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Afshar-Oromieh A, Wolf MB, Kratochwil C, Giesel FL, Combs SE, Dimitrakopoulou-Strauss A, Gnirs R, Roethke MC, Schlemmer HP, Haberkorn U. Comparison of ⁶⁸Ga-DOTATOC-PET/CT and PET/MRI hybrid systems in patients with cranial meningioma: Initial results. Neuro Oncol 2014; 17:312-9. [PMID: 25008094 DOI: 10.1093/neuonc/nou131] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND (68)Ga-DOTATOC-PET/CT is a well-established method for detecting and targeting the volume definition of meningiomas prior to radiotherapy. Moreover, there is evidence that this method is able to detect meningiomas with higher sensitivity than the goldstandard MRI. Since the hybrid PET/MRI scanner became available in the past few years, the next stage of development could consequently evolve by evaluating the feasibility of a hybrid PET/MRI scanner using (68)Ga-DOTATOC for detecting meningiomas. METHODS Fifteen patients received (68)Ga-DOTATOC-PET/CT (0.5 h post injection [p.i.]) followed by PET/MRI 2 hours p.i. Both investigations were analyzed separately and then compared with respect to image quality, detection of intracranial meningiomas, and radiotracer uptake values (RUVs). In addition, ratios between radiotracer uptake in meningiomas and pituitary glands were compared between both PET/CT and PET/MRI. RESULTS Overall, 33 intracranial meningiomas were detected. All were visible with high contrast in both PET/CT and PET/MRI. (68)Ga-DOTATOC-PET/MRI provided flawless image quality without artefacts. Calculated RUV in meningiomas, as well as the ratios of RUVs in meningiomas to those of pituitary glands, were higher in PET/CT. As a result, meningiomas can be distinguished from pituitary glands better in early images. CONCLUSIONS (68)Ga-DOTATOC-PET/MRI provided flawless image quality and presented an ideal combination of high sensitivity/specificity (PET) and the best possible morphological visualization of meningiomas (MRI). In addition, excellent detection of meningiomas is already possible at 0.5 hours p.i. Later images do not improve the distinction between pituitary gland and adjacent meningiomas. However, RUVs need to be carefully compared between both imaging modalities.
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Affiliation(s)
- Ali Afshar-Oromieh
- Department of Nuclear Medicine, University Hospital of Heidelberg, Heidelberg, Germany (A.A.-O., C.K., F.L.G., U.H.); Department of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.A.-O., M.B.W., R.G., M.C.R., H.P.S.); Clinical Cooperation Unit of Nuclear Medicine, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.A.-O., A.D.-S.); Department of Radiation Oncology and Therapy, University Hospital of Heidelberg, Heidelberg, Germany (S.E.C.)
| | - Maya B Wolf
- Department of Nuclear Medicine, University Hospital of Heidelberg, Heidelberg, Germany (A.A.-O., C.K., F.L.G., U.H.); Department of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.A.-O., M.B.W., R.G., M.C.R., H.P.S.); Clinical Cooperation Unit of Nuclear Medicine, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.A.-O., A.D.-S.); Department of Radiation Oncology and Therapy, University Hospital of Heidelberg, Heidelberg, Germany (S.E.C.)
| | - Clemens Kratochwil
- Department of Nuclear Medicine, University Hospital of Heidelberg, Heidelberg, Germany (A.A.-O., C.K., F.L.G., U.H.); Department of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.A.-O., M.B.W., R.G., M.C.R., H.P.S.); Clinical Cooperation Unit of Nuclear Medicine, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.A.-O., A.D.-S.); Department of Radiation Oncology and Therapy, University Hospital of Heidelberg, Heidelberg, Germany (S.E.C.)
| | - Frederik L Giesel
- Department of Nuclear Medicine, University Hospital of Heidelberg, Heidelberg, Germany (A.A.-O., C.K., F.L.G., U.H.); Department of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.A.-O., M.B.W., R.G., M.C.R., H.P.S.); Clinical Cooperation Unit of Nuclear Medicine, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.A.-O., A.D.-S.); Department of Radiation Oncology and Therapy, University Hospital of Heidelberg, Heidelberg, Germany (S.E.C.)
| | - Stephanie E Combs
- Department of Nuclear Medicine, University Hospital of Heidelberg, Heidelberg, Germany (A.A.-O., C.K., F.L.G., U.H.); Department of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.A.-O., M.B.W., R.G., M.C.R., H.P.S.); Clinical Cooperation Unit of Nuclear Medicine, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.A.-O., A.D.-S.); Department of Radiation Oncology and Therapy, University Hospital of Heidelberg, Heidelberg, Germany (S.E.C.)
| | - Antonia Dimitrakopoulou-Strauss
- Department of Nuclear Medicine, University Hospital of Heidelberg, Heidelberg, Germany (A.A.-O., C.K., F.L.G., U.H.); Department of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.A.-O., M.B.W., R.G., M.C.R., H.P.S.); Clinical Cooperation Unit of Nuclear Medicine, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.A.-O., A.D.-S.); Department of Radiation Oncology and Therapy, University Hospital of Heidelberg, Heidelberg, Germany (S.E.C.)
| | - Regula Gnirs
- Department of Nuclear Medicine, University Hospital of Heidelberg, Heidelberg, Germany (A.A.-O., C.K., F.L.G., U.H.); Department of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.A.-O., M.B.W., R.G., M.C.R., H.P.S.); Clinical Cooperation Unit of Nuclear Medicine, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.A.-O., A.D.-S.); Department of Radiation Oncology and Therapy, University Hospital of Heidelberg, Heidelberg, Germany (S.E.C.)
| | - Matthias C Roethke
- Department of Nuclear Medicine, University Hospital of Heidelberg, Heidelberg, Germany (A.A.-O., C.K., F.L.G., U.H.); Department of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.A.-O., M.B.W., R.G., M.C.R., H.P.S.); Clinical Cooperation Unit of Nuclear Medicine, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.A.-O., A.D.-S.); Department of Radiation Oncology and Therapy, University Hospital of Heidelberg, Heidelberg, Germany (S.E.C.)
| | - Heinz P Schlemmer
- Department of Nuclear Medicine, University Hospital of Heidelberg, Heidelberg, Germany (A.A.-O., C.K., F.L.G., U.H.); Department of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.A.-O., M.B.W., R.G., M.C.R., H.P.S.); Clinical Cooperation Unit of Nuclear Medicine, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.A.-O., A.D.-S.); Department of Radiation Oncology and Therapy, University Hospital of Heidelberg, Heidelberg, Germany (S.E.C.)
| | - Uwe Haberkorn
- Department of Nuclear Medicine, University Hospital of Heidelberg, Heidelberg, Germany (A.A.-O., C.K., F.L.G., U.H.); Department of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.A.-O., M.B.W., R.G., M.C.R., H.P.S.); Clinical Cooperation Unit of Nuclear Medicine, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.A.-O., A.D.-S.); Department of Radiation Oncology and Therapy, University Hospital of Heidelberg, Heidelberg, Germany (S.E.C.)
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Afshar-Oromieh A, Giesel FL, Linhart HG, Haberkorn U, Haufe S, Combs SE, Podlesek D, Eisenhut M, Kratochwil C. Detection of cranial meningiomas: comparison of ⁶⁸Ga-DOTATOC PET/CT and contrast-enhanced MRI. Eur J Nucl Med Mol Imaging 2012; 39:1409-15. [PMID: 22669255 DOI: 10.1007/s00259-012-2155-3] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2012] [Accepted: 05/10/2012] [Indexed: 10/28/2022]
Abstract
PURPOSE PET imaging with somatostatin receptor ligands, such as (68)Ga-DOTATOC, is a well-established method for detection and target volume definition of meningiomas prior to radiotherapy. Since DOTATOC PET delivers a higher contrast between meningiomas and surrounding tissues than MRI, we conducted a retrospective analysis to compare the diagnostic accuracy of contrast-enhanced MRI (CE-MRI) with (68)Ga-DOTATOC PET/CT in patients with cranial meningiomas prior to radiotherapy. METHODS Over a period of 6 years, 134 patients (20-82 years of age, 107 women and 27 men) underwent cranial CE-MRI and (68)Ga-DOTATOC PET/CT. To compare the two methods, the lesions considered typical of meningiomas visually were counted and analysed with respect to their location and SUVmax. RESULTS In the 134 patients investigated by both modalities, 190 meningiomas were detected by (68)Ga-DOTATOC PET/CT and 171 by CE-MRI. With knowledge of the PET/CT data, the MRI scans were reinvestigated, which led to the detection of 4 of the 19 incidental meningiomas, resulting in an overall detection rate of 92 % of the meningioma lesions that were found by PET/CT. CONCLUSION Ga-DOTATOC PET/CT demonstrated an improved sensitivity in meningioma detection when compared to CE-MRI. Tumours adjacent to the falx cerebri, located at the skull base or obscured by imaging artefacts or calcification are particularly difficult to detect by MRI. Therefore (68)Ga-DOTATOC PET/CT may provide additional information in patients with uncertain or equivocal results on MRI or could help to confirm a diagnosis of meningioma based on MRI or could help to confirm MRI-based diagnosis of meningiomas in cases of biopsy limitations. It is possible that not only radiotherapy and surgical planning, but also follow-up strategies would benefit from this imaging modality.
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Affiliation(s)
- Ali Afshar-Oromieh
- Department of Nuclear Medicine, University Hospital of Heidelberg, INF 400, 69120 Heidelberg, Germany.
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