A 46-year old female with suspected meningioma. Ga-68 DOTATATE PET MRI was done for further assessment.
Axial T1W (left) and Axial PET MR fused image (right) reveals a solitary DOTATATE positive enhancing extra-axial dural based mass lesion in relation to the falx: Falx meningioma.
A 49-year old female with suspected meningioma. Ga-68 DOTATATE PET MRI was done for further assessment.
Coronal T1W (left) and Coronal PET MR fused image (right) reveals a solitary DOTATATE positive enhancing extra-axial mass lesion in relation to the left cavernous sinus
A 24-year old male, Operated case of left parietal meningioma. Ga-68 DOTATATE PET MRI was done for further assessment.
Sagittal PET MR fused (left), T1W (center) and MIP (right) images reveal post op changes and DOTATATE positive residual meningioma with extension.
A 50-year old female operated in 2010.Ga-68 DOTATATE PET MRI was done for further assessment.
Coronal T1W (left) and PET MR fused coronal image (right) reveals a DOTATATE avid enhancing left high parietal parasagittal meningioma.
A 53-year old female operated for olfactory meningioma. Ga-68 DOTATATE PET MRI was done for further assessment.
PET MR fused axial images at different levels reveals multiple DOTATATE positive bilateral residual predominantly extra-axial enhancing dural-based lesions in the left parietal region, left posterior parietal parasagittal region and left petrous region. In addition, diffuse nodular dural thickening is seen throughout the dural lining with mild diffuse SSR tracer uptake.
A 58-year old female, operated for meningioma in 2001. Ga-68 DOTATATE PET MRI was
done for suspected recurrence.
Coronal post contrast T1W (left) and PET MR fused coronal image (right ) reveals a
DOTATATE positive enhancing dural based lesion at the previously operated site : recurrent meningioma.
Another discrete subcentimeter size focal uptake of Ga 68 DOTATATE was seen in left suprasellar region. Axial post contrast image (left) reveals a subcentimeter enhancing lesion along the dura in left suprasellar region (red arrow). Corresponding PET MR fused image axial (middle) and coronal (right ) reveals focal tracer uptake corresponding to the enhancing lesion on MR.
Meningiomas have a high density of somatostatin tracer receptor expression and hence accumulate DOTATATE. Positron imaging with radiolabelled synthetic somatostatin receptor analogues such as Ga-68 DOTATATE is an established modality for diagnosis and target volume delineation of intracranial meningiomas prior to any surgical intervention or radiotherapy planning. In these cases, additional foci were identified thus having a significant overall impact on treatment planning and further management.
The case studies described above demonstrate the Ga-68 DOTATATE positivity of meningiomas.
This short PET-MRI Scan case was compiled by Dr. Sangeeta Taneja and Dr. Amarnath Jena (Nuclear Medicine Physician at PET-Suite @ Indraprastha Apollo Hospital, Sarita Vihar).
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