RT Journal Article
SR Electronic
T1 DOTATATE PET/MR Imaging Differentiates Secondary-Progressive from de Novo World Health Organization Grade 3 Meningiomas
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
DO 10.3174/ajnr.A8219
A1 Kim, Joon Tae
A1 Chang, Se Jung Chris
A1 Haghdel, Arsalan
A1 Ramakrishna, Rohan R.
A1 Pannullo, Susan C.
A1 Schwartz, Theodore H.
A1 Osborne, Joseph R.
A1 Magge, Rajiv S.
A1 Fine, Howard A.
A1 Cisse, Babacar
A1 Stieg, Philip
A1 Lin, Eaton
A1 Roytman, Michelle
A1 Palmer, Joshua D.
A1 Karakatsanis, Nicolas A.
A1 Pisapia, David
A1 Liechty, Benjamin
A1 Knisely, Jonathan P.S.
A1 Ivanidze, Jana
YR 2024
UL http://www.ajnr.org/content/early/2024/04/11/ajnr.A8219.abstract
AB BACKGROUND AND PURPOSE: WHO grade 3 meningiomas are rare and poorly understood and have a higher propensity for recurrence, metastasis, and worsened clinical outcomes compared with lower-grade meningiomas. The purpose of our study was to prospectively evaluate the molecular profile, PET characteristics, and outcomes of patients with World Health Organization grade 3 meningiomas who were imaged with gallium 68 (68Ga) DOTATATE PET/MR imaging.MATERIALS AND METHODS: Patients with World Health Organization grade 3 meningiomas enrolled in our prospective observational cohort evaluating the utility of (68Ga) DOTATATE PET/MR imaging in somatostatin receptor positive brain tumors were included. We stratified patients by de novo–versus–secondary-progressive status and evaluated the differences in the PET standard uptake value, molecular profiles, and clinical outcomes.RESULTS: Patients met the inclusion criteria (secondary-progressive: 7/14; de novo: 7/14). The secondary-progressive cohort had a significantly higher per-patient number of surgeries (4.1 versus 1.6; P = .011) and trended toward a higher number of radiation therapy courses (2.4 versus 1.6; P = .23) and cumulative radiation therapy doses (106Gy versus 68.3Gy; P = .31). The secondary-progressive cohort had a significantly lower progression-free survival compared with the de novo cohort (4.8 versus 37.7 months; P = .004). Secondary-progressive tumors had distinct molecular pathology profiles with higher numbers of mutations (3.5 versus 1.2; P = .024). Secondary-progressive tumors demonstrated higher PET standard uptake values (17.1 versus 12.4; P = .0021).CONCLUSIONS: Our study confirms prior work illustrating distinct clinical outcomes in secondary-progressive and de novo World Health Organization grade 3 meningiomas. Furthermore, our findings support (68Ga) DOTATATE PET/MR imaging as a useful management strategy in World Health Organization grade 3 meningiomas and provide insight into meningioma biology, as well as clinical management implications.GTRgross total resectionPFSprogression-free survivalRANOResponse Assessment in Neuro-OncologyRTradiation therapySSSsuperior sagittal sinusSSTRsomatostatin-receptorSUVstandard uptake valueSUVRSUV ratioWHOWorld Health Organization