[Ga68] DOTATATE PET/MRI-guided radiosurgical treatment planning and response assessment in meningiomas

Jana Ivanidze; Se Jung Chang; Arsalan Haghdel; Joon Tae Kim; Arindam Roy Choudhury; Alan Wu; Rohan Ramakrishna; Theodore H. Schwartz; Babacar Cisse; Philip Stieg; Leland Muller; Joseph R. Osborne; Rajiv S. Magge; Nicolas A. Karakatsanis; Michelle Roytman; Eaton Lin; Susan C. Pannullo; Joshua D. Palmer; Jonathan P.S. Knisely

doi:10.1093/neuonc/noae067

[Ga68] DOTATATE PET/MRI-guided radiosurgical treatment planning and response assessment in meningiomas

Jana Ivanidze
, Se Jung Chang
, Arsalan Haghdel
, Joon Tae Kim
, Arindam Roy Choudhury
, Alan Wu
, Rohan Ramakrishna
, Theodore H. Schwartz
, Babacar Cisse
, Philip Stieg
, Leland Muller
, Joseph R. Osborne
, Rajiv S. Magge
, Nicolas A. Karakatsanis
, Michelle Roytman
, Eaton Lin
, Susan C. Pannullo
, Joshua D. Palmer
, Jonathan P.S. Knisely

Research output: Contribution to journal › Article › peer-review

23 Scopus citations

Abstract

Background: Our purpose was to determine the utility of [68Ga]-DOTATATE PET/MRI in meningioma response assessment following radiosurgery. Methods: Patients with meningioma prospectively underwent postoperative DOTATATE PET/MRI. Co-registered PET and gadolinium-enhanced T1-weighted MRI were employed for radiosurgery planning. Follow-up DOTATATE PET/MRI was performed at 6-12 months post-radiosurgery. Maximum absolute standardized uptake value (SUV) and SUV ratio (SUVR_SSS) referencing superior sagittal sinus (SSS) blood pool were obtained. Size change was determined by Response Assessment in Neuro-Oncology (RANO) criteria. Association of SUVR_SSS change magnitude and progression-free survival (PFS) was evaluated using Cox regression. Results: Twenty-seven patients with 64 tumors (26% World Health Organization [WHO]-1, 41% WHO-2, 26% WHO-3, and 7% WHO-unknown) were prospectively followed post stereotactic radiosurgery (SRS) or stereotactic body radiotherapy (SBRT; mean dose: 30 Gy, modal dose 35 Gy, mean of 5 fractions). Post-irradiation SUV and SUVR_SSS decreased by 37.4% and 44.4%, respectively (P < .0001). Size product decreased by 8.9%, thus failing to reach the 25% significance threshold as determined by RANO guidelines. Mean follow-up time was 26 months (range: 6-44). Overall mean PFS was 83% and 100%/100%/54% in WHO-1/-2/-3 subcohorts, respectively, at 34 months. At maximum follow-up (42-44 months), PFS was 100%/83%/54% in WHO-1/-2/-3 subcohorts, respectively. Cox regression analyses revealed a hazard ratio of 0.48 for 10-unit reduction in SUVR_SSS in the SRS cohort. Conclusions: DOTATATE PET SUV and SUVR_SSS demonstrated marked, significant decrease post-radiosurgery. Lesion size decrease was statistically significant; however, it was not clinically significant by RANO criteria. DOTATATE PET/MR thus represents a promising imaging biomarker for response assessment in meningiomas treated with radiosurgery.

Original language	English
Pages (from-to)	1526-1535
Number of pages	10
Journal	Neuro-Oncology
Volume	26
Issue number	8
DOIs	https://doi.org/10.1093/neuonc/noae067
State	Published - 1 Aug 2024
Externally published	Yes

Keywords

DOTATATE
PET/MRI
meningioma
outcomes
radiosurgery

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10.1093/neuonc/noae067

Cite this

Ivanidze, J., Chang, S. J., Haghdel, A., Kim, J. T., Roy Choudhury, A., Wu, A., Ramakrishna, R., Schwartz, T. H., Cisse, B., Stieg, P., Muller, L., Osborne, J. R., Magge, R. S., Karakatsanis, N. A., Roytman, M., Lin, E., Pannullo, S. C., Palmer, J. D., & Knisely, J. P. S. (2024). [Ga68] DOTATATE PET/MRI-guided radiosurgical treatment planning and response assessment in meningiomas. Neuro-Oncology, 26(8), 1526-1535. https://doi.org/10.1093/neuonc/noae067

@article{c5e8be8a9d4542deaf4c332faf0f5a99,

title = "[Ga68] DOTATATE PET/MRI-guided radiosurgical treatment planning and response assessment in meningiomas",

abstract = "Background: Our purpose was to determine the utility of [68Ga]-DOTATATE PET/MRI in meningioma response assessment following radiosurgery. Methods: Patients with meningioma prospectively underwent postoperative DOTATATE PET/MRI. Co-registered PET and gadolinium-enhanced T1-weighted MRI were employed for radiosurgery planning. Follow-up DOTATATE PET/MRI was performed at 6-12 months post-radiosurgery. Maximum absolute standardized uptake value (SUV) and SUV ratio (SUVRSSS) referencing superior sagittal sinus (SSS) blood pool were obtained. Size change was determined by Response Assessment in Neuro-Oncology (RANO) criteria. Association of SUVRSSS change magnitude and progression-free survival (PFS) was evaluated using Cox regression. Results: Twenty-seven patients with 64 tumors (26\% World Health Organization [WHO]-1, 41\% WHO-2, 26\% WHO-3, and 7\% WHO-unknown) were prospectively followed post stereotactic radiosurgery (SRS) or stereotactic body radiotherapy (SBRT; mean dose: 30 Gy, modal dose 35 Gy, mean of 5 fractions). Post-irradiation SUV and SUVRSSS decreased by 37.4\% and 44.4\%, respectively (P < .0001). Size product decreased by 8.9\%, thus failing to reach the 25\% significance threshold as determined by RANO guidelines. Mean follow-up time was 26 months (range: 6-44). Overall mean PFS was 83\% and 100\%/100\%/54\% in WHO-1/-2/-3 subcohorts, respectively, at 34 months. At maximum follow-up (42-44 months), PFS was 100\%/83\%/54\% in WHO-1/-2/-3 subcohorts, respectively. Cox regression analyses revealed a hazard ratio of 0.48 for 10-unit reduction in SUVRSSS in the SRS cohort. Conclusions: DOTATATE PET SUV and SUVRSSS demonstrated marked, significant decrease post-radiosurgery. Lesion size decrease was statistically significant; however, it was not clinically significant by RANO criteria. DOTATATE PET/MR thus represents a promising imaging biomarker for response assessment in meningiomas treated with radiosurgery.",

keywords = "DOTATATE, PET/MRI, meningioma, outcomes, radiosurgery",

author = "Jana Ivanidze and Chang, \{Se Jung\} and Arsalan Haghdel and Kim, \{Joon Tae\} and \{Roy Choudhury\}, Arindam and Alan Wu and Rohan Ramakrishna and Schwartz, \{Theodore H.\} and Babacar Cisse and Philip Stieg and Leland Muller and Osborne, \{Joseph R.\} and Magge, \{Rajiv S.\} and Karakatsanis, \{Nicolas A.\} and Michelle Roytman and Eaton Lin and Pannullo, \{Susan C.\} and Palmer, \{Joshua D.\} and Knisely, \{Jonathan P.S.\}",

year = "2024",

month = aug,

day = "1",

doi = "10.1093/neuonc/noae067",

language = "English",

volume = "26",

pages = "1526--1535",

journal = "Neuro-Oncology",

issn = "1522-8517",

publisher = "Oxford University Press",

number = "8",

}

Ivanidze, J, Chang, SJ, Haghdel, A, Kim, JT, Roy Choudhury, A, Wu, A, Ramakrishna, R, Schwartz, TH, Cisse, B, Stieg, P, Muller, L, Osborne, JR, Magge, RS, Karakatsanis, NA, Roytman, M, Lin, E, Pannullo, SC, Palmer, JD & Knisely, JPS 2024, '[Ga68] DOTATATE PET/MRI-guided radiosurgical treatment planning and response assessment in meningiomas', Neuro-Oncology, vol. 26, no. 8, pp. 1526-1535. https://doi.org/10.1093/neuonc/noae067

TY - JOUR

T1 - [Ga68] DOTATATE PET/MRI-guided radiosurgical treatment planning and response assessment in meningiomas

AU - Ivanidze, Jana

AU - Chang, Se Jung

AU - Haghdel, Arsalan

AU - Kim, Joon Tae

AU - Roy Choudhury, Arindam

AU - Wu, Alan

AU - Ramakrishna, Rohan

AU - Schwartz, Theodore H.

AU - Cisse, Babacar

AU - Stieg, Philip

AU - Muller, Leland

AU - Osborne, Joseph R.

AU - Magge, Rajiv S.

AU - Karakatsanis, Nicolas A.

AU - Roytman, Michelle

AU - Lin, Eaton

AU - Pannullo, Susan C.

AU - Palmer, Joshua D.

AU - Knisely, Jonathan P.S.

PY - 2024/8/1

Y1 - 2024/8/1

N2 - Background: Our purpose was to determine the utility of [68Ga]-DOTATATE PET/MRI in meningioma response assessment following radiosurgery. Methods: Patients with meningioma prospectively underwent postoperative DOTATATE PET/MRI. Co-registered PET and gadolinium-enhanced T1-weighted MRI were employed for radiosurgery planning. Follow-up DOTATATE PET/MRI was performed at 6-12 months post-radiosurgery. Maximum absolute standardized uptake value (SUV) and SUV ratio (SUVRSSS) referencing superior sagittal sinus (SSS) blood pool were obtained. Size change was determined by Response Assessment in Neuro-Oncology (RANO) criteria. Association of SUVRSSS change magnitude and progression-free survival (PFS) was evaluated using Cox regression. Results: Twenty-seven patients with 64 tumors (26% World Health Organization [WHO]-1, 41% WHO-2, 26% WHO-3, and 7% WHO-unknown) were prospectively followed post stereotactic radiosurgery (SRS) or stereotactic body radiotherapy (SBRT; mean dose: 30 Gy, modal dose 35 Gy, mean of 5 fractions). Post-irradiation SUV and SUVRSSS decreased by 37.4% and 44.4%, respectively (P < .0001). Size product decreased by 8.9%, thus failing to reach the 25% significance threshold as determined by RANO guidelines. Mean follow-up time was 26 months (range: 6-44). Overall mean PFS was 83% and 100%/100%/54% in WHO-1/-2/-3 subcohorts, respectively, at 34 months. At maximum follow-up (42-44 months), PFS was 100%/83%/54% in WHO-1/-2/-3 subcohorts, respectively. Cox regression analyses revealed a hazard ratio of 0.48 for 10-unit reduction in SUVRSSS in the SRS cohort. Conclusions: DOTATATE PET SUV and SUVRSSS demonstrated marked, significant decrease post-radiosurgery. Lesion size decrease was statistically significant; however, it was not clinically significant by RANO criteria. DOTATATE PET/MR thus represents a promising imaging biomarker for response assessment in meningiomas treated with radiosurgery.

AB - Background: Our purpose was to determine the utility of [68Ga]-DOTATATE PET/MRI in meningioma response assessment following radiosurgery. Methods: Patients with meningioma prospectively underwent postoperative DOTATATE PET/MRI. Co-registered PET and gadolinium-enhanced T1-weighted MRI were employed for radiosurgery planning. Follow-up DOTATATE PET/MRI was performed at 6-12 months post-radiosurgery. Maximum absolute standardized uptake value (SUV) and SUV ratio (SUVRSSS) referencing superior sagittal sinus (SSS) blood pool were obtained. Size change was determined by Response Assessment in Neuro-Oncology (RANO) criteria. Association of SUVRSSS change magnitude and progression-free survival (PFS) was evaluated using Cox regression. Results: Twenty-seven patients with 64 tumors (26% World Health Organization [WHO]-1, 41% WHO-2, 26% WHO-3, and 7% WHO-unknown) were prospectively followed post stereotactic radiosurgery (SRS) or stereotactic body radiotherapy (SBRT; mean dose: 30 Gy, modal dose 35 Gy, mean of 5 fractions). Post-irradiation SUV and SUVRSSS decreased by 37.4% and 44.4%, respectively (P < .0001). Size product decreased by 8.9%, thus failing to reach the 25% significance threshold as determined by RANO guidelines. Mean follow-up time was 26 months (range: 6-44). Overall mean PFS was 83% and 100%/100%/54% in WHO-1/-2/-3 subcohorts, respectively, at 34 months. At maximum follow-up (42-44 months), PFS was 100%/83%/54% in WHO-1/-2/-3 subcohorts, respectively. Cox regression analyses revealed a hazard ratio of 0.48 for 10-unit reduction in SUVRSSS in the SRS cohort. Conclusions: DOTATATE PET SUV and SUVRSSS demonstrated marked, significant decrease post-radiosurgery. Lesion size decrease was statistically significant; however, it was not clinically significant by RANO criteria. DOTATATE PET/MR thus represents a promising imaging biomarker for response assessment in meningiomas treated with radiosurgery.

KW - DOTATATE

KW - PET/MRI

KW - meningioma

KW - outcomes

KW - radiosurgery

UR - https://www.scopus.com/pages/publications/85200773239

U2 - 10.1093/neuonc/noae067

DO - 10.1093/neuonc/noae067

M3 - Article

C2 - 38553990

AN - SCOPUS:85200773239

SN - 1522-8517

VL - 26

SP - 1526

EP - 1535

JO - Neuro-Oncology

JF - Neuro-Oncology

IS - 8

ER -

[Ga68] DOTATATE PET/MRI-guided radiosurgical treatment planning and response assessment in meningiomas

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Keywords

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