SPECT and PET Imaging of Meningiomas

Abstract

Meningiomas arise from the meningothelial cells of the arachnoid membranes. They are the most common primary intracranial neoplasms and represent about 20% of all intracranial tumors. They are usually diagnosed after the third decade of life and they are more frequent in women than in men. According to the World Health Organization (WHO) criteria, meningiomas can be classified into grade I meningiomas, which are benign, grade II (atypical) and grade III (anaplastic) meningiomas, which have a much more aggressive clinical behaviour. Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) are routinely used in the diagnostic workup of patients with meningiomas. Molecular Nuclear Medicine Imaging with Single Photon Emission Computed Tomography (SPECT) and Positron Emission Tomography (PET) could provide complementary information to CT and MRI. Various SPECT and PET tracers may provide information about cellular processes and biological characteristics of meningiomas. Therefore, SPECT and PET imaging could be used for the preoperative noninvasive diagnosis and differential diagnosis of meningiomas, prediction of tumor grade and tumor recurrence, response to treatment, target volume delineation for radiation therapy planning, and distinction between residual or recurrent tumour from scar tissue.

Advanced Imaging of Intracranial Meningiomas

“…Radionuclides also have been made to target somatostatin receptors, which are expressed in meningiomas. Indium-111–labeled octreotide, as well as technetium-99m–labeled depreotide, have been used with single-photon emission CT to image meningiomas, 31 with gallium-68–labeled DOTA-D-Phe1-Tyr3-octreotide, which has a high affinity for the somatostatin receptor subtype 2 (SSTR 2), used with PET to image meningiomas. The high tumor-to-background ratio, along with the advent of hybrid PET and MRI systems, allow for highly sensitive and specific diagnosis of intracranial meningiomas.…”

SPECT / CT: Vorteile und Indikationen der Hybridbildgebung

“…Meningeome | Ein großer Anteil primärer ZNS-Tumore sind Meningeome [26]. Eine nuklearmedizinische Diagnostik mittels SPECT -obwohl noch nicht routinemäßig verwendet -kann ergänzende diagnostische Informationen zur CT und MRT liefern.…”

“…Auf diese Weise kann festgestellt werden, ob Patienten für eine Radiopeptidtherapie in Frage kommen (▶ Abb. 3) [26][27][28]. [16].…”

Effect of High Activity Technetium-99m on the Stability of Tc-99m Tetrofosmin as Injectable radiopharmaceuticals

“…Tc-99m tetrofosmin is commonly used for myocardial perfusion imaging agent, mainly at Harapan Kita Cardiac Hospital, Jakarta and Hasan Sadikin General Hospital, Bandung [1]. However, in recent year the use of Tc-99m tetrofosmin has been expanding not only for myocardial imaging but also for detection of several tumors and cancers such as brain cancer (glioma, glioblastoma, and meningioma), breast cancer and parathyroid adenoma [2][3][4][5]. The chemical structure of Tc-99m tetrofosmin has been discussed elsewhere [6].…”