Magnetic resonance imaging, computed tomography, and 68Ga-DOTATOC positron emission tomography for imaging skull base meningiomas with infracranial extension treated with stereotactic radiotherapy--a case series.
BACKGROUND
Magnetic resonance imaging (MRI) and computed tomography (CT) with (68)Ga-DOTATOC positron emission tomography ((68)Ga-DOTATOC-PET) were compared retrospectively for their ability to delineate infracranial extension of skull base (SB) meningiomas treated with fractionated stereotactic radiotherapy.


METHODS
Fifty patients with 56 meningiomas of the SB underwent MRI, CT, and (68)Ga-DOTATOC PET/CT prior to fractionated stereotactic radiotherapy. The study group consisted of 16 patients who had infracranial meningioma extension, visible on MRI ± CT (MRI/CT) or PET, and were evaluated further. The respective findings were reviewed independently, analyzed with respect to correlations, and compared with each other.


RESULTS
Within the study group, SB transgression was associated with bony changes visible by CT in 14 patients (81%). Tumorous changes of the foramen ovale and rotundum were evident in 13 and 8 cases, respectively, which were accompanied by skeletal muscular invasion in 8 lesions. We analysed six designated anatomical sites of the SB in each of the 16 patients. Of the 96 sites, 42 had infiltration that was delineable by MRI/CT and PET in 35 cases and by PET only in 7 cases. The mean infracranial volume that was delineable in PET was 10.1 ± 10.6 cm(3), which was somewhat larger than the volume detectable in MRI/CT (8.4 ± 7.9 cm(3)).


CONCLUSIONS
(68)Ga-DOTATOC-PET allows detection and assessment of the extent of infracranial meningioma invasion. This method seems to be useful for planning fractionated stereotactic radiation when used in addition to conventional imaging modalities that are often inconclusive in the SB region.
Department of Radiation Oncology, Charité Universitätsmedizin Berlin, Berlin, Germany. reinhold.graf@charite.de
Reinhold
R
Graf
Michail
M
Plotkin
Ingo G
IG
Steffen
Reinhard
R
Wurm
Peter
P
Wust
Winfried
W
Brenner
Volker
V
Budach
Harun
H
Badakhshi
D000368:Aged; D003952:Diagnostic Imaging; D019583:Dose Fractionation, Radiation; D005260:Female; D054085:Foramen Ovale / Q000473:pathology; D005710:Gallium Radioisotopes; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D008579:Meningioma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D015282:Octreotide / Q000031:analogs & derivatives*; D009942:Organometallic Compounds; D049268:Positron-Emission Tomography; D016634:Radiosurgery; D012189:Retrospective Studies; D019292:Skull Base Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed
C499142:Ga(III)-DOTATOC; D005710:Gallium Radioisotopes; D009942:Organometallic Compounds; D015282:Octreotide