 90 °C, resulting in an almost complete incorporation of gallium-68 after 10 min of heating. In these experiments, 90 µg of EMP-100 peptide were initially used and then lower amounts (30, 50, 75 µg) were explored to determine the minimum required for sufficient synthesis yield. Radiolysis impurities were identified by radio-HPLC and ascorbic acid and ethanol were used to improve the purity of the compound. Three batches of [68Ga]Ga-EMP100 were then prepared according to the optimised parameters and all met the established specifications. Finally, the stability of [68Ga]Ga-EMP100 was assessed at room temperature over 3 h with satisfactory results in terms of appearance, pH, radiochemical purity and sterility. Conclusions For the automated synthesis of [68Ga]Ga-EMP100, the parameters of pH, temperature, precursor peptide content and the use of adjuvants for impurity management were efficiently optimised, resulting in the production of three compliant and stable batches according to the principles of good manufacturing practice. [68Ga]Ga-EMP100 was successfully synthesised and is now available for clinical development in PET-CT imaging.

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Diagnostic performance and impact on patient management of [68Ga]Ga-DOTA-TOC PET/CT in colorectal neuroendocrine tumors derived from hindgut

Cited by 2 publications

References 39 publications

Unusual presentation of tumor‐induced osteomalacia mismanaged due to misdiagnosis: A literature review based on a case report

Unusual presentation of tumor‐induced osteomalacia mismanaged due to misdiagnosis: A literature review based on a case report

Fully automated radiolabeling of [68Ga]Ga-EMP100 targeting c-MET for PET-CT clinical imaging

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