Premium
Gallium‐68 DOTATATE PET in the Evaluation of Intracranial Meningiomas
Author(s) -
Ivanidze Jana,
Roytman Michelle,
Lin Eaton,
Magge Rajiv S.,
Pisapia David J.,
Liechty Benjamin,
Karakatsanis Nicolas,
Ramakrishna Rohan,
Knisely Jonathan,
Schwartz Theodore H.,
Osborne Joseph R.,
Pannullo Susan C.
Publication year - 2019
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/jon.12632
Subject(s) - medicine , meningioma , magnetic resonance imaging , radiology , positron emission tomography , somatostatin receptor , radiation therapy , nuclear medicine , radiosurgery , adjuvant radiotherapy , adjuvant therapy , cancer , somatostatin
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.