[68Ga]-DOTATOC-PET/CT for meningioma IMRT treatment planning
Tóm tắt
The observation that human meningioma cells strongly express somatostatin receptor (SSTR 2) was the rationale to analyze retrospectively in how far DOTATOC PET/CT is helpful to improve target volume delineation for intensity modulated radiotherapy (IMRT).
In 26 consecutive patients with preferentially skull base meningioma, diagnostic magnetic resonance imaging (MRI) and planning-computed tomography (CT) was complemented with data from [68Ga]-DOTA-D Phe1-Tyr3-Octreotide (DOTATOC)-PET/CT. Image fusion of PET/CT, diagnostic computed tomography, MRI and radiotherapy planning CT as well as target volume delineation was performed with OTP-Masterplan®. Initial gross tumor volume (GTV) definition was based on MRI data only and was secondarily complemented with DOTATOC-PET information. Irradiation was performed as EUD based IMRT, using the Hyperion Software package.
The integration of the DOTATOC data led to additional information concerning tumor extension in 17 of 26 patients (65%). There were major changes of the clinical target volume (CTV) which modify the PTV in 14 patients, minor changes were realized in 3 patients. Overall the GTV-MRI/CT was larger than the GTV-PET in 10 patients (38%), smaller in 13 patients (50%) and almost the same in 3 patients (12%). Most of the adaptations were performed in close vicinity to bony skull base structures or after complex surgery. Median GTV based on MRI was 18.1 cc, based on PET 25.3 cc and subsequently the CTV was 37.4 cc. Radiation planning and treatment of the DOTATOC-adapted volumes was feasible.
DOTATOC-PET/CT information may strongly complement patho-anatomical data from MRI and CT in cases with complex meningioma and is thus helpful for improved target volume delineation especially for skull base manifestations and recurrent disease after surgery.
Từ khóa
Tài liệu tham khảo
Mirimanoff RO, Dosoretz DE, Linggood RM, Ojemann RG, Martuza RL: Meningioma: analysis of recurrence and progression following neurosurgical resection. J Neurosurg 1985,62(1):18-24. 10.3171/jns.1985.62.1.0018
Stafford SL, Perry A, Suman VJ, Meyer FB, Scheithauer BW, Lohse CM, Shaw EG: Primarily resected meningiomas: outcome and prognostic factors in 581 Mayo Clinic patients, 1978 through 1988. Mayo Clin Proc 1998,73(10):936-942. 10.4065/73.10.936
Mathiesen T, Lindquist C, Kihlstrom L, Karlsson B: Recurrence of cranial base meningiomas. Neurosurgery 1996,39(1):2-7. discussion8–9 10.1097/00006123-199607000-00002
Barbaro NM, Gutin PH, Wilson CB, Sheline GE, Boldrey EB, Wara WM: Radiation therapy in the treatment of partially resected meningiomas. Neurosurgery 1987,20(4):525-528. 10.1097/00006123-198704000-00003
Goldsmith BJ, Wara WM, Wilson CB, Larson DA: Postoperative irradiation for subtotally resected meningiomas. A retrospective analysis of 140 patients treated from 1967 to 1990. J Neurosurg 1994,80(2):195-201. 10.3171/jns.1994.80.2.0195
Mesic JB, Hanks GE, Doggett RL: The value of radiation therapy as an adjuvant to surgery in intracranial meningiomas. Am J Clin Oncol 1986,9(4):337-340. 10.1097/00000421-198608000-00013
Taylor BW Jr, Marcus RB Jr, Friedman WA, Ballinger WE Jr, Million RR: The meningioma controversy: postoperative radiation therapy. Int J Radiat Oncol Biol Phys 1988,15(2):299-304. 10.1016/S0360-3016(98)90008-6
Debus J, Wuendrich M, Pirzkall A, Hoess A, Schlegel W, Zuna I, Engenhart-Cabillic R, Wannenmacher M: High efficacy of fractionated stereotactic radiotherapy of large base-of-skull meningiomas: long-term results. J Clin Oncol 2001,19(15):3547-3553.
Milker-Zabel S, Zabel A, Schulz-Ertner D, Schlegel W, Wannenmacher M, Debus J: Fractionated stereotactic radiotherapy in patients with benign or atypical intracranial meningioma: long-term experience and prognostic factors. Int J Radiat Oncol Biol Phys 2005,61(3):809-816.
van Rij CM, Oughlane-Heemsbergen WD, Ackerstaff AH, Lamers EA, Balm AJ, Rasch CR: Parotid gland sparing IMRT for head and neck cancer improves xerostomia related quality of life. