The Quarterly Journal of Nuclear Medicine and Molecular Imaging 2004 March;48(1):26-32

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

111Indium-octreotide brain scintigraphy: a prognostic factor in skull base meningiomas treated with gamma knife radiosurgery

Nicolato A.

Department of Neurosurgery University Hospital, Verona, Italy

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Aim. The pur­pose of ­this ­study is to pros­pec­tive­ly inves­ti­gate the prog­nos­tic ­role of som­a­tos­ta­tin recep­tor scin­tig­ra­phy (SRS) ­using an 111Indium-­labelled som­a­tos­ta­tin ana­logue, Octreotide, in ­skull ­base menin­gio­mas (SBMs) treat­ed ­with γ ­knife (GK) radio­sur­gery.
Methods. From December 1997 to March 2000, SRS was per­formed ­both ­before and with­in 1 ­year of radio­sur­gery on 12 ­patients. Semi-quan­ti­ta­tive ­data ­were cal­cu­lat­ed as SRS ­index; the ­index ­decrease was arbi­trar­i­ly con­sid­ered sig­nif­i­cant ­above 10%. A poten­tial cor­re­la­tion ­between the ­decrease in ­post/pre-GK SRS ­index and radio­sur­gi­cal out­come was eval­u­at­ed.
Results. The fol­low-up peri­od was at ­least 30 ­months in the ­whole ­series (­median, 43 ­months). In all 12 ­patients, the pre-GK SRS ­index was ­always >1, aver­ag­ing 3.73±2.9. A ­decrease in the ­post-GK aver­age SRS ­index (2.35±1.5) was ­observed. The dif­fer­ence ­between the pre- and ­post-GK aver­age val­ues was sta­tis­ti­cal­ly sig­nif­i­cant (p<0.03). At the 1st ­high-res­o­lu­tion mag­net­ic res­o­nance imag­ing (MRI) fol­low-up with­in 1 ­year of GK, ­there was no ­tumor shrink­age in any of the 12 ­patients of our ­series. A ­post/pre-GK SRS ­index ­decrease >10% was ­observed in 9 ­patients and <10% in 3. Delayed MRI fol­low-up doc­u­met­ed ­tumor reduc­tion in all 9 cas­es hav­ing an 111In ­uptake ­decrease >10%, ­with ­stable imag­ing in the oth­ers (p=0.00024).
Conclusion. Our pre­lim­i­nary find­ings sug­gest a prog­nos­tic cor­re­la­tion ­between a ­decrease in con­cen­tra­tion of som­a­tos­ta­tin recep­tors on menin­gio­ma ­cells with­in 1 ­year of radio­sur­gery and ­delayed menin­gio­ma shrink­age.