Carola Lütgendorf-Caucig1, Maciej Pelak2, Birgit Flechl1, Petra Georg1, Piero Fossati1, Markus Stock1, Tatjana Traub-Weidinger3, Christine Marosi4, Christine Haberler5, Gloria Zechmeister-Machhart1,6, Lauritz Hermsmeyer1,6, Eugen Hug1, Anton Staudenherz7. 1. MedAustron Ion Therapy Center, Marie Curie-Straße 5, 2700, Wiener Neustadt, Austria. 2. MedAustron Ion Therapy Center, Marie Curie-Straße 5, 2700, Wiener Neustadt, Austria. maciej.pelak@medaustron.at. 3. Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria. 4. Division of Palliative Care, Department of Internal Medicine 1, Medical University of Vienna, Vienna, Austria. 5. Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Vienna, Austria. 6. Karl Landsteiner University of Health Sciences, Krems, Austria. 7. Department of Nuclear Medicine, University Clinic St. Poelten, St. Poelten, Austria.
Abstract
PURPOSE: Overexpression of the somatostatin receptor (SSTR) has led to adoption of SSTR PET/CT for diagnosis and radiotherapy planning in meningioma, but data on SSTR expression during follow-up remain scarce. We investigated PET/CT quantifiers of SSTR tracers in WHO grade I meningioma following fractionated proton beam therapy (PBT) compared to standard response assessment with MRI. METHODS: Twenty-two patients diagnosed with low-grade meningioma treated by PBT were included. Follow-up included clinical visits, MRI, and [68Ga]Ga-DOTATOC PET/CT scans. Radiologic tumor response, MRI and PET volume (VMRI and VPET), maximum and mean standardied uptake value (SUVmax/SUVmean), total lesion activity (TLA), and heterogeneity index (HI) were evaluated. RESULTS: Median follow-up was 35.3 months (range: 6.4-47.9). Nineteen patients (86.4%, p = 0.0009) showed a decrease of SUVmax between baseline and first follow-up PET/CT (median: -24%, range: -53% to +89%) and in 81.8% of all cases, the SUVmax, SUVmean, and TLA at last follow-up were eventually lower than at baseline (p = 0.0043). Ambiguous trends without significance between the timepoints analyzed were observed for VPET. HI increased between baseline and last follow-up in 75% of cases (p = 0.024). All patients remained radiologically and clinically stable. Median VMRI decreased by -9.3% (range 0-32.5%, p < 0.0001) between baseline and last follow-up. CONCLUSION: PET/CT in follow-up of irradiated meningioma showed an early trend towards decreased binding of SSTR-specific tracers following radiation and MRI demonstrated consistently stable or decreasing tumor volume. Translational research is needed to clarify the underlying biology of the subsequent increase in SSTR PET quantifiers.
PURPOSE: Overexpression of the somatostatin receptor (SSTR) has led to adoption of SSTR PET/CT for diagnosis and radiotherapy planning in meningioma, but data on SSTR expression during follow-up remain scarce. We investigated PET/CT quantifiers of SSTR tracers in WHO grade I meningioma following fractionated proton beam therapy (PBT) compared to standard response assessment with MRI. METHODS: Twenty-two patients diagnosed with low-grade meningioma treated by PBT were included. Follow-up included clinical visits, MRI, and [68Ga]Ga-DOTATOC PET/CT scans. Radiologic tumor response, MRI and PET volume (VMRI and VPET), maximum and mean standardied uptake value (SUVmax/SUVmean), total lesion activity (TLA), and heterogeneity index (HI) were evaluated. RESULTS: Median follow-up was 35.3 months (range: 6.4-47.9). Nineteen patients (86.4%, p = 0.0009) showed a decrease of SUVmax between baseline and first follow-up PET/CT (median: -24%, range: -53% to +89%) and in 81.8% of all cases, the SUVmax, SUVmean, and TLA at last follow-up were eventually lower than at baseline (p = 0.0043). Ambiguous trends without significance between the timepoints analyzed were observed for VPET. HI increased between baseline and last follow-up in 75% of cases (p = 0.024). All patients remained radiologically and clinically stable. Median VMRI decreased by -9.3% (range 0-32.5%, p < 0.0001) between baseline and last follow-up. CONCLUSION: PET/CT in follow-up of irradiated meningioma showed an early trend towards decreased binding of SSTR-specific tracers following radiation and MRI demonstrated consistently stable or decreasing tumor volume. Translational research is needed to clarify the underlying biology of the subsequent increase in SSTR PET quantifiers.
Authors: Raymond Y Huang; Wenya Linda Bi; Michael Weller; Thomas Kaley; Jaishri Blakeley; Ian Dunn; Evanthia Galanis; Matthias Preusser; Michael McDermott; Leland Rogers; Jeffrey Raizer; David Schiff; Riccardo Soffietti; Jörg-Christian Tonn; Michael Vogelbaum; Damien Weber; David A Reardon; Patrick Y Wen Journal: Neuro Oncol Date: 2019-01-01 Impact factor: 12.300
Authors: Norbert Galldiks; Nathalie L Albert; Michael Sommerauer; Anca L Grosu; Ute Ganswindt; Ian Law; Matthias Preusser; Emilie Le Rhun; Michael A Vogelbaum; Gelareh Zadeh; Frédéric Dhermain; Michael Weller; Karl-Josef Langen; Jörg C Tonn Journal: Neuro Oncol Date: 2017-11-29 Impact factor: 12.300
Authors: Wolfgang G Kunz; Lisa M Jungblut; Philipp M Kazmierczak; Franziska J Vettermann; Andreas Bollenbacher; Jörg C Tonn; Christian Schichor; Axel Rominger; Nathalie L Albert; Peter Bartenstein; Maximilian F Reiser; Clemens C Cyran Journal: J Nucl Med Date: 2017-04-27 Impact factor: 10.057
Authors: Kerstin A Kessel; Wolfgang Weber; Igor Yakushev; Hanna Fischer; Theresa Voglhuber; Christian Diehl; Christoph Straube; Claus Zimmer; Benedikt Wiestler; Jens Gempt; Bernhard Meyer; Stephanie E Combs Journal: Eur J Nucl Med Mol Imaging Date: 2019-11-22 Impact factor: 9.236
Authors: Roland Goldbrunner; Pantelis Stavrinou; Michael D Jenkinson; Felix Sahm; Christian Mawrin; Damien C Weber; Matthias Preusser; Giuseppe Minniti; Morten Lund-Johansen; Florence Lefranc; Emanuel Houdart; Kita Sallabanda; Emilie Le Rhun; David Nieuwenhuizen; Ghazaleh Tabatabai; Riccardo Soffietti; Michael Weller Journal: Neuro Oncol Date: 2021-11-02 Impact factor: 13.029