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Purpose <p>This study aims to evaluate differences in PET/CT imaging of meningioma using both gallium-68- and fluorine-18-labelled somatostatin receptor (SSTR) tracers, to characterize incidentally detected meningiomas on SSTR PET/CT, and to analyse institutional experience with Peptide Receptor Radionuclide Therapy (PRRT) in meningioma.</p> Methods <p>This single centre retrospective study included all SSTR PET/CT scans of meningioma patients (2007-2024) performed with [<sup>68</sup>Ga]Ga-DOTATOC, [<sup>68</sup>Ga]Ga-DOTATATE or [<sup>18</sup>F]AlF-NOTA-octreotide. For lesions ≥ 1cm<sup>3</sup>, tumour uptake was quantified using three distinct delineation methods: an absolute SUV threshold of 2.3, a relative threshold of 1.73 × SUV<sub>peak</sub> of a meningeal reference region, and a relative threshold of 11% of the lesion’s SUV<sub>max</sub>. Tumour-to-background ratios were calculated. Meningioma patients treated with PRRT were identified from our institutional registry (2016-2024).</p> Results <p>Of 4,136 SSTR PET/CTs, 152 patients with 171 SSTR-expressing meningiomas were included. Incidental meningiomas were found in 3.7% of patients imaged for unrelated indications. Quantitative analysis of 86 lesions (≥ 1 cm<sup>3</sup>) showed robust uptake for [<sup>18</sup>F]AlF-NOTA-octreotide (<i>n</i> = 7), [<sup>68</sup>Ga]Ga-DOTATATE (<i>n</i> = 73), and [<sup>68</sup>Ga]Ga-DOTATOC (<i>n</i> = 6), without significant between-tracer differences across delineation strategies. All tracers demonstrated high tumour‐to‐meningeal uptake ratios with ratios ranging from 51 to 146 for [<sup>18</sup>F]AlF-NOTA-octreotide, 10-329 for [<sup>68</sup>Ga]Ga-DOTATATE, and 12-76 for [<sup>68</sup>Ga]Ga-DOTATOC, confirming excellent tumour-to-background contrast. Among 12 heavily pretreated patients receiving PRRT, disease control rate was 50%, median progression-free survival 8&#xa0;months, and overall survival 20&#xa0;months.</p> Conclusion <p>SSTR PET/CT enables high-contrast meningioma visualisation. [<sup>18</sup>F]AlF-NOTA-octreotide seems clinically interchangeable with gallium-68-labelled tracers, while offering logistical advantages. PRRT achieves meaningful disease stabilisation, supporting further validation in prospective randomised studies.</p>

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Meningioma theranostics: a retrospective analysis of somatostatin receptor PET/CT imaging and peptide receptor radionuclide therapy

  • 期刊论文

  • 发表日期：

    2026年2月17日

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  • L. Degryse,
  • L. Teles,
  • S. De Vleeschouwer,
  • L. Boeckxstaens,
  • S. Jentjens,
  • W. Deckers,
  • M. Lambrecht,
  • J. F. Daisne,
  • K. Van Laere,
  • A. J. A. T. Braat,
  • P. M. Clement,
  • K. Goffin,
  • C. M. Deroose

摘要

Purpose

This study aims to evaluate differences in PET/CT imaging of meningioma using both gallium-68- and fluorine-18-labelled somatostatin receptor (SSTR) tracers, to characterize incidentally detected meningiomas on SSTR PET/CT, and to analyse institutional experience with Peptide Receptor Radionuclide Therapy (PRRT) in meningioma.

Methods

This single centre retrospective study included all SSTR PET/CT scans of meningioma patients (2007-2024) performed with [68Ga]Ga-DOTATOC, [68Ga]Ga-DOTATATE or [18F]AlF-NOTA-octreotide. For lesions ≥ 1cm3, tumour uptake was quantified using three distinct delineation methods: an absolute SUV threshold of 2.3, a relative threshold of 1.73 × SUVpeak of a meningeal reference region, and a relative threshold of 11% of the lesion’s SUVmax. Tumour-to-background ratios were calculated. Meningioma patients treated with PRRT were identified from our institutional registry (2016-2024).

Results

Of 4,136 SSTR PET/CTs, 152 patients with 171 SSTR-expressing meningiomas were included. Incidental meningiomas were found in 3.7% of patients imaged for unrelated indications. Quantitative analysis of 86 lesions (≥ 1 cm3) showed robust uptake for [18F]AlF-NOTA-octreotide (n = 7), [68Ga]Ga-DOTATATE (n = 73), and [68Ga]Ga-DOTATOC (n = 6), without significant between-tracer differences across delineation strategies. All tracers demonstrated high tumour‐to‐meningeal uptake ratios with ratios ranging from 51 to 146 for [18F]AlF-NOTA-octreotide, 10-329 for [68Ga]Ga-DOTATATE, and 12-76 for [68Ga]Ga-DOTATOC, confirming excellent tumour-to-background contrast. Among 12 heavily pretreated patients receiving PRRT, disease control rate was 50%, median progression-free survival 8 months, and overall survival 20 months.

Conclusion

SSTR PET/CT enables high-contrast meningioma visualisation. [18F]AlF-NOTA-octreotide seems clinically interchangeable with gallium-68-labelled tracers, while offering logistical advantages. PRRT achieves meaningful disease stabilisation, supporting further validation in prospective randomised studies.