| Autor: |
Knisely, Jonathan, Kim, Sean H., Roytman, Michelle, Chang, Se Jung, Ramakrishna, Rohan, Pannullo, Susan C., Schwartz, Theodore E., Osborne, Joseph R., Magge, Rajiv, Lin, Eaton, Ivanidze, Jana |
| Předmět: |
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| Zdroj: |
Journal of Radiosurgery & SBRT; 2022 Supplement, Vol. 8, p180-180, 1p |
| Abstrakt: |
Background: The optimal post-surgical management of meningiomas is a subject of debate. In patients with a gross total resection (Simpson Grade 1-3), the highest risk for progression is likely from occult residual disease. Postoperative [68Ga]-DOTATATE PET/MRI can differentiate postoperative changes from residual meningioma in such patients and aid in accurately defining stereotactic radiosurgical targets. We wanted to further explore DOTATATE imaging’s utility through assessing responses of meningiomas to radiosurgery. Methods: Patients underwent postoperative imaging using DOTATATE PET/MRI as part of our IRB-approved prospective trial. The co-registered DOTATATE PET and gadolinium-enhanced T1 weighted MR imaging were employed for radiosurgery planning. MR imaging for surveillance purposes was routinely performed in all patients and post-radiosurgical DOTATATE PET/MRI imaging was performed in a subset of patients after an interval of approximately 6-12 months; some patients declined repeat PET imaging. Maximum absolute standardized uptake value (SUV) and SUV ratio (SUVR) of the meningioma / superior sagittal sinus SUV were obtained. RANO criteria were applied to determine MRIdetermined size change significance. Paired t-tests were used for statistical analyses. Results: Twenty-nine meningiomas (in 13 patients) underwent DOTATATE PET/MRI evaluation for radiosurgical planning. 46% (6/13) of subjects received SBRT and 54% (7/13) received SRS. Post-RT DOTATATE PET/MRI demonstrated a 46.4% SUV decrease (p-value = 0.0001) and a 60.8% SUVR decrease (p-value < 0.0001). Of 21 measurable lesions, the size product decreased by 21%. This decrease was statistically significant (p-value = 0.0008) albeit below the 25% decrease defined as clinically significant by RANO guidelines. To date, all patients remain stable radiographically without evidence of recurrence (mean follow-up post RT: 14 months; range: 6-24 months). Conclusions: DOTATATE PET SUV and SUVR demonstrated marked, significant decrease post radiosurgery. Lesion size decrease was statistically significant but not clinically significant by RANO criteria. DOTATATE PET/MR thus represents a promising approach to aid in response assessment for meningiomas treated with radiosurgery. Longer-term follow-up is needed to determine correlations between the degree of post-RT SUV and/or SUVR decrease and progression-free-survival. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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