Gallium-68 DOTATATE PET in the Evaluation of Intracranial Meningiomas.
| Publication Type | Academic Article |
| Authors | Ivanidze J, Roytman M, Lin E, Magge R, Pisapia D, Liechty B, Karakatsanis N, Ramakrishna R, Knisely J, Schwartz T, Osborne J, Pannullo S |
| Journal | J Neuroimaging |
| Volume | 29 |
| Issue | 5 |
| Pagination | 650-656 |
| Date Published | 05/20/2019 |
| ISSN | 1552-6569 |
| Keywords | Brain Neoplasms, Gallium Radioisotopes, Meningeal Neoplasms, Meningioma, Organometallic Compounds, Positron-Emission Tomography |
| Abstract | 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. |
| DOI | 10.1111/jon.12632 |
| PubMed ID | 31107591 |