The Complementary Role of ⁶⁸Ga-DOTATATE PET/CT in Diagnosis of Recurrent Meningioma

Contrast-enhanced brain MRI is the imaging modality of choice in diagnosis and posttreatment evaluation, but its role is limited in distinguishing recurrent lesions from postoperative changes. ⁶⁸Ga-DOTATATE is a somatostatin analog PET tracer that has high affinity to meningioma expressing somatostatin receptor. Methods: In this case series review, we describe 8 patients with brain MRI showing suspected recurrent meningioma who underwent focused ⁶⁸Ga-DOTATATE PET/CT for radiation treatment planning. Results: The combined brain MRI and PET/CT improved the conspicuity of the lesions and aided radiation treatment planning. The time from the initial surgery to PET/CT varied widely, ranging from 1 to 12 y. Three patients underwent PET/CT shortly after the initial surgery (1-3 y) and underwent targeted radiation therapy. Subsequent imaging showed no evidence of recurrence. Four patients had a prolonged time between the PET/CT and the initial surgery (7-12 y), which showed an extensive tumor burden. All 4 patients died shortly after the last PET/CT scan. Conclusion: ⁶⁸Ga-DOTATATE PET shows a promising complementary role in detection and treatment planning of recurrent meningioma.