|Title||Gallium-68 DOTATATE PET in the Evaluation of Intracranial Meningiomas.|
|Publication Type||Journal Article|
|Year of Publication||2019|
|Authors||Ivanidze J, Roytman M, Lin E, Magge RS, Pisapia DJ, Liechty B, Karakatsanis N, Ramakrishna R, Knisely J, Schwartz TH, Osborne JR, Pannullo SC|
|Date Published||2019 Sep|
|Keywords||Adult, Aged, Aged, 80 and over, Brain Neoplasms, Female, Gallium Radioisotopes, Humans, Magnetic Resonance Imaging, Male, Meningeal Neoplasms, Meningioma, Middle Aged, Neoplasm Recurrence, Local, Organometallic Compounds, Positron-Emission Tomography, Prospective Studies|
BACKGROUND AND PURPOSE: 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: 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: 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: [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.
|Alternate Journal||J Neuroimaging|