Somatostatin receptor scintigraphy for optic nerve sheath meningiomas.

Abstract

OBJECTIVE:

To investigate the value of somatostatin receptor scintigraphy (SSRS) in the diagnosis of optic nerve sheath meningiomas (ONSMs).

DESIGN:

Prospective, comparative case series.

PARTICIPANTS:

SSRS was used to investigate 68 orbits in 61 patients diagnosed with an orbital tumor.

METHODS:

Patients were injected intravenously with 200 MBq of indium-111 ((111)In)-octreotide. SSRS with single photon emission computed tomography (SPECT) was performed 24 hours after injection.

MAIN OUTCOME MEASURES:

The (111)In-octreotide uptake in orbital lesions was determined by semiquantitative uptake-ratio analysis (lesion/brain) on attenuation-corrected transverse SPECT slices.

RESULTS:

All orbital meningiomas, including 14 ONSMs and 12 spheno-orbital meningiomas, showed high median (111)In-octreotide uptake ratios of 7.2 (range, 4.6-15.4) and 16.3 (range, 4.6-15.4), respectively. In 7 patients with a diagnosis of ONSM, the SSRS uptake ratio was significantly decreased 2.7 (1-6.8) after treatment with 54 Gy of radiotherapy. Median uptake ratios of other tumors were vascular anomalies/vascular tumors, 1.2 (range, 0.5-3.3); non-Hodgkin lymphomas, 2.9 (range, 0.9-4.2); optic nerve gliomas, 1.5 (range, 0.2-3.3); and idiopathic orbital inflammation, 1.6 (range, 1.4-1.9). By using a threshold uptake ratio of 5.9, the sensitivity of SSRS with (111)In-octreotide for ONSM was 100%, with a specificity of 97.2%.

CONCLUSIONS:

SSRS is a useful additional tool in diagnosing ONSM and has 100% sensitivity and 97% specificity at a threshold uptake ratio of 5.9.

• Authors: Peerooz Saeed, Michael W T Tanck, Nicole Freling, Lelio Baldeschi, Maarten P Mourits, Roelof J Bennink
• Journal: Ophthalmology (Ophthalmology) Vol. 116 Issue 8 Pg. 1581-6 (Aug 2009) ISSN: 1549-4713 [Electronic] United States
• PMID: 19500849 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Indium Radioisotopes
• Receptors, Somatostatin
• Octreotide

Topics

• Adult
• Aged
• Female
• Humans
• Indium Radioisotopes
• Male
• Meningeal Neoplasms (diagnostic imaging, metabolism)
• Meningioma (diagnostic imaging, metabolism)
• Middle Aged
• Octreotide
• Optic Nerve Neoplasms (diagnostic imaging, metabolism)
• Prospective Studies
• Receptors, Somatostatin (metabolism)
• Tomography, Emission-Computed, Single-Photon
• Tomography, X-Ray Computed
• Young Adult