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Detection of cranial meningiomas: comparison of ⁶⁸Ga-DOTATOC PET/CT and contrast-enhanced MRI.

AbstractPURPOSE:
PET imaging with somatostatin receptor ligands, such as (68)Ga-DOTATOC, is a well-established method for detection and target volume definition of meningiomas prior to radiotherapy. Since DOTATOC PET delivers a higher contrast between meningiomas and surrounding tissues than MRI, we conducted a retrospective analysis to compare the diagnostic accuracy of contrast-enhanced MRI (CE-MRI) with (68)Ga-DOTATOC PET/CT in patients with cranial meningiomas prior to radiotherapy.
METHODS:
Over a period of 6 years, 134 patients (20-82 years of age, 107 women and 27 men) underwent cranial CE-MRI and (68)Ga-DOTATOC PET/CT. To compare the two methods, the lesions considered typical of meningiomas visually were counted and analysed with respect to their location and SUVmax.
RESULTS:
In the 134 patients investigated by both modalities, 190 meningiomas were detected by (68)Ga-DOTATOC PET/CT and 171 by CE-MRI. With knowledge of the PET/CT data, the MRI scans were reinvestigated, which led to the detection of 4 of the 19 incidental meningiomas, resulting in an overall detection rate of 92 % of the meningioma lesions that were found by PET/CT.
CONCLUSION:
Ga-DOTATOC PET/CT demonstrated an improved sensitivity in meningioma detection when compared to CE-MRI. Tumours adjacent to the falx cerebri, located at the skull base or obscured by imaging artefacts or calcification are particularly difficult to detect by MRI. Therefore (68)Ga-DOTATOC PET/CT may provide additional information in patients with uncertain or equivocal results on MRI or could help to confirm a diagnosis of meningioma based on MRI or could help to confirm MRI-based diagnosis of meningiomas in cases of biopsy limitations. It is possible that not only radiotherapy and surgical planning, but also follow-up strategies would benefit from this imaging modality.
AuthorsAli Afshar-Oromieh, Frederik L Giesel, Heinz G Linhart, Uwe Haberkorn, Sabine Haufe, Stephanie E Combs, Dino Podlesek, Michael Eisenhut, Clemens Kratochwil
JournalEuropean journal of nuclear medicine and molecular imaging (Eur J Nucl Med Mol Imaging) Vol. 39 Issue 9 Pg. 1409-15 (Sep 2012) ISSN: 1619-7089 [Electronic] Germany
PMID22669255 (Publication Type: Comparative Study, Journal Article)
Chemical References
  • Contrast Media
  • Ga(III)-DOTATOC
  • Organometallic Compounds
  • Octreotide
Topics
  • Adult
  • Aged
  • Aged, 80 and over
  • Brain Neoplasms (diagnosis, radionuclide imaging, radiotherapy)
  • Contrast Media
  • Female
  • Humans
  • Magnetic Resonance Imaging (methods)
  • Male
  • Meningeal Neoplasms (diagnosis, radionuclide imaging, radiotherapy)
  • Meningioma (diagnosis, radionuclide imaging, radiotherapy)
  • Middle Aged
  • Multimodal Imaging (methods)
  • Octreotide (analogs & derivatives)
  • Organometallic Compounds
  • Positron-Emission Tomography
  • Retrospective Studies
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed
  • Young Adult

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