nach oben

European Journal of Nuclear Medicine and Molecular Imaging

Erschienen in:

01.02.2010 | Original Article

Potential impact of ⁶⁸Ga-DOTATOC PET/CT on stereotactic radiotherapy planning of meningiomas

verfasst von: Fonyuy Nyuyki, Michail Plotkin, Reinhold Graf, Roger Michel, Ingo Steffen, Timm Denecke, Lilli Geworski, Daniel Fahdt, Winfried Brenner, Reinhard Wurm

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 2/2010

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Since meningiomas show a high expression of somatostatin receptor subtype 2, PET with ⁶⁸Ga-DOTATOC was proposed as an additional imaging modality beside CT and MRI for planning radiotherapy. We investigated the input of ⁶⁸Ga-DOTATOC-PET/CT on the definition of the “gross tumour volume” (GTV) in meningiomas, in order to assess the potential value of this method.

Methods

Prior to radiotherapy, 42 patients with meningiomas (26 f, 16 m, mean age 55) underwent MRI and ⁶⁸Ga-DOTATOC-PET/CT examinations. History: operated n = 24, radiotherapy n = 1, operation and radiotherapy n = 8, no treatment n = 9. PET/CT and MRI data were co-registered using a BrainLAB workstation. For comparison, the GTV was defined first under consideration of CT and MRI data, then using PET data.

Results

3/42 patients were excluded from the analysis (two with negative PET results, one with an extensive tumour, not precisely delineable by MRI or PET/CT). The average GTV_CT/MRI was 22(±19)cm³; GTV_PET was 23(±20)cm³. Additional GTV, obtained as a result of PET was 9(±10)cm³ and was observed in patients with osseous infiltration. In some pre-treated patients there were intratumoural areas (as identified in CT/MRI) without SR-expression (7(±11)cm³). Common GTV as obtained by both CT/MRI and PET was 15(±14)cm³. The mean bi-directional difference between the GTV_CT/MRI and GTV_PET accounted to 16(±15)cm³ (93%, p < 0.001). In a subgroup of seven patients with multiple meningiomas, PET showed a total of 19 lesions; nine of them were not recognizable by CT or MRI.

Conclusion

⁶⁸Ga-DOTATOC-PET enables delineation of SR-positive meningiomas and delivers additional information to both CT and MRI regarding the planning of stereotactic radiotherapy. The acquisition on a PET/CT scanner helps to estimate the relation of PET findings to anatomical structures and is especially useful for detection of osseous infiltration. ⁶⁸Ga-DOTATOC-PET also allows detection of additional lesions in patients with multiple meningiomas.

Preston-Martin S. Descriptive epidemiology of primary tumors of the brain, cranial nerves and cranial meninges in Los Angeles County. Neuroepidemiology. 1989;8:283–95.CrossRefPubMed

Simpson D. The recurrence of intracranial meningiomas after surgical treatment. J Neurol Neurosurg Psychiatry. 1957;20:22–39.CrossRefPubMed

Khoo VS, Adams EJ, Saran F, Bedford JL, Perks JR, Warrington AP, et al. A comparison of clinical target volumes determined by CT and MRI for the radiotherapy planning of base of skull meningiomas. Int J Radiat Oncol Biol Phys. 2000;46:1309–17.PubMed

Tomura N, Hirano H, Sashi R, Hashimoto M, Kato K, Takahashi S, et al. Comparison of MR imaging and CT in discriminating tumour infiltration of bone and bone marrow in the skull base. Comput Med Imaging Graph. 1998;22:41–51.CrossRefPubMed

Paling MR, Black WC, Levine PA, Cantrell RW. Tumor invasion of the anterior skull base: a comparison of MR and CT studies. J Comput Assist Tomogr. 1987;11:824–30.CrossRefPubMed

Weingarten K, Ernst RJ, Jahre C, Zimmerman RD. Detection of residual or recurrent meningioma after surgery: value of enhanced vs. unenhanced MR imaging. Am J Roentgenol. 1992;158:645–50.

Schörner W, Schubeus P, Henkes H, Lanksch W, Felix R. “Meningeal sign”: a characteristic finding of meningiomas on contrast-enhanced MR images. Neuroradiology. 1990;32:90–3.CrossRefPubMed

Dutour A, Kumar U, Panetta R, Ouafik L, Fina F, Sasi R, et al. Expression of somatostatin receptor subtypes in human brain tumors. Int J Cancer. 1998;76:620–7.CrossRefPubMed

Schulz S, Pauli SU, Schulz S, Händel M, Dietzmann K, Firsching R, et al. Immunohistochemical determination of five somatostatin receptors in meningioma reveals frequent over expression of somatostatin receptor subtype sst2A. Clin Cancer Res. 2000;6:1865–74.PubMed

10.

Schmidt M, Scheidhauer K, Luyken C, Voth E, Hildebrandt G, Klug N, et al. Somatostatin receptor imaging in intracranial tumours. Eur J Nucl Med. 1998;25:675–86.CrossRefPubMed

11.

Bohuslavizki KH, Brenner W, Braunsdorf WE, Behnke A, Tinnemeyer S, Hugo HH, et al. Somatostatin receptor scintigraphy in the differential diagnosis of meningioma. Nucl Med Commun. 1996;17:302–10.PubMedCrossRef

12.

Reubi JC, Schär JC, Waser B, Wenger S, Heppeler A, Schmitt JS, et al. Affinity profiles for human somatostatin receptor subtypes SST1-SST5 of somatostatin radiotracers selected for scintigraphic and radiotherapeutic use. Eur J Nucl Med. 2000;27:273–82.CrossRefPubMed

13.

Zhernosekov KP, Filosofov DV, Baum RP, Aschoff P, Bihl H, Razbash AA, et al. Processing of generator-produced ⁶⁸Ga for medical application. J Nucl Med. 2007;48:1741–8.CrossRefPubMed

14.

Henze M, Schuhmacher J, Hipp P, Kowalski J, Becker DW, Doll J, et al. PET imaging of somatostatin receptors using [⁶⁸GA]DOTA-D-Phe1-Tyr3-octreotide: first results in patients with meningiomas. J Nucl Med. 2001;42:1053–6.PubMed

15.

Grosu AL, Lachner R, Wiedenmann N, Stärk S, Thamm R, Kneschaurek P, et al. Validation of a method for automatic image fusion (BrainLAB System) of CT data and 11C-methionine-PET data for stereotactic radiotherapy using a LINAC: first clinical experience. Int J Radiat Oncol Biol Phys. 2003;56:1450–63.CrossRefPubMed

16.

ICRU Report 50. Prescribing, recording and reporting photon beam therapy. Bethesda, MD: International Commission on Radiation Units and Measurements; 1993.

17.

ICRU Report 62. Prescribing, recording and reporting photon beam therapy. Supplement to ICRU Report 50. Bethesda, MD: International Commission on Radiation Units and Measurements; 1999.

18.

Astner ST, Dobrei-Ciuchendea M, Essler M, Bundschuh RA, Sai H, Schwaiger M, et al. Effect of ¹¹C-Methionine-Positron emission tomography on gross tumor volume delineation in stereotactic radiotherapy of skull base meningiomas. Int J Radiat Oncol Biol Phys. 2008;15:1161–7.

19.

Nael K, Fenchel M, Salamon N, Duckwiler GR, Laub G, Finn JP, et al. Three-dimensional cerebral contrast-enhanced magnetic resonance venography at 3.0 Tesla: initial results using highly accelerated parallel acquisition. Invest Radiol. 2006;41(10):763–8.CrossRefPubMed

20.

Milker-Zabel S, Zabel-du Bois A, Henze M, Huber P, Schulz-Ertner D, Hoess A, et al. Improved target volume definition for fractionated stereotactic radiotherapy in patients with intracranial meningiomas by correlation of CT, MRI, and [⁶⁸Ga]-DOTATOC-PET. Int J Radiat Oncol Biol Phys. 2006;65:222–7.PubMed

21.

Henze M, Dimitrakopoulou-Strauss A, Milker-Zabel S, Schuhmacher J, Strauss LG, Doll J, et al. Characterization of ⁶⁸Ga-DOTA-D-Phe¹-Tyr³-octreotide kinetics in patients with meningiomas. J Nucl Med. 2005;46:763–9.PubMed

22.

Grosu AL, Weber WA, Astner ST, Adam M, Krause BJ, Schwaiger M, et al. ¹¹C-methionine PET improves the target volume delineation of meningiomas treated with stereotactic fractionated radiotherapy. Int J Radiat Oncol Biol Phys. 2006;66:339–44.PubMed

23.

Rutten I, Cabay JE, Withofs N, Lemaire C, Aerts J, Baart V, et al. PET/CT of skull base meningiomas using 2–18F-fluoro-L-tyrosine: initial report. J Nucl Med. 2007;48:720–5.CrossRefPubMed

24.

Iuchi T, Iwadate Y, Namba H, Osato K, Saeki N, Yamaura A, et al. Glucose and methionine uptake and proliferative activity in meningiomas. Neurol Res. 1999;21:640–4.PubMed

25.

Nyberg G, Bergstrom M, Enblad P, Lilja A, Muhr C, Langstrom B. PET-methionine of skull base neuromas and meningiomas. Acta Otolaryngol. 1997;117:482–9.CrossRefPubMed

26.

Gudjonsson O, Blomquist E, Lilja A, Ericson H, Bergström M, Nyberg G. Evaluation of the effect of high-energy proton irradiation treatment on meningiomas by means of 11C-L-methionine PET. Eur J Nucl Med. 2000;27:1793–9.CrossRefPubMed

27.

Weber W, Wester HJ, Grosu AL, Herz M, Dzewas B, Feldmann HJ, et al. O-(2-[18F] fluoroethyl)-L-tyrosine and L-[methyl-11C] methionine uptake in brain tumours: initial results of a comparative study. Eur J Nucl Med. 2000;27:542–9.CrossRefPubMed

28.

Pauleit D, Floeth F, Hamacher K, et al. O-(2-[18F]fluoroethyl)-L-tyrosine PET combined with MRI improves the diagnostic assessment of cerebral gliomas. Brain. 2005;128:678–87.CrossRefPubMed

29.

Stockhammer F, Plotkin M, Amthauer H, van Landeghem FK, Woiciechowsky C. Correlation of F-18-fluoro-ethyl-tyrosin uptake with vascular and cell density in non-contrast-enhancing gliomas. J Neuro Oncol. 2008;88:205–10.CrossRef

Titel: Potential impact of 68Ga-DOTATOC PET/CT on stereotactic radiotherapy planning of meningiomas
verfasst von: Fonyuy Nyuyki
Michail Plotkin
Reinhold Graf
Roger Michel
Ingo Steffen
Timm Denecke
Lilli Geworski
Daniel Fahdt
Winfried Brenner
Reinhard Wurm
Publikationsdatum: 01.02.2010
Verlag: Springer-Verlag
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 2/2010
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-009-1270-2

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 2/2010

Radiobiological effects of hypoxia-dependent uptake of 64Cu-ATSM: enhanced DNA damage and cytotoxicity in hypoxic cells

Optimization of flow reserve measurement using SPECT technology to evaluate the determinants of coronary microvascular dysfunction in diabetes

Molecular imaging in cognitive impairment: the relevance of cognitive reserve, importance of multisite longitudinal trials and challenges of standardised analysis

Meta-analysis of the performance of 18F-FDG PET in cutaneous melanoma

Wild-type p53 enhances the cytotoxic effect of radionuclide gene therapy using sodium iodide symporter in a murine anaplastic thyroid cancer model

Predictive factors of [11C]choline PET/CT in patients with biochemical failure after radical prostatectomy