Improved Detection of Postoperative Residual Meningioma with [68Ga]Ga-DOTA-TOC PET Imaging Using a High-resolution Research Tomograph PET Scanner
Open Access
- 1 February 2021
- journal article
- research article
- Published by American Association for Cancer Research (AACR) in Clinical Cancer Research
- Vol. 27 (8), 2216-2225
- https://doi.org/10.1158/1078-0432.ccr-20-3362
Abstract
Purpose: PET with somatostatin receptor ligand [68Ga]Ga-DOTA-D-Phe1-Tyr3-octreotide ([68Ga]Ga-DOTA-TOC) is an established method in radiotherapy planning because of the improved detection and delineation of meningioma tissue. We investigated the diagnostic accuracy of supplementary [68Ga]Ga-DOTA-TOC PET in patients with a 3-month postoperative MRI reporting gross-total resection (GTR). Experimental Design: Thirty-seven patients with a histologically proven meningioma and GTR on postoperative MRI were prospectively referred to [68Ga]Ga-DOTA-TOC PET. Detection and volume measurements of [68Ga]Ga-DOTA-TOC-avid lesions in relation to the primary tumor site were recorded. Residual tumor in suspicious lesions suggested by [68Ga]Ga-DOTA-TOC PET was verified by (i) tumor recurrence/progression on subsequent MRI scans according to the Response Assessment of Neuro-Oncology criteria, (ii) subsequent histology, and (iii) follow-up [68Ga]Ga-DOTA-TOC PET scan. Results: Twenty-three PET scans demonstrated [68Ga]Ga-DOTA-TOC-avid lesions suspicious of residual meningioma, where 18 could be verified by (i) tumor progression on subsequent MRI scans (n = 6), (ii) histologic confirmation (n = 3), and (iii) follow-up [68Ga]Ga-DOTA-TOC PET scans confirming the initial PET findings (n = 9) after an overall median follow-up time of 17 months (range, 9–35 months). In contrast, disease recurrence was seen in only 2 of 14 patients without [68Ga]Ga-DOTA-TOC-avid lesions (P < 0.0001). The sensitivity, specificity, and diagnostic accuracy of [68Ga]Ga-DOTA-TOC PET in detecting meningioma residue was 90% [95% confidence interval (CI), 67–99], 92% (95% CI, 62–100), and 90% (95% CI, 74–98; P < 0.0001), respectively. Conclusions: The majority of patients with GTR on 3-month postoperative MRI may have small unrecognized meningioma residues that can be detected using [68Ga]Ga-DOTA-TOC PET.Keywords
Funding Information
- Danish Cancer Society Research Center (R146-A9508-16-S2)
This publication has 43 references indexed in Scilit:
- Significance of Simpson grading system in modern meningioma surgery: integration of the grade with MIB-1 labeling index as a key to predict the recurrence of WHO Grade I meningiomasJournal of Neurosurgery, 2012
- Combination of peptide receptor radionuclide therapy with fractionated external beam radiotherapy for treatment of advanced symptomatic meningiomaRadiation Oncology, 2012
- Magnetic resonance imaging, computed tomography, and 68Ga-DOTATOC positron emission tomography for imaging skull base meningiomas with infracranial extension treated with stereotactic radiotherapy - a case seriesHead & Face Medicine, 2012
- The relevance of Simpson Grade I and II resection in modern neurosurgical treatment of World Health Organization Grade I meningiomasJournal of Neurosurgery, 2010
- [68Ga]-DOTATOC-PET/CT for meningioma IMRT treatment planningRadiation Oncology, 2009
- Impact of Image-Space Resolution Modeling for Studies with the High-Resolution Research TomographJournal of Nuclear Medicine, 2008
- Predicting the Probability of Meningioma Recurrence in the Preoperative and Early Postoperative Period: A Multivariate Analysis in the Midterm Follow-UpJournal of Neurological Surgery Part B: Skull Base, 2007
- Performance evaluation of the ECAT HRRT: an LSO-LYSO double layer high resolution, high sensitivity scannerPhysics in Medicine & Biology, 2007
- The ECAT HRRT: performance and first clinical application of the new high resolution research tomographIEEE Transactions on Nuclear Science, 2002
- Seemingly complete removal of histologically benign intracranial meningioma: Late recurrence rate and factors predicting recurrence in 657 patients. A multivariate analysisSurgical Neurology, 1986