Department of Nuclear Medicine, Beijing , Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China.
Department of Radiation Oncology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Eur J Nucl Med Mol Imaging. 2023 Dec;51(1):218-225. doi: 10.1007/s00259-023-06391-1. Epub 2023 Sep 8.
Clinical studies of PET imaging using SSTR2 agonists have demonstrated high accuracy and correlation with SSTR2 expression in meningiomas. However, the usefulness of the SSTR2 antagonist with [ Ga]Ga-DOTA-JR11 is uncertain. To evaluate the diagnostic performance of [ Ga]Ga-DOTA-JR11 PET/CT and to clarify tumor characteristics in patients with suspected meningiomas.
Patients with suspected de novo or recurrent meningioma in complex locations or atypical images were enrolled from August 2021 to October 2022 in prospective study. All patients underwent contrast-enhanced MRI (CE-MRI), [ Ga]Ga-DOTA-JR11 PET/CT, and histopathological evaluation. Tumor uptake of [ Ga]Ga-DOTA-JR11 was measured by SUVmax and tumor-endocranium ratio (TBR). Diagnostic performance was compared between PET and MRI.
Of 36 (50.0 ± 13.0 years of age, 20 women) patients, 32 were histopathologically confirmed meningiomas and four with other tumors. [ Ga]Ga-DOTA-JR11 uptake was significantly higher in meningioma patients than in those with other tumors (SUVmax: 13.6 ± 7.7 vs. 5.2 ± 3.0, P < 0.001; TBR: 64.2 ± 27.7 vs. 25.0 ± 18.9, P = 0.001). [ Ga]Ga-DOTA-JR11 PET/CT detected 31 meningiomas, while CE-MRI detected 17 meningiomas of 25 initial diagnosis and 11 recurrent tumors; [ Ga]Ga-DOTA-JR11 PET had an incremental diagnostic value of 24% (6/25) over MRI in the group of initial diagnosis. There was no statistically significant difference in diagnostic efficacy between PET and MRI (P = 0.45) for all 36 patients. In skull base meningiomas, PET provided a more definitive diagnosis of pituitary involvement (in 12, not in12), compared to MRI (in eight, possible in six, possible not in six, not in four). PET revealed bone involvement in all 14 patients proven by pathology, while MRI identified only 11.
[ Ga]Ga-DOTA-JR11 PET/CT provided high image quality and presented an ideal diagnostic performance in detecting meningioma and evaluating the involvement of the pituitary and bone. The study provides valuable evidence for the use of [ Ga]Ga-DOTA-JR11 PET/CT as a complementary imaging modality to CE-MRI in the evaluation of meningiomas.
使用 SSTR2 激动剂的 PET 成像的临床研究表明，其在脑膜瘤中的准确性和与 SSTR2 表达的相关性均较高。然而，[Ga]Ga-DOTA-JR11 这种 SSTR2 拮抗剂的用途尚不确定。评估[Ga]Ga-DOTA-JR11 PET/CT 的诊断性能，并阐明疑似脑膜瘤患者的肿瘤特征。
本前瞻性研究于 2021 年 8 月至 2022 年 10 月间纳入复杂部位或表现不典型的新发或复发性脑膜瘤疑似患者。所有患者均行对比增强 MRI（CE-MRI）、[Ga]Ga-DOTA-JR11 PET/CT 和组织病理学评估。通过最大标准摄取值（SUVmax）和肿瘤-颅腔比（TBR）来测量[Ga]Ga-DOTA-JR11 的肿瘤摄取。比较了 PET 和 MRI 的诊断性能。
36 例（年龄 50.0±13.0 岁，女性 20 例）患者中，32 例经组织病理学证实为脑膜瘤，4 例为其他肿瘤。脑膜瘤患者的[Ga]Ga-DOTA-JR11 摄取明显高于其他肿瘤患者（SUVmax：13.6±7.7 比 5.2±3.0，P<0.001；TBR：64.2±27.7 比 25.0±18.9，P=0.001）。[Ga]Ga-DOTA-JR11 PET/CT 检测到 31 例脑膜瘤，而 CE-MRI 检测到 25 例初诊中的 17 例脑膜瘤和 11 例复发性肿瘤；在初诊组中，[Ga]Ga-DOTA-JR11 PET 比 MRI 的诊断效能提高了 24%（6/25）。对于所有 36 例患者，PET 和 MRI 的诊断效能无统计学差异（P=0.45）。在颅底脑膜瘤中，与 MRI 相比，PET 能更明确地诊断垂体受累（12 例确定，12 例可能）。与 MRI 相比（11 例确定，6 例可能，6 例可能不，4 例不），PET 显示所有 14 例经病理证实的骨受累。
[Ga]Ga-DOTA-JR11 PET/CT 提供了高质量的图像，在检测脑膜瘤和评估垂体和骨受累方面表现出理想的诊断性能。该研究为使用[Ga]Ga-DOTA-JR11 PET/CT 作为 CE-MRI 的补充成像方式来评估脑膜瘤提供了有价值的证据。
