中华骨质疏松和骨矿盐疾病杂志2026，Vol.19Issue(4)：442-450,9.DOI:10.3969/j.issn.1674-2591.2026.04.003
功能性计算机导航在肿瘤性骨软化症手术中的应用实践
Application of functional computer navigation in surgery for tumor-induced osteomalacia
摘要
Abstract
Objective To summarize the surgical workflow,technical feasibility and preliminary clinical value of functional computer navigation that integrates somatostatin receptor positron emission tomography/computed tomography(SSTR-PET/CT)into an intraoperative computer navigation system for surgery in patients with tumor-in-duced osteomalacia(TIO).Methods Five patients with TIO who underwent functional computer navigation assisted resection of the causative lesion were retrospectively included.All patients underwent preoperative clinical,biochemical and imaging evaluations.Functional high-uptake information identified on SSTR-PET/CT was fused with CT anatomical images and imported into the intraoperative navigation platform.Baseline characteristics,image fusion and navigation procedures,surgical methods,pathological findings,postoperative serum phosphate recovery,symptom improvement and complications were analyzed descriptively.Results Among the five patients,three were female and two were male,with a median age of 39 years and a median disease duration of 3 years.Preoperative serum phosphate levels ranged from 0.37 to 0.50 mmol/L.All patients underwent preoperative tumor localization using Al 18 F-NOTA-LM3-PET/CT or 68 Ga-DOTATATE-PET/CT combined with anatomical imaging.Image fusion,navigation data import,intra-operative registration and navigated lesion localization were successfully completed in all five cases.Surgical procedures included curettage of bone lesions or excision of soft-tissue lesions.Pathology confirmed phosphaturic mesenchymal tumor in all cases.Four patients achieved normalization of serum phosphate levels accompanied by symptomatic improve-ment after surgery,corresponding to a biochemical remission rate of 80.0%(4/5).In the remaining patient with mul-tifocal disease,hypophosphatemia persisted postoperatively,given the presence of multiple lesions and pulmonary mi-cronodules,residual causative lesions were suspected.No surgery-related complications occurred in any patient.Conclusion Functional computer navigation can translate metabolic activity information from SSTR-PET/CT into an in-traoperative localization reference,demonstrating good feasibility and safety in this series of patients with TIO.This technique may be particularly useful for cases involving occult lesions,complex anatomical locations or altered anatomy due to previous surgery.However,its impact on biochemical remission and recurrence risk requires validation in larger prospective studies.关键词
肿瘤性骨软化症/生长抑素受体PET/CT/功能性计算机导航/计算机辅助手术/磷酸盐尿性间叶肿瘤Key words
tumor-induced osteomalacia/somatostatin receptor PET/CT/functional computer navigation/com-puter-assisted surgery/phosphaturic mesenchymal tumor分类
医药卫生引用本文复制引用
崔丽嘉,刘巍峰,徐启明,蔡豌苹,杨泽希,吴雨朔,姜艳,李远,翟笑,夏维波..功能性计算机导航在肿瘤性骨软化症手术中的应用实践[J].中华骨质疏松和骨矿盐疾病杂志,2026,19(4):442-450,9.基金项目
北京市自然科学基金(7252109) （7252109）
四大慢病防治研究国家科技重大专项(2024ZD0532204) （2024ZD0532204）
中央高水平医院临床研究科研业务费(2026-PUMCH-A-063) （2026-PUMCH-A-063）
协和人才培育支持计划(ULJ04417,UHB11952) （ULJ04417,UHB11952）
北京医师科学家培养计划(BJPSTP-2026-44) （BJPSTP-2026-44）
