Potential Impact of (68)Ga-DOTATOC PET/CT on Stereotactic Radiotherapy Planning of Meningiomas

Overview

Journal Eur J Nucl Med Mol Imaging

Specialties Biophysics
Nuclear Medicine
Radiology

Date 2009 Sep 19

PMID 19763565

Citations 33

Authors

Fonyuy Nyuyki

Michail Plotkin

Reinhold Graf

Roger Michel

Ingo Steffen

Timm Denecke

Lilli Geworski

Daniel Fahdt

Winfried Brenner

Reinhard Wurm

Affiliations

Soon will be listed here.

Abstract

Purpose: Since meningiomas show a high expression of somatostatin receptor subtype 2, PET with (68)Ga-DOTATOC was proposed as an additional imaging modality beside CT and MRI for planning radiotherapy. We investigated the input of (68)Ga-DOTATOC-PET/CT on the definition of the "gross tumour volume" (GTV) in meningiomas, in order to assess the potential value of this method.

Methods: Prior to radiotherapy, 42 patients with meningiomas (26 f, 16 m, mean age 55) underwent MRI and (68)Ga-DOTATOC-PET/CT examinations.

History: operated n = 24, radiotherapy n = 1, operation and radiotherapy n = 8, no treatment n = 9. PET/CT and MRI data were co-registered using a BrainLAB workstation. For comparison, the GTV was defined first under consideration of CT and MRI data, then using PET data.

Results: 3/42 patients were excluded from the analysis (two with negative PET results, one with an extensive tumour, not precisely delineable by MRI or PET/CT). The average GTV(CT/MRI) was 22(+/-19)cm(3); GTV(PET) was 23(+/-20)cm(3). Additional GTV, obtained as a result of PET was 9(+/-10)cm(3) and was observed in patients with osseous infiltration. In some pre-treated patients there were intratumoural areas (as identified in CT/MRI) without SR-expression (7(+/-11)cm(3)). Common GTV as obtained by both CT/MRI and PET was 15(+/-14)cm(3). The mean bi-directional difference between the GTV(CT/MRI) and GTV(PET) accounted to 16(+/-15)cm(3) (93%, p < 0.001). In a subgroup of seven patients with multiple meningiomas, PET showed a total of 19 lesions; nine of them were not recognizable by CT or MRI.

Conclusion: (68)Ga-DOTATOC-PET enables delineation of SR-positive meningiomas and delivers additional information to both CT and MRI regarding the planning of stereotactic radiotherapy. The acquisition on a PET/CT scanner helps to estimate the relation of PET findings to anatomical structures and is especially useful for detection of osseous infiltration. (68)Ga-DOTATOC-PET also allows detection of additional lesions in patients with multiple meningiomas.

Citing Articles

Joint EANM/EANO/RANO/SNMMI practice guideline/procedure standards for diagnostics and therapy (theranostics) of meningiomas using radiolabeled somatostatin receptor ligands: version 1.0.

Albert N, Preusser M, Traub-Weidinger T, Tolboom N, Law I, Palmer J Eur J Nucl Med Mol Imaging. 2024; 51(12):3662-3679.

PMID: 38898354 PMC: 11445317. DOI: 10.1007/s00259-024-06783-x.

[Ga68] DOTATATE PET/MRI-guided radiosurgical treatment planning and response assessment in meningiomas.

Ivanidze J, Chang S, Haghdel A, Kim J, Roy Choudhury A, Wu A Neuro Oncol. 2024; 26(8):1526-1535.

PMID: 38553990 PMC: 11300004. DOI: 10.1093/neuonc/noae067.

Utility of 68Ga-DOTATATE PET-MRI for Gamma Knife® stereotactic radiosurgery treatment planning for meningioma.

Ratnayake G, Huo M, Mehta A, Ramachandran P, Pinkham M, Law P Br J Radiol. 2024; 97(1153):180-185.

PMID: 38263827 PMC: 11027229. DOI: 10.1093/bjr/tqad026.

Somatostatin receptor subtype expression and radiomics from DWI-MRI represent SUV of [68Ga]Ga-DOTATOC PET in patients with meningioma.

Iglseder S, Iglseder A, Beliveau V, Heugenhauser J, Gizewski E, Kerschbaumer J J Neurooncol. 2023; 164(3):711-720.

PMID: 37707754 PMC: 10589159. DOI: 10.1007/s11060-023-04414-3.

Somatostatin Receptor-PET/CT/MRI of Head and Neck Neuroendocrine Tumors.

Rini J, Keir G, Caravella C, Goenka A, Franceschi A AJNR Am J Neuroradiol. 2023; 44(8):959-966.

PMID: 37442593 PMC: 10411831. DOI: 10.3174/ajnr.A7934.

References

Paling M, Black W, Levine P, Cantrell R . Tumor invasion of the anterior skull base: a comparison of MR and CT studies. J Comput Assist Tomogr. 1987; 11(5):824-30. DOI: 10.1097/00004728-198709000-00016. View

Simpson D . The recurrence of intracranial meningiomas after surgical treatment. J Neurol Neurosurg Psychiatry. 1957; 20(1):22-39. PMC: 497230. DOI: 10.1136/jnnp.20.1.22. View

Tomura N, Hirano H, Sashi R, Hashimoto M, Kato K, Takahashi S . Comparison of MR imaging and CT in discriminating tumor infiltration of bone and bone marrow in the skull base. Comput Med Imaging Graph. 1998; 22(1):41-51. DOI: 10.1016/s0895-6111(98)00008-1. View

