Slotty Philipp Jörg, Behrendt Florian Friedrich, Langen Karl-Josef, Cornelius Jan Frederick
Division of Neurosurgery, Department of Surgery, University of British Columbia, Vancouver, BC, Canada ; Department of Neurosurgery, Heinrich-Heine University Düsseldorf, Germany.
Department of Nuclear Medicine, University Hospital RWTH Aachen, Germany.
J Craniovertebr Junction Spine. 2014 Jan;5(1):44-6. doi: 10.4103/0974-8237.135224.
Imaging with positron emission tomography (PET) and (68)Ga-DOTA peptides is a promising method in intracranial meningiomas. Especially in recurrent meningioma discrimination between scar tissue and recurrent tumor tissue in magnetic resonance imaging (MRI) is often difficult. We report the first case of (68)Ga-DOTATATE-PET/computed tomography (PET/CT) imaging in recurrent spinal meningioma. A 64-year-old Caucasian female patient was referred to our department with the second recurrence of thoracic meningothelial meningioma. In MRI, it remained unclear if the multiple enhancements seen represented scar tissue or vital tumor. We offered (68)Ga-DOTATATE-PET/CT imaging in order to evaluate the best strategy. (68)Ga-DOTATATE-PET/CT imaging revealed strong tracer uptake in parts of the lesions. The pattern did distinctly differ from MRI enhancement. Multiple biopsies were performed in the PET-positive and PET-negative regions. Histological results confirmed the prediction of (68)Ga-DOTATATE-PET with vital tumor in PET-positive regions and scar tissue in PET-negative regions. Differentiating scar tissue from tumor can be challenging in recurrent spinal meningioma with MRI alone. In the presented case, (68)Ga-DOTATATE-PET imaging was able to differentiate noninvasively between tumor and scar.
正电子发射断层扫描（PET）及（68）镓-多胺基多羧基肽成像在颅内脑膜瘤中是一种很有前景的方法。特别是在复发性脑膜瘤中，磁共振成像（MRI）往往难以区分瘢痕组织和复发肿瘤组织。我们报告首例（68）镓-奥曲肽-PET/计算机断层扫描（PET/CT）成像用于复发性脊髓脑膜瘤的病例。一名64岁的白种女性患者因胸椎脑膜内皮型脑膜瘤第二次复发转诊至我科。在MRI检查中，尚不清楚所见的多处强化是代表瘢痕组织还是存活肿瘤。我们提供（68）镓-奥曲肽-PET/CT成像以评估最佳治疗策略。（68）镓-奥曲肽-PET/CT成像显示部分病灶有强烈的示踪剂摄取。该表现与MRI强化明显不同。在PET阳性和PET阴性区域进行了多次活检。组织学结果证实了（68）镓-奥曲肽-PET的预测，PET阳性区域为存活肿瘤，PET阴性区域为瘢痕组织。仅靠MRI区分复发性脊髓脑膜瘤中的瘢痕组织和肿瘤可能具有挑战性。在本病例中，（68）镓-奥曲肽-PET成像能够无创地区分肿瘤和瘢痕。
