Molecular Perspectives on Meningioma with Osseous Infiltration Revealed by Ga-DOTA TOC PET-CT.

Meningiomas express the somatostatin receptor (SSTR). The utilization of SSTR ligands, specifically Gallium-68 (Ga) isotope, a radioactive isotope (Ga)-DOTA-labeled peptides, has demonstrated exceptional diagnostic precision for the detection of meningiomas, primarily due to the absence of normal brain and bone activity. We report a case of a 48-year-old woman with sphenoid wing meningioma who underwent Ga-DOTA TOC positron emission tomography (PET) for tumor delineation. Ga-DOTA TOC PET shows SSTR-avid meningioma in the right sphenoid/anterior temporal region with significant hyperostosis with high expression of SSTR in the bone. Ga-DOTA TOC uptake in the hyperostosis signifies bone infiltration rather than reactive changes. Ga-DOTA PET provides a better assessment of osseous involvement and provides additional information in terms of meningioma extent and planning for further management.