Evaluation of [68Ga]-DOTATOC PET/MRI in Patients with Meningioma of the Subcranial and Intraorbital Space

J Nucl Med. 2023 Aug;64(8):1185-1190. doi: 10.2967/jnumed.123.265424. Epub 2023 Jun 29.

Abstract

Meningiomas are known to express somatostatin receptor (SSTR) type 2 to a high degree. Therefore, radiolabeled somatostatin analogs, such as DOTATOC, have been introduced for PET imaging of meningiomas. However, the benefit of hybrid SSTR PET/MRI is still debated. Here, we report our experience with [68Ga]-DOTATOC PET/MRI. Methods: PET/MRI was performed in 60 patients with suspected or diagnosed meningiomas of the skull plane and eye socket. Acquired datasets were reported by 2 independent readers regarding local tumor extent and signal characteristics. Histopathologic results and follow-up imaging served as the reference standard. SUVs of target lesions were analyzed according to the corresponding maximal tracer uptake. The diagnostic accuracy of PET/MRI and conventional MRI was determined independently and compared with the reference standard. Results: In total, 60 target lesions were identified, with 54 considered to be meningiomas according to the reference standard. Sensitivity and specificity of PET/MRI versus MRI alone were 95% versus 96% and 75% versus 66%, respectively. The McNemar test was not able to distinguish any differences between PET/MRI and the reference standard or MRI and the reference standard. No differences were found between the 2 modalities with respect to local infiltration. Conclusion: SSTR PET/MRI and MRI yielded similar accuracy for the detection of meningiomas of the skull base and intraorbital space. Here, sequential low-dose SSTR PET/CT might be helpful for the planning of radioligand therapy or radiotherapy.

Keywords: DOTATOC; PET; meningioma; oncologic imaging; somatostatin receptor ligands.

MeSH terms

  • Gallium Radioisotopes
  • Humans
  • Magnetic Resonance Imaging / methods
  • Meningeal Neoplasms* / diagnostic imaging
  • Meningeal Neoplasms* / radiotherapy
  • Meningioma* / diagnostic imaging
  • Meningioma* / pathology
  • Octreotide
  • Organometallic Compounds*
  • Positron Emission Tomography Computed Tomography
  • Positron-Emission Tomography / methods
  • Tomography, X-Ray Computed / methods

Substances

  • Gallium Radioisotopes
  • Edotreotide
  • Octreotide
  • Organometallic Compounds