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

IF 16.4 1区 医学 Q1 CLINICAL NEUROLOGY Neuro-oncology Pub Date : 2024-08-05 DOI:10.1093/neuonc/noae067
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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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.

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[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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