Gallium-68 DOTATATE PET in the Evaluation of Intracranial Meningiomas.
Adult
Aged
Aged, 80 and over
Brain Neoplasms
/ diagnostic imaging
Female
Gallium Radioisotopes
Humans
Magnetic Resonance Imaging
/ methods
Male
Meningeal Neoplasms
/ diagnostic imaging
Meningioma
/ diagnostic imaging
Middle Aged
Neoplasm Recurrence, Local
Organometallic Compounds
Positron-Emission Tomography
/ methods
Prospective Studies
DOTATATE
Meningioma
PET/MRI
molecular imaging
somatostatin receptor
Journal
Journal of neuroimaging : official journal of the American Society of Neuroimaging
ISSN: 1552-6569
Titre abrégé: J Neuroimaging
Pays: United States
ID NLM: 9102705
Informations de publication
Date de publication:
Sep 2019
Sep 2019
Historique:
received:
17
04
2019
accepted:
09
05
2019
pubmed:
21
5
2019
medline:
20
6
2020
entrez:
21
5
2019
Statut:
ppublish
Résumé
Meningiomas are the most common primary intracranial tumors, typically treated with surgery and adjuvant radiation in cases of subtotal resection and/or higher histopathologic grade. Contrast-enhanced magnetic resonance imaging (MRI) is the gold standard for postoperative assessment and adjuvant treatment planning. However, MRI can have limited accuracy particularly in the presence of posttreatment change. [68Ga]-DOTATATE is a Positron Emission Tomography (PET) radiotracer targeting somatostatin receptor 2A (SSTR2A). SSTR2A is a reliable biomarker of meningiomas. We report a consecutive case series of 20 patients evaluated with [68Ga]-DOTATATE PET/MRI, propose a novel approach to quantitative analysis, and discuss clinical implications. We present a consecutive case series of 20 patients with clinically suspected or pathology-proven meningioma evaluated between July 2018 and February 2019. [68Ga]-DOTATATE PET/MRI was obtained in order to confirm the diagnosis or determine tumor recurrence/progression to help guide surgical and/or radiation therapy management in cases in which MRI findings were indeterminate or equivocal. Seventeen (85%) patients had undergone prior surgery and 11 (55%) underwent adjuvant radiation therapy. In 17 patients [68Ga]-DOTATATE confirmed the presence of recurrent meningioma. A total of 49 meningiomas were identified (median: 2 meningiomas/patient, range 0-14). There was excellent differentiation between meningioma and posttreatment change based on our approach of target lesion/superior sagittal sinus maximum standardized uptake values ratio (16.6 vs. 1.6, P < .0001). [68Ga]-DOTATATE PET/MRI is a promising tool in the assessment of both treatment naïve and resected/irradiated meningiomas, allowing improved diagnosis and extent of disease evaluation. Future prospective studies are needed to determine utility of [68Ga]-DOTATATE PET/MRI in treatment response assessment.
Sections du résumé
BACKGROUND AND PURPOSE
OBJECTIVE
Meningiomas are the most common primary intracranial tumors, typically treated with surgery and adjuvant radiation in cases of subtotal resection and/or higher histopathologic grade. Contrast-enhanced magnetic resonance imaging (MRI) is the gold standard for postoperative assessment and adjuvant treatment planning. However, MRI can have limited accuracy particularly in the presence of posttreatment change. [68Ga]-DOTATATE is a Positron Emission Tomography (PET) radiotracer targeting somatostatin receptor 2A (SSTR2A). SSTR2A is a reliable biomarker of meningiomas. We report a consecutive case series of 20 patients evaluated with [68Ga]-DOTATATE PET/MRI, propose a novel approach to quantitative analysis, and discuss clinical implications.
METHODS
METHODS
We present a consecutive case series of 20 patients with clinically suspected or pathology-proven meningioma evaluated between July 2018 and February 2019. [68Ga]-DOTATATE PET/MRI was obtained in order to confirm the diagnosis or determine tumor recurrence/progression to help guide surgical and/or radiation therapy management in cases in which MRI findings were indeterminate or equivocal.
RESULTS
RESULTS
Seventeen (85%) patients had undergone prior surgery and 11 (55%) underwent adjuvant radiation therapy. In 17 patients [68Ga]-DOTATATE confirmed the presence of recurrent meningioma. A total of 49 meningiomas were identified (median: 2 meningiomas/patient, range 0-14). There was excellent differentiation between meningioma and posttreatment change based on our approach of target lesion/superior sagittal sinus maximum standardized uptake values ratio (16.6 vs. 1.6, P < .0001).
CONCLUSIONS
CONCLUSIONS
[68Ga]-DOTATATE PET/MRI is a promising tool in the assessment of both treatment naïve and resected/irradiated meningiomas, allowing improved diagnosis and extent of disease evaluation. Future prospective studies are needed to determine utility of [68Ga]-DOTATATE PET/MRI in treatment response assessment.