Milker-Zabel S, Zabel-du Bois A, Henze M, Huber P, Schulz-Ertner D, Hoess A . Improved target volume definition for fractionated stereotactic radiotherapy in patients with intracranial meningiomas by correlation of CT, MRI, and [68Ga]-DOTATOC-PET. Int J Radiat Oncol Biol Phys. 2006; 65(1):222-7. DOI: 10.1016/j.ijrobp.2005.12.006. View

Khoo V, Adams E, Saran F, Bedford J, Perks J, Warrington A . A Comparison of clinical target volumes determined by CT and MRI for the radiotherapy planning of base of skull meningiomas. Int J Radiat Oncol Biol Phys. 2000; 46(5):1309-17. DOI: 10.1016/s0360-3016(99)00541-6. View

Henze M, Schuhmacher J, Hipp P, Kowalski J, Becker D, Doll J . PET imaging of somatostatin receptors using [68GA]DOTA-D-Phe1-Tyr3-octreotide: first results in patients with meningiomas. J Nucl Med. 2001; 42(7):1053-6. View

Henze M, Dimitrakopoulou-Strauss A, Milker-Zabel S, Schuhmacher J, Strauss L, Doll J . Characterization of 68Ga-DOTA-D-Phe1-Tyr3-octreotide kinetics in patients with meningiomas. J Nucl Med. 2005; 46(5):763-9. View

Astner S, Dobrei-Ciuchendea M, Essler M, Bundschuh R, Sai H, Schwaiger M . Effect of 11C-methionine-positron emission tomography on gross tumor volume delineation in stereotactic radiotherapy of skull base meningiomas. Int J Radiat Oncol Biol Phys. 2008; 72(4):1161-7. DOI: 10.1016/j.ijrobp.2008.02.058. View

Schmidt M, Scheidhauer K, Luyken C, Voth E, Hildebrandt G, Klug N . Somatostatin receptor imaging in intracranial tumours. Eur J Nucl Med. 1998; 25(7):675-86. DOI: 10.1007/s002590050269. View

10.

Nyberg G, Bergstrom M, Enblad P, Lilja A, Muhr C, Langstrom B . PET-methionine of skull base neuromas and meningiomas. Acta Otolaryngol. 1997; 117(4):482-9. DOI: 10.3109/00016489709113425. View

11.

Weingarten K, Ernst R, Jahre C, Zimmerman R . Detection of residual or recurrent meningioma after surgery: value of enhanced vs unenhanced MR imaging. AJR Am J Roentgenol. 1992; 158(3):645-50. DOI: 10.2214/ajr.158.3.1739012. View

12.

Pauleit D, Floeth F, Hamacher K, Riemenschneider M, Reifenberger G, Muller H . O-(2-[18F]fluoroethyl)-L-tyrosine PET combined with MRI improves the diagnostic assessment of cerebral gliomas. Brain. 2005; 128(Pt 3):678-87. DOI: 10.1093/brain/awh399. View

13.

Stockhammer F, Plotkin M, Amthauer H, van Landeghem F, Woiciechowsky C . Correlation of F-18-fluoro-ethyl-tyrosin uptake with vascular and cell density in non-contrast-enhancing gliomas. J Neurooncol. 2008; 88(2):205-10. DOI: 10.1007/s11060-008-9551-3. View

14.

Zhernosekov K, Filosofov D, Baum R, Aschoff P, Bihl H, Razbash A . Processing of generator-produced 68Ga for medical application. J Nucl Med. 2007; 48(10):1741-8. DOI: 10.2967/jnumed.107.040378. View

15.

Grosu A, Lachner R, Wiedenmann N, Stark S, Thamm R, Kneschaurek P . Validation of a method for automatic image fusion (BrainLAB System) of CT data and 11C-methionine-PET data for stereotactic radiotherapy using a LINAC: first clinical experience. Int J Radiat Oncol Biol Phys. 2003; 56(5):1450-63. DOI: 10.1016/s0360-3016(03)00279-7. View

16.

Reubi J, Schar J, Waser B, Wenger S, Heppeler A, Schmitt J . Affinity profiles for human somatostatin receptor subtypes SST1-SST5 of somatostatin radiotracers selected for scintigraphic and radiotherapeutic use. Eur J Nucl Med. 2000; 27(3):273-82. DOI: 10.1007/s002590050034. View

17.

Grosu A, Weber W, Astner S, Adam M, Krause B, Schwaiger M . 11C-methionine PET improves the target volume delineation of meningiomas treated with stereotactic fractionated radiotherapy. Int J Radiat Oncol Biol Phys. 2006; 66(2):339-44. DOI: 10.1016/j.ijrobp.2006.02.047. View

18.

Bohuslavizki K, Brenner W, Braunsdorf W, Behnke A, Tinnemeyer S, Hugo H . Somatostatin receptor scintigraphy in the differential diagnosis of meningioma. Nucl Med Commun. 1996; 17(4):302-10. DOI: 10.1097/00006231-199604000-00157. View

19.

Pauli S, Schulz S, Handel M, Dietzmann K, Firsching R, Hollt V . Immunohistochemical determination of five somatostatin receptors in meningioma reveals frequent overexpression of somatostatin receptor subtype sst2A. Clin Cancer Res. 2000; 6(5):1865-74. View

20.

Gudjonsson O, Blomquist E, Lilja A, Ericson H, Bergstrom M, Nyberg G . Evaluation of the effect of high-energy proton irradiation treatment on meningiomas by means of 11C-L-methionine PET. Eur J Nucl Med. 2001; 27(12):1793-9. DOI: 10.1007/s002590000335. View