lutetium-lu-177-dotatate and Meningioma

 In somatostatin receptor (SSTR) expressing progressive meningioma, peptide receptor radionuclide therapy (PRRT) has shown effect in small clinical series. However, standardized treatment and response assessment protocols are lacking. We present our experience on PPRT with.  Retrospective analysis on PRRT with.  Seven patients with progressive intracranial meningioma (median age 73 years, interquartile range 60-76; 5 WHO II, 2 WHO I; 5 multifocal) received a median of 4 cycles 2 3 4 of PRRT with.  In this heterogeneous collective of seven patients with progressive meningioma, 177Lu-DOTATATE therapies showed heterogeneous effectiveness. PET-based volumetric assessment should be used for response assessment in PRRT additionally to bidimensional imaging..  Bei Somatostatinrezeptor (SSTR) -exprimierenden progredienten Meningeomen hat die Peptidrezeptor-Radionuklidtherapie (PRRT) in kleinen klinischen Serien einen positiven Effekt gezeigt. Es fehlen jedoch standardisierte Protokolle für die Behandlung und insbesondere für die Beurteilung des Ansprechens. Wir stellen unsere Erfahrungen mit der PPRT mit.  Sieben Patienten mit progredientem intrakraniellem Meningeom (median: 73 Jahre, IQR: 60–76; 5 WHO II, 2 WHO I; 5 multifokal) erhielten im Median 4 Zyklen 2 3 4 der PRRT mit.  In diesem Kollektiv von 7 Patienten mit progressivem Meningeom zeigte die

Topics: Adult; Aged; Coordination Complexes; Female; Humans; Ligands; Male; Meningeal Neoplasms; Meningioma; Middle Aged; Octreotide; Positron-Emission Tomography; Receptors, Somatostatin; Retrospective Studies; Treatment Outcome

Lutetium-177 (DOTATATE) (

Topics: Humans; Meningeal Neoplasms; Meningioma; Nuclear Medicine; Occupational Exposure; Octreotide; Organometallic Compounds; Precision Medicine; Radiotherapy Dosage

Ga-DOTATATE imaging for meningiomas is gaining clinical use for selecting patients that may benefit from targeted therapy (eg, Lu-DOTATATE). We present an image of a 67-year-old man with an intracranial WHO grade III anaplastic meningioma. He underwent tumor resection followed by intensity-modulated radiation therapy but experienced a recurrence 25 months later. He received an F-(FDG) and Ga-DOTATATE PET/MR to evaluate for the presence of somatostatin receptor expression and guide subsequent treatment. The scans showed both concordant and discordant regions of uptake, indicating that high somatostatin receptor (SSTR2) expression may not coincide with areas of increased metabolic rate.

Topics: Aged; Fluorodeoxyglucose F18; Humans; Male; Meningeal Neoplasms; Meningioma; Octreotide; Organometallic Compounds; Positron Emission Tomography Computed Tomography; Radiopharmaceuticals

Somatostatin receptor subtype 2 upregulation is very common in meningiomas, and the use of peptide receptor radionuclide therapy (PRRT) is recognized in recent European guidelines, with long-term stable disease and a long overall survival. Treatment efficacy of radionuclide treatments is correlated with tumour radiation absorbed dose. Meningioma patients with low tumour uptake might benefit less from treatment. Thus, a method to increase tumour uptake in these patients is needed. We describe a case treated with both intravenous and intra-arterial PRRT. Tumour uptake after intravenous PRRT was disappointing, and after intra-arterial administration significantly increased tumour uptake was seen. Patient had a partial response on imaging and reduction in tumour-related complaints. Potentially, intra-arterial administration of PRRT could increase treatment efficacy in meningioma patients.Level of Evidence 5 (case report).

Topics: Female; Humans; Infusions, Intra-Arterial; Meningeal Neoplasms; Meningioma; Middle Aged; Neuroendocrine Tumors; Octreotide; Organometallic Compounds; Receptors, Somatostatin; Salvage Therapy; Treatment Outcome

Meningiomas are typically benign solitary intracranial tumors. Atypical (World Health Organization [WHO] grade II) or malignant/anaplastic (WHO grade III) meningiomas are seldom, and distant metastases occur only in rare exceptions. We present a case of a 54-year-old male patient with atypical (WHO grade II) meningioma who underwent 1 cycle of peptide receptor radionuclide therapy. Previous imaging studies were confined to the head, but posttherapeutic whole-body Lu-DOTATATE scintigraphy revealed thoracic uptake arising from previously undetected pulmonic meningioma metastases. The case highlights the importance of consideration of rare/untypical metastatic sides and the value of radiotracer whole-body imaging in identifying these.

Topics: Humans; Lung Neoplasms; Male; Meningeal Neoplasms; Meningioma; Middle Aged; Octreotide; Organometallic Compounds; Radiopharmaceuticals; Single Photon Emission Computed Tomography Computed Tomography

The prognosis of patients with progressive meningioma after failure of surgery and radiotherapy is poor.. We retrospectively evaluated the safety and efficacy of somatostatin-receptor (SSTR)-targeted radionuclide therapy (. SSTR-targeted radionuclide treatment has activity in a subset of patients with meningioma. Expression of SSTR via immunohistochemistry or radionuclide uptake might serve as a predictive biomarker for outcome to facilitate individualized treatment optimization in patients with uni- and multifocal meningiomas.

Topics: Adolescent; Adult; Aged; Disease-Free Survival; Female; Gallium Radioisotopes; Humans; Male; Meningeal Neoplasms; Meningioma; Middle Aged; Octreotide; Organometallic Compounds; Radiopharmaceuticals; Receptors, Somatostatin; Retrospective Studies; Survival Rate; Treatment Outcome; Young Adult

An 18-year-old girl presented with a 3-year history of a recurrent skull base mass confirmed to be a rhabdoid papillary meningioma. The tumor was octreotide avid and metastatic to the lungs, thoracic lymph nodes, and bones, and she was referred for PRRT (peptide receptor radionuclide therapy) with 177Lu DOTATATE. After 3 induction treatment cycles of 177Lu DOTATATE, she experienced significant improvements in her symptoms; however, just before the fourth treatment, she developed cervical spinal cord compression and passed away shortly thereafter. The use of 177Lu DOTATATE therapy in the management of rhabdoid papillary meningioma warrants further research.

Topics: Adolescent; Female; Humans; Meningeal Neoplasms; Meningioma; Octreotide; Organometallic Compounds; Radiopharmaceuticals; Receptors, Peptide; Rhabdoid Tumor

To investigate whether the tumour uptake of radionuclide in peptide receptor radionuclide therapy (PRRT) of meningioma can be predicted by a PET scan with (68)Ga-labelled somatostatin analogue.. In this pilot trial, 11 meningioma patients with a PET scan indicating somatostatin receptor expression received PRRT with 7.4 GBq (177)Lu-DOTATOC or (177)Lu-DOTATATE, followed by external beam radiotherapy. A second PET scan was scheduled for 3 months after therapy. During PRRT, multiple whole-body scans and a SPECT/CT scan of the head and neck region were acquired and used to determine the kinetics and dose in the voxel with the highest radionuclide uptake within the tumour. Maximum voxel dose and retention of activity 1 h after administration in PRRT were compared to the maximum standardized uptake values (SUV(max)) in the meningiomas from the PET scans before and after therapy.. The median SUV(max) in the meningiomas was 13.7 (range 4.3 to 68.7), and the maximum fractional radionuclide uptake in voxels of size 0.11 cm³ was a median of 23.4 × 10(-6) (range 0.4 × 10(-6) to 68.3 × 10(-6)). A strong correlation was observed between SUV(max) and the PRRT radionuclide tumour retention in the voxels with the highest uptake (Spearman's rank test, P < 0.01). Excluding one patient who showed large differences in biokinetics between PET and PRRT and another patient with incomplete data, linear regression analysis indicated significant correlations between SUV(max) and the therapeutic uptake (r = 0.95) and between SUV(max) and the maximum voxel dose from PRRT (r = 0.76). Observed absolute deviations from the values expected from regression were a median of 5.6 × 10(-6) (maximum 9.3 × 10(-6)) for the voxel fractional radionuclide uptake and 0.40 Gy per GBq (maximum 0.85 Gy per GBq) (177)Lu for the voxel dose from PRRT.. PET with (68)Ga-labelled somatostatin analogues allows the pretherapeutic assessment of tumour radionuclide uptake in PRRT of meningioma and an estimate of the achievable dose.

Topics: Adult; Aged; Biological Transport; Female; Gallium Radioisotopes; Humans; Male; Meningioma; Middle Aged; Molecular Targeted Therapy; Octreotide; Organometallic Compounds; Positron-Emission Tomography; Receptors, Somatostatin; Somatostatin

A patient with anaplastic meningioma and lung metastases resistant to conventional treatment underwent radiopeptide therapy with 177Lu- DOTA-octreotate in our institute. The treatment resulted in significant improvement in patient's quality of life and inhibition of tumor progression. This case may eventually help to establish the value of radiopeptide therapy in patients with this rare condition.

Topics: Blood-Brain Barrier; Coordination Complexes; Disease Progression; Female; Humans; Lung Neoplasms; Meningioma; Middle Aged; Neoplasm Metastasis; Octreotide; Positron-Emission Tomography; Quality of Life; Radiopharmaceuticals; Receptors, Peptide; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed; Treatment Outcome