[Ga68] DOTATATE PET/MRI-guided radiosurgical treatment planning and response assessment in meningiomas.
| Publication Type | Academic Article |
| Authors | Ivanidze J, Chang S, Haghdel A, Kim J, Roy Choudhury A, Wu A, Ramakrishna R, Schwartz T, Cisse B, Stieg P, Muller L, Osborne J, Magge R, Karakatsanis N, Roytman M, Lin E, Pannullo S, Palmer J, Knisely J |
| Journal | Neuro Oncol |
| Volume | 26 |
| Issue | 8 |
| Pagination | 1526-1535 |
| Date Published | 08/05/2024 |
| ISSN | 1523-5866 |
| Keywords | Meningioma, Radiosurgery, Meningeal Neoplasms, Positron-Emission Tomography, Magnetic Resonance Imaging, Organometallic Compounds |
| Abstract | BACKGROUND: Our purpose was to determine the utility of [68Ga]-DOTATATE PET/MRI in meningioma response assessment following radiosurgery. METHODS: Patients with meningioma prospectively underwent postoperative DOTATATE PET/MRI. Co-registered PET and gadolinium-enhanced T1-weighted MRI were employed for radiosurgery planning. Follow-up DOTATATE PET/MRI was performed at 6-12 months post-radiosurgery. Maximum absolute standardized uptake value (SUV) and SUV ratio (SUVRSSS) referencing superior sagittal sinus (SSS) blood pool were obtained. Size change was determined by Response Assessment in Neuro-Oncology (RANO) criteria. Association of SUVRSSS change magnitude and progression-free survival (PFS) was evaluated using Cox regression. RESULTS: Twenty-seven patients with 64 tumors (26% World Health Organization [WHO]-1, 41% WHO-2, 26% WHO-3, and 7% WHO-unknown) were prospectively followed post stereotactic radiosurgery (SRS) or stereotactic body radiotherapy (SBRT; mean dose: 30 Gy, modal dose 35 Gy, mean of 5 fractions). Post-irradiation SUV and SUVRSSS decreased by 37.4% and 44.4%, respectively (P < .0001). Size product decreased by 8.9%, thus failing to reach the 25% significance threshold as determined by RANO guidelines. Mean follow-up time was 26 months (range: 6-44). Overall mean PFS was 83% and 100%/100%/54% in WHO-1/-2/-3 subcohorts, respectively, at 34 months. At maximum follow-up (42-44 months), PFS was 100%/83%/54% in WHO-1/-2/-3 subcohorts, respectively. Cox regression analyses revealed a hazard ratio of 0.48 for 10-unit reduction in SUVRSSS in the SRS cohort. CONCLUSIONS: DOTATATE PET SUV and SUVRSSS demonstrated marked, significant decrease post-radiosurgery. Lesion size decrease was statistically significant; however, it was not clinically significant by RANO criteria. DOTATATE PET/MR thus represents a promising imaging biomarker for response assessment in meningiomas treated with radiosurgery. CLINICALTRIALS.GOV IDENTIFIER: NCT04081701. |
| DOI | 10.1093/neuonc/noae067 |
| PubMed ID | 38553990 |
| PubMed Central ID | PMC11300004 |