目的
使用 SSTR2 激动剂进行 PET 成像的临床研究已证明其准确性高，并且与脑膜瘤中 SSTR2 的表达具有相关性。然而，SSTR2拮抗剂与[ 68 Ga]Ga-DOTA-JR11的有效性尚不确定。评价[ 68 Ga]Ga-DOTA-JR11 PET/CT的诊断性能并阐明疑似脑膜瘤患者的肿瘤特征。
材料和方法
2021年8月至2022年10月期间，纳入了疑似新发或复发性复杂部位脑膜瘤或影像不典型的患者进行前瞻性研究。所有患者均接受对比增强MRI（CE-MRI）、[ 68 Ga]Ga-DOTA-JR11 PET/CT和组织病理学评估。通过SUVmax和肿瘤-内分泌比(TBR)测量[ 68 Ga]Ga-DOTA-JR11的肿瘤摄取。比较 PET 和 MRI 的诊断性能。
结果
在 36 名患者（50.0 ± 13.0 岁，20 名女性）中，32 名经组织病理学证实为脑膜瘤，4 名患有其他肿瘤。脑膜瘤患者的 [ 68 Ga]Ga-DOTA-JR11 摄取显着高于其他肿瘤患者（SUVmax：13.6 ± 7.7 vs. 5.2 ± 3.0， P < 0.001；TBR：64.2 ± 27.7 vs. 25.0 ± 18.9， P = 0.001）。 [ 68 Ga]Ga-DOTA-JR11 PET/CT 检出 31 例脑膜瘤，CE-MRI 检出 25 例初诊脑膜瘤和 11 例复发肿瘤中的 17 例；在初次诊断组中，[ 68 Ga]Ga-DOTA-JR11 PET 的诊断价值较 MRI 提高了 24%（6/25）。 36 例患者的 PET 与 MRI 诊断效能差异无统计学意义（ P = 0.45）。在颅底脑膜瘤中，与 MRI（8 例，可能 6 例，可能不是 6 例，可能不是 4 例）相比，PET 提供了更明确的垂体受累诊断（12 例，不是 12 例）。 PET 显示所有 14 名患者均经病理证实有骨受累，而 MRI 仅发现 11 名患者。
结论
[ 68 Ga]Ga-DOTA-JR11 PET/CT 提供了高图像质量，在检测脑膜瘤和评估垂体和骨骼的受累情况方面呈现出理想的诊断性能。该研究为使用[ 68 Ga]Ga-DOTA-JR11 PET/CT 作为CE-MRI 的补充成像方式来评估脑膜瘤提供了宝贵的证据。
"点击查看英文标题和摘要"
The usefulness of [68 Ga]Ga-DOTA-JR11 PET/CT in patients with meningioma: comparison with MRI
Purpose
Clinical studies of PET imaging using SSTR2 agonists have demonstrated high accuracy and correlation with SSTR2 expression in meningiomas. However, the usefulness of the SSTR2 antagonist with [68 Ga]Ga-DOTA-JR11 is uncertain. To evaluate the diagnostic performance of [68 Ga]Ga-DOTA-JR11 PET/CT and to clarify tumor characteristics in patients with suspected meningiomas.
Materials and methods
Patients with suspected de novo or recurrent meningioma in complex locations or atypical images were enrolled from August 2021 to October 2022 in prospective study. All patients underwent contrast-enhanced MRI (CE-MRI), [68 Ga]Ga-DOTA-JR11 PET/CT, and histopathological evaluation. Tumor uptake of [68 Ga]Ga-DOTA-JR11 was measured by SUVmax and tumor-endocranium ratio (TBR). Diagnostic performance was compared between PET and MRI.
Results
Of 36 (50.0 ± 13.0 years of age, 20 women) patients, 32 were histopathologically confirmed meningiomas and four with other tumors. [68 Ga]Ga-DOTA-JR11 uptake was significantly higher in meningioma patients than in those with other tumors (SUVmax: 13.6 ± 7.7 vs. 5.2 ± 3.0, P < 0.001; TBR: 64.2 ± 27.7 vs. 25.0 ± 18.9, P = 0.001). [68 Ga]Ga-DOTA-JR11 PET/CT detected 31 meningiomas, while CE-MRI detected 17 meningiomas of 25 initial diagnosis and 11 recurrent tumors; [68 Ga]Ga-DOTA-JR11 PET had an incremental diagnostic value of 24% (6/25) over MRI in the group of initial diagnosis. There was no statistically significant difference in diagnostic efficacy between PET and MRI (P = 0.45) for all 36 patients. In skull base meningiomas, PET provided a more definitive diagnosis of pituitary involvement (in 12, not in12), compared to MRI (in eight, possible in six, possible not in six, not in four). PET revealed bone involvement in all 14 patients proven by pathology, while MRI identified only 11.
Conclusions
[68 Ga]Ga-DOTA-JR11 PET/CT provided high image quality and presented an ideal diagnostic performance in detecting meningioma and evaluating the involvement of the pituitary and bone. The study provides valuable evidence for the use of [68 Ga]Ga-DOTA-JR11 PET/CT as a complementary imaging modality to CE-MRI in the evaluation of meningiomas.
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