Roytman Michelle, Pisapia David J, Liechty Benjamin, Lin Eaton, Skafida Myrto, Magge Rajiv S, Osborne Joseph R, Pannullo Susan C, Knisely Jonathan P S, Ramakrishna Rohan, Ivanidze Jana
Department of Radiology, Weill Cornell Medicine-New York Presbyterian Hospital, United States of America.
Department of Pathology and Laboratory Medicine, Weill Cornell Medicine-New York Presbyterian Hospital, United States of America.
Clin Imaging. 2020 Oct;66:18-22. doi: 10.1016/j.clinimag.2020.04.026. Epub 2020 Apr 25.
Meningiomas are the most common non-malignant primary intracranial tumors, accounting for nearly 40% of all primary brain tumors, usually expressing high levels of somatostatin receptors (SSTR), particularly SSTR2. Because Ga-DOTATATE targets SSTR2, it is increasingly used clinically for meningioma evaluation. While previous apparent lack of SSTR expression in meningiomas has been reported in isolated cases, these prior studies utilized Indium-111 (In) Octreotide, which is of lesser diagnostic accuracy compared to Ga-DOTATATE, as well as Technetium-99m (Tc)-DTPA scintigraphy, which necessitates an intact blood-tumor-permeability barrier. This paper presents a histopathologic proven atypical meningioma, WHO Grade II, with low level avidity on Ga-DOTATATE PET/MRI, subsequently proven to be SSTR2-negative by immunohistochemistry, with a review and discussion of the current literature and imaging implications.
脑膜瘤是最常见的非恶性原发性颅内肿瘤，占所有原发性脑肿瘤的近40%，通常表达高水平的生长抑素受体（SSTR），尤其是SSTR2。由于镓[68Ga] DOTATATE靶向SSTR2，它在临床上越来越多地用于脑膜瘤评估。虽然之前有孤立病例报道脑膜瘤明显缺乏SSTR表达，但这些先前的研究使用的是铟[111In]奥曲肽，其诊断准确性低于镓[68Ga] DOTATATE，以及锝[99mTc] - DTPA闪烁扫描，后者需要完整的血脑屏障。本文介绍了一例经组织病理学证实的非典型脑膜瘤，WHO二级，在镓[68Ga] DOTATATE PET/MRI上摄取率低，随后经免疫组化证实为SSTR2阴性，并对当前文献及影像学意义进行了综述和讨论。
