[Ga68] DOTATATE PET/MRI-guided radiosurgical treatment planning and response assessment in meningiomas.

IF 16.4 1区 医学 Q1 CLINICAL NEUROLOGY
Jana Ivanidze, Se Jung Chang, Arsalan Haghdel, Joon Tae Kim, Arindam Roy Choudhury, Alan Wu, Rohan Ramakrishna, Theodore H Schwartz, Babacar Cisse, Philip Stieg, Leland Muller, Joseph R Osborne, Rajiv S Magge, Nicolas A Karakatsanis, Michelle Roytman, Eaton Lin, Susan C Pannullo, Joshua D Palmer, Jonathan P S Knisely
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引用次数: 0

Abstract

Background: Our purpose was to determine the utility of [68Ga]-DOTATATE PET/MRI in meningioma response assessment following radiosurgery.

Methods: Patients with meningioma prospectively underwent postoperative DOTATATE PET/MRI. Co-registered PET and gadolinium-enhanced T1-weighted MRI were employed for radiosurgery planning. Follow-up DOTATATE PET/MRI was performed at 6-12 months post-radiosurgery. Maximum absolute standardized uptake value (SUV) and SUV ratio (SUVRSSS) referencing superior sagittal sinus (SSS) blood pool were obtained. Size change was determined by Response Assessment in Neuro-Oncology (RANO) criteria. Association of SUVRSSS change magnitude and progression-free survival (PFS) was evaluated using Cox regression.

Results: Twenty-seven patients with 64 tumors (26% World Health Organization [WHO]-1, 41% WHO-2, 26% WHO-3, and 7% WHO-unknown) were prospectively followed post stereotactic radiosurgery (SRS) or stereotactic body radiotherapy (SBRT; mean dose: 30 Gy, modal dose 35 Gy, mean of 5 fractions). Post-irradiation SUV and SUVRSSS decreased by 37.4% and 44.4%, respectively (P < .0001). Size product decreased by 8.9%, thus failing to reach the 25% significance threshold as determined by RANO guidelines. Mean follow-up time was 26 months (range: 6-44). Overall mean PFS was 83% and 100%/100%/54% in WHO-1/-2/-3 subcohorts, respectively, at 34 months. At maximum follow-up (42-44 months), PFS was 100%/83%/54% in WHO-1/-2/-3 subcohorts, respectively. Cox regression analyses revealed a hazard ratio of 0.48 for 10-unit reduction in SUVRSSS in the SRS cohort.

Conclusions: DOTATATE PET SUV and SUVRSSS demonstrated marked, significant decrease post-radiosurgery. Lesion size decrease was statistically significant; however, it was not clinically significant by RANO criteria. DOTATATE PET/MR thus represents a promising imaging biomarker for response assessment in meningiomas treated with radiosurgery.

Clinicaltrials.gov identifier: NCT04081701.

[Ga68] DOTATATE PET/MRI引导的脑膜瘤放射外科治疗计划和反应评估。
背景:我们的目的是确定[68Ga]-DOTATATE PET/MRI在放射手术后脑膜瘤反应评估中的应用:我们的目的是确定[68Ga]-DOTATATE PET/MRI在放射手术后脑膜瘤反应评估中的实用性:方法:对脑膜瘤患者进行术后DOTATATE PET/MRI检查。在制定放射手术计划时,采用了PET和钆增强T1加权MRI联合注册。放射手术后 6-12 个月进行 DOTATATE PET/MRI 随访。以上矢状窦(SSS)血池为参照,获得最大绝对标准化摄取值(SUV)和SUV比值(SUVRSSS)。大小变化根据神经肿瘤学反应评估(RANO)标准确定。结果:对27名患者的64个肿瘤(26% WHO-1、41% WHO-2、26% WHO-3、7% WHO-未知)进行了立体定向放射手术(SRS)或立体定向体放射治疗(SBRT)后的前瞻性随访(平均剂量:30 Gy,标准剂量35 Gy,平均5次分割)。放疗后 SUV 和 SUVRSSS 分别下降了 37.4% 和 44.4%(p < 0.0001)。大小乘积下降了8.9%,因此未达到RANO指南规定的25%显著性阈值。平均随访时间为 26 个月(6-44 个月)。34个月时,WHO-1/-2/-3亚组的总体平均PFS分别为83%和100%/100%/54%。在最长随访时间(42-44 个月)内,WHO-1/-2/-3 亚组的 PFS 分别为 100%/83%/54%。Cox回归分析显示,SRS队列中SUVRSSS降低10个单位的危险比为0.48:结论:放射手术后,DOTATATE PET SUV 和 SUVRSSS 均显著下降。病灶大小的缩小在统计学上有显著意义,但根据 RANO 标准,其临床意义并不大。因此,DOTATATE PET/MR 是放射外科治疗脑膜瘤反应评估的一种有前途的成像生物标志物。
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来源期刊
Neuro-oncology
Neuro-oncology 医学-临床神经学
CiteScore
27.20
自引率
6.30%
发文量
1434
审稿时长
3-8 weeks
期刊介绍: Neuro-Oncology, the official journal of the Society for Neuro-Oncology, has been published monthly since January 2010. Affiliated with the Japan Society for Neuro-Oncology and the European Association of Neuro-Oncology, it is a global leader in the field. The journal is committed to swiftly disseminating high-quality information across all areas of neuro-oncology. It features peer-reviewed articles, reviews, symposia on various topics, abstracts from annual meetings, and updates from neuro-oncology societies worldwide.
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