Department of Neurological Surgery, University of California at Irvine Medical Center, Orange, California, USA.
Cancer. 2011 Oct 1;117(19):4506-11. doi: 10.1002/cncr.26065. Epub 2011 Mar 28.
Meningioma is the most common extra-axial primary intracranial tumor in adults that rarely metastasizes outside of the central nervous system (CNS). Among recognized sites of metastases, the lung is the most common, but the importance of lung metastases relative to prognosis is unknown. ¹¹¹Indium (¹¹¹In)-octreotide scintigraphy (octreotide scanning) is a valuable imaging modality with which to evaluate intracranial meningiomas and their response to treatment with somatostatin analogues and has the potential to identify extracranial metastatic disease.
In this retrospective multicenter study, adult patients treated for recurrent meningioma were identified. These patients underwent ¹¹¹In-octreotide positron emission tomography/computed tomography imaging (octreotide scintigraphy) and were found to have positive octreotide uptake in their lungs.
Six cases were identified with recurrent meningioma (after surgery, radiotherapy, and at least 1 chemotherapy agent) and pulmonary lesions by octreotide scintigraphy. Biopsy of a pulmonary lesion in 1 patient confirmed the diagnosis of metastatic meningioma. Patients with metastatic pulmonary involvement identified by ¹¹¹In-octreotide scintigraphy in this case series had an overall survival of 6 months, which is less than that reported from previously published series of patients with unknown systemic disease status.
¹¹¹In-octreotide scintigraphy is useful for assessing both CNS disease and extracranial metastases. The presence of pulmonary metastases appears to negatively affect survival in patients with recurrent meningioma. The usefulness of ¹¹¹In-octreotide scintigraphy should be considered in staging patients with recurrent meningioma who are considered for further treatment. A prospective study to confirm this finding is warranted
脑膜瘤是成人中最常见的轴外原发性颅内肿瘤，很少在中枢神经系统（CNS）之外转移。在已识别的转移部位中，肺部是最常见的，但肺部转移与预后的关系尚不清楚。¹¹¹铟（¹¹¹In）-奥曲肽闪烁扫描（奥曲肽扫描）是一种评估颅内脑膜瘤及其对生长抑素类似物治疗反应的有价值的成像方式，并且有可能识别颅外转移性疾病。
在这项回顾性多中心研究中，鉴定了接受复发性脑膜瘤治疗的成年患者。这些患者接受了¹¹¹In-奥曲肽正电子发射断层扫描/计算机断层扫描成像（奥曲肽闪烁扫描），并发现其肺部有奥曲肽摄取阳性。
在 1 例患者中，通过奥曲肽闪烁扫描发现 6 例复发性脑膜瘤（手术、放疗和至少 1 种化疗药物后）和肺部病变。1 例肺部病变的活检证实了转移性脑膜瘤的诊断。该病例系列中通过¹¹¹In-奥曲肽闪烁扫描识别出有转移性肺受累的患者的总生存率为 6 个月，低于先前发表的未知全身疾病状态患者系列报告的生存率。
¹¹¹In-奥曲肽闪烁扫描可用于评估中枢神经系统疾病和颅外转移。肺部转移的存在似乎会降低复发性脑膜瘤患者的生存。对于考虑进一步治疗的复发性脑膜瘤患者，应考虑¹¹¹In-奥曲肽闪烁扫描的用途。需要前瞻性研究来证实这一发现。
