Detection of cranial meningiomas: comparison of 68Ga-DOTATOC PET/CT and contrast-enhanced MRI
Detection of cranial meningiomas: comparison of 68Ga-DOTATOC PET/CT and contrast-enhanced MRI
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DOI：
10.1007/s00259-012-2155-3
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发表时间：
2012-09-01
影响因子：
9.1
通讯作者：
Kratochwil, Clemens
中科院分区：
文献类型：
--
作者：
Afshar-Oromieh, Ali;Giesel, Frederik L.;Kratochwil, Clemens
生长抑素受体配体的PET成像，如Ga-68-DOTATOC，是一种在放射治疗前检测脑膜瘤和确定靶区体积的成熟方法。由于DOTATOC PET在脑膜瘤及其周围组织之间的对比度高于MRI，我们进行了一项回顾性分析，以比较对比增强MRI(CE-MRI)和Ga-68-DOTATOC PET/CT在脑膜瘤放射治疗前诊断的准确性。为了比较这两种方法的优劣，对在视觉上被认为是典型脑膜瘤的病变进行了统计和分析。在两种方法调查的134例患者中，用Ga-68-DOTATOC PET/CT检出了190个脑膜瘤，用CE-MRI检出了171个。在了解了PET/CT的数据后，重新研究了MRI扫描，结果发现了19个偶发脑膜瘤中的4个，总体诊断率为92%。与CE-MRI相比，Ga-DOTATOC PET/CT对脑膜瘤的检出具有更高的敏感性。邻近大脑镰状突起、位于颅底、或被影像伪影或钙化遮挡的肿瘤，MRI尤其难以发现。因此，GA-68-DOTATOC PET/CT可以为MRI结果不确定或不明确的患者提供额外的信息，或有助于确认基于MRI的脑膜瘤诊断，或有助于在活检受限的情况下确认基于MRI的脑膜瘤诊断。有可能不仅放射治疗和手术计划，而且后续的策略将受益于这种成像方式。
PET imaging with somatostatin receptor ligands, such as Ga-68-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 Ga-68-DOTATOC PET/CT in patients with cranial meningiomas prior to radiotherapy.Over a period of 6 years, 134 patients (20-82 years of age, 107 women and 27 men) underwent cranial CE-MRI and Ga-68-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.In the 134 patients investigated by both modalities, 190 meningiomas were detected by Ga-68-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.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 Ga-68-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.