Department of Clinical Physiology, Nuclear Medicine and PET, Copenhagen University Hospital, Rigshospitalet, Denmark.
Department of Radiology, Copenhagen University Hospital, Rigshospitalet, Denmark.
Clin Cancer Res. 2021 Apr 15;27(8):2216-2225. doi: 10.1158/1078-0432.CCR-20-3362. Epub 2021 Feb 1.
PET with somatostatin receptor ligand [Ga]Ga-DOTA-D-Phe-Tyr-octreotide ([Ga]Ga-DOTA-TOC) is an established method in radiotherapy planning because of the improved detection and delineation of meningioma tissue. We investigated the diagnostic accuracy of supplementary [Ga]Ga-DOTA-TOC PET in patients with a 3-month postoperative MRI reporting gross-total resection (GTR).
Thirty-seven patients with a histologically proven meningioma and GTR on postoperative MRI were prospectively referred to [Ga]Ga-DOTA-TOC PET. Detection and volume measurements of [Ga]Ga-DOTA-TOC-avid lesions in relation to the primary tumor site were recorded. Residual tumor in suspicious lesions suggested by [Ga]Ga-DOTA-TOC PET was verified by (i) tumor recurrence/progression on subsequent MRI scans according to the Response Assessment of Neuro-Oncology criteria, (ii) subsequent histology, and (iii) follow-up [Ga]Ga-DOTA-TOC PET scan.
Twenty-three PET scans demonstrated [Ga]Ga-DOTA-TOC-avid lesions suspicious of residual meningioma, where 18 could be verified by (i) tumor progression on subsequent MRI scans ( = 6), (ii) histologic confirmation ( = 3), and (iii) follow-up [Ga]Ga-DOTA-TOC PET scans confirming the initial PET findings ( = 9) after an overall median follow-up time of 17 months (range, 9-35 months). In contrast, disease recurrence was seen in only 2 of 14 patients without [Ga]Ga-DOTA-TOC-avid lesions ( < 0.0001). The sensitivity, specificity, and diagnostic accuracy of [Ga]Ga-DOTA-TOC PET in detecting meningioma residue was 90% [95% confidence interval (CI), 67-99], 92% (95% CI, 62-100), and 90% (95% CI, 74-98; < 0.0001), respectively.
The majority of patients with GTR on 3-month postoperative MRI may have small unrecognized meningioma residues that can be detected using [Ga]Ga-DOTA-TOC PET.
正电子发射断层扫描（PET）采用生长抑素受体配体[Ga]Ga-DOTA-D-Phe-Tyr-octreotide([Ga]Ga-DOTA-TOC)，这是一种成熟的放疗计划方法，因为它可以提高脑膜瘤组织的检测和勾画能力。我们调查了在术后 3 个月磁共振成像（MRI）报告完全切除（GTR）的患者中，补充[Ga]Ga-DOTA-TOC PET 的诊断准确性。
前瞻性地将 37 例经组织学证实为脑膜瘤且术后 MRI 显示 GTR 的患者转诊至[Ga]Ga-DOTA-TOC PET。记录[Ga]Ga-DOTA-TOC 阳性病变与原发性肿瘤部位的检测和体积测量结果。[Ga]Ga-DOTA-TOC PET 提示可疑残留肿瘤的残留肿瘤，通过以下方法得到验证：（i）根据神经肿瘤反应评估标准，随后的 MRI 扫描显示肿瘤复发/进展；（ii）随后的组织学检查；（iii）随后的[Ga]Ga-DOTA-TOC PET 扫描。
23 次 PET 扫描显示[Ga]Ga-DOTA-TOC 可疑脑膜瘤残留，其中 18 例可通过（i）随后的 MRI 扫描显示肿瘤进展（6 例）、（ii）组织学证实（3 例）和（iii）随后的[Ga]Ga-DOTA-TOC PET 扫描证实初始 PET 结果（9 例）得到验证，中位随访时间为 17 个月（9-35 个月）。相比之下，在没有[Ga]Ga-DOTA-TOC 阳性病变的 14 例患者中，仅 2 例出现疾病复发（<0.0001）。[Ga]Ga-DOTA-TOC PET 检测脑膜瘤残留的灵敏度、特异性和准确性分别为 90%（95%可信区间（CI），67-99）、92%（95% CI，62-100）和 90%（95% CI，74-98；<0.0001）。
术后 3 个月 MRI 报告 GTR 的大多数患者可能有较小的未被识别的脑膜瘤残留，可通过[Ga]Ga-DOTA-TOC PET 检测到。