Substances chimiques
Gallium Radioisotopes
0
Organometallic Compounds
0
gallium Ga 68 dotatate
9L17Y0H71P
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
650-656Informations de copyright
© 2019 by the American Society of Neuroimaging.
Références
Ostrom QT, Gittleman H, Liao P, et al. CBTRUS Statistical Report: Primary brain and other central nervous system tumors diagnosed in the United States in 2010-2014. Neuro Oncol 2017;19(Suppl-5):v1-v88.
Durand A, Labrousse F, Jouvet A, et al. WHO grade II and III meningiomas: a study of prognostic factors. J Neurooncol 2009;95:367-75.
Rogers L, Barani I, Chamberlain M, et al. Meningiomas: knowledge base, treatment outcomes, and uncertainties. A RANO review. J Neurosurg 2015;122:4-23.
Kunz WG, Jungblut LM, Kazmierczak PM, et al. Improved detection of transosseous meningiomas using (68)Ga-DOTATATE PET/CT compared with contrast-enhanced MRI. J Nucl Med 2017;58:1580-7.
Galldiks N, Albert NL, Sommerauer M, et al. PET imaging in patients with meningioma-report of the RANO/PET Group. Neuro Oncol 2017;19:1576-87.
Lee JW, Kang KW, Park SH, et al. 18F-FDG PET in the assessment of tumor grade and prediction of tumor recurrence in intracranial meningioma. Eur J Nucl Med Mol Imaging 2009;36:1574-82.
Silva CB, Ongaratti BR, Trott G, et al. Expression of somatostatin receptors (SSTR1-SSTR5) in meningiomas and its clinicopathological significance. Int J Clin Exp Pathol 2015;8:13185-92.
Menke JR, Raleigh DR, Gown AM, et al. Somatostatin receptor 2a is a more sensitive diagnostic marker of meningioma than epithelial membrane antigen. Acta Neuropathol 2015;130:441-3.
Stade F, Dittmar JO, Jakel O, et al. Influence of (68)Ga-DOTATOC on sparing of normal tissue for radiation therapy of skull base meningioma: differential impact of photon and proton radiotherapy. Radiat Oncol 2018;13:58.
Thorwarth D, Henke G, Muller AC, et al. Simultaneous 68Ga-DOTATOC-PET/MRI for IMRT treatment planning for meningioma: first experience. Int J Radiat Oncol Biol Phys 2011;81:277-83.
Rachinger W, Stoecklein VM, Terpolilli NA, et al. Increased 68Ga-DOTATATE uptake in PET imaging discriminates meningioma and tumor-free tissue. J Nucl Med 2015;56:347-53.
Reubi JC, Schar JC, Waser B, et al. Affinity profiles for human somatostatin receptor subtypes SST1-SST5 of somatostatin radiotracers selected for scintigraphic and radiotherapeutic use. Eur J Nucl Med 2000;27:273-82.
Afshar-Oromieh A, Giesel FL, Linhart HG, et al. Detection of cranial meningiomas: comparison of (6)(8)Ga-DOTATOC PET/CT and contrast-enhanced MRI. Eur J Nucl Med Mol Imaging 2012;39:1409-15.
Judenhofer MS, Wehrl HF, Newport DF, et al. Simultaneous PET-MRI: a new approach for functional and morphological imaging. Nat Med 2008;14:459-65.
Afshar-Oromieh A, Wolf MB, Kratochwil C, et al. Comparison of (6)(8)Ga-DOTATOC-PET/CT and PET/MRI hybrid systems in patients with cranial meningioma: Initial results. Neuro-oncology 2015;17:312-9.
Wehrl HF, Sauter AW, Divine MR, et al. Combined PET/MR: a technology becomes mature. J Nucl Med 2015;56:165-8.
Villanueva-Meyer JE, Magill ST, Lee JC, et al. Detection of metastatic meningioma to the liver using 68Ga-DOTA-Octreotate PET/CT. Clin Nucl Med 2018;43:e338-40.
Al Feghali KA, Yeboa DN, Chasen B, et al. The use of (68)Ga-DOTATATE PET/CT in the non-invasive diagnosis of optic nerve sheath meningioma: a case report. Front Oncol 2018;8:454.
Rahmim A, Zaidi H. PET versus SPECT: strengths, limitations and challenges. Nucl Med Commun 2008;29:193-207.
Taneja S, Jena A, Kaul S, et al. Somatostatin receptor-positive granulomatous inflammation mimicking as meningioma on simultaneous PET/MRI. Clin Nucl Med 2015;40:e71-2.
Kaley T, Barani I, Chamberlain M, et al. Historical benchmarks for medical therapy trials in surgery- and radiation-refractory meningioma: a RANO review. Neuro Oncol 2014;16:829-40.
Seystahl K, Stoecklein V, Schuller U, et al. Somatostatin receptor-targeted radionuclide therapy for progressive meningioma: benefit linked to 68Ga-DOTATATE/-TOC uptake. Neuro Oncol 2016;18:1538-47.