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19-10-2022 | Meningioma | Original Article

The trends and significance of SSTR PET/CT added to MRI in follow-up imaging of low-grade meningioma treated with fractionated proton therapy

Authors: Carola Lütgendorf-Caucig, Maciej Pelak, Birgit Flechl, Petra Georg, Piero Fossati, Markus Stock, Tatjana Traub-Weidinger, Christine Marosi, Christine Haberler, Gloria Zechmeister-Machhart, Lauritz Hermsmeyer, Eugen Hug, Anton Staudenherz

Published in: Strahlentherapie und Onkologie | Issue 4/2023

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 (V_MRI and V_PET), 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 V_PET. HI increased between baseline and last follow-up in 75% of cases (p = 0.024). All patients remained radiologically and clinically stable. Median V_MRI 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.

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Title: The trends and significance of SSTR PET/CT added to MRI in follow-up imaging of low-grade meningioma treated with fractionated proton therapy
Authors: Carola Lütgendorf-Caucig
Maciej Pelak
Birgit Flechl
Petra Georg
Piero Fossati
Markus Stock
Tatjana Traub-Weidinger
Christine Marosi
Christine Haberler
Gloria Zechmeister-Machhart
Lauritz Hermsmeyer
Eugen Hug
Anton Staudenherz
Publication date: 19-10-2022
Publisher: Springer Berlin Heidelberg
Keywords: Meningioma
Magnetic Resonance Imaging
Magnetic Resonance Imaging
Meningioma
Published in: Strahlentherapie und Onkologie / Issue 4/2023
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-022-02010-4

At a glance: The STEP trials

Springer Medicine

The trends and significance of SSTR PET/CT added to MRI in follow-up imaging of low-grade meningioma treated with fractionated proton therapy

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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