68ga-dotanoc and Meningioma

Medulloblastomas, especially the sonic hedgehog subgroup, are treated aggressively with surgery and chemoradiotherapy, as they are associated with high local site recurrence rate and poor overall survival. Radiation-induced meningioma is the most common delayed complication of craniospinal irradiation. This needs to be differentiated from meningeal or ependymal metastases as the later need aggressive management. We report one such rare case, in a patient who completed treatment for medulloblastoma 11 years ago, was in remission, and now presented with dural-based lesions.

Topics: Cerebellar Neoplasms; Humans; Medulloblastoma; Meningioma; Neoplasms, Radiation-Induced; Organometallic Compounds; Positron Emission Tomography Computed Tomography

To assess the ability of Ga DOTA-NOC PET/computed tomography (CT) to differentiate dural metastases from meningioma.. Patients who underwent a Ga DOTA-NOC PET/CT for differentiating meningiomas from dural metastases were included in the study. A visual score was assigned to the dural lesions (visual score - 1 to 3) in relation to the uptake in liver and spleen and variation in the visual score was evaluated. SUVmax of the dural lesions was also noted and difference in the values of the two pathologies were compared for statistical significance using nonparametric statistical tests. Final diagnosis was decided by histopathological confirmation whenever available.. Imaging, histopathology or follow-up data of 42 patients was available for analysis. Meningioma was the final diagnosis in 31 (73.8%) patients, whereas dural metastases were diagnosed in 9 (21.4%) patients. In two patients, histopathology revealed inflammatory pseudotumor and hemangioblastoma. Meningiomas showed intense tracer uptake in 30/31 patients (visual score 3). All metastatic lesions showed some degree of tracer uptake though the intensity was lesser compared to meningioma (visual score 1, 2). Meningiomas showed a significantly higher median SUV max value compared to metastases (12.7 vs. 6.0, P = 0.001).. Meningiomas can be differentiated from dural metastases by virtue of their higher uptake of Ga-labeled DOTA peptides reflecting higher SSTR expression. An asymptomatic meningeal based lesion with a high visual score (Visual score 3) has a very high probability to be a meningioma rather than dural metastasis.

Topics: Adolescent; Adult; Aged; Diagnosis, Differential; Dura Mater; Female; Humans; Male; Meningeal Neoplasms; Meningioma; Middle Aged; Neoplasm Metastasis; Organometallic Compounds; Positron Emission Tomography Computed Tomography; Young Adult

The goal of this study was to compare the tumor uptake kinetics and diagnostic value of three (68)Ga-DOTA-labeled somatostatin analogues ((68)Ga-DOTATOC, (68)Ga-DOTANOC, and (68)Ga-DOTATATE) using PET/CT in a murine model with subcutaneous meningioma xenografts.. The experiment was performed with 16 male NUDE NU/NU mice bearing xenografts of a human meningioma cell line (CH-157MN). (68)Ga-DOTATOC, (68)Ga-DOTANOC, and (68)Ga-DOTATATE were produced in a FASTLab automated platform. Imaging was performed on an Argus small-animal PET/CT scanner. The SUVmax of the liver and muscle, and the tumor-to-liver (T/L) and tumor-to-muscle (T/M) SUV ratios were computed. Kinetic analysis was performed using Logan graphical analysis for a two-tissue reversible compartmental model, and the volume of distribution (Vt) was determined.. Hepatic SUVmax and Vt were significantly higher with (68)Ga-DOTANOC than with (68)Ga-DOTATOC and (68)Ga-DOTATATE. No significant differences between tracers were found for SUVmax in tumor or muscle. No differences were found in the T/L SUV ratio between (68)Ga-DOTATATE and (68)Ga-DOTATOC, both of which had a higher fraction than (68)Ga-DOTANOC. The T/M SUV ratio was significantly higher with (68)Ga-DOTATATE than with (68)Ga-DOTATOC and (68)Ga-DOTANOC. The Vt for tumor was higher with (68)Ga-DOTATATE than with (68)Ga-DOTANOC and relatively similar to that of (68)Ga-DOTATOC.. This study demonstrates, for the first time, the ability of the three radiolabeled somatostatin analogues tested to image a human meningioma cell line. Although Vt was relatively similar with (68)Ga-DOTATATE and (68)Ga-DOTATOC, uptake was higher with (68)Ga-DOTATATE in the tumor than with (68)Ga-DOTANOC and (68)Ga-DOTATOC, suggesting a higher diagnostic value of (68)Ga-DOTATATE for detecting meningiomas.

Topics: Animals; Humans; Male; Meningeal Neoplasms; Meningioma; Mice; Mice, Nude; Molecular Imaging; Octreotide; Organometallic Compounds; Positron-Emission Tomography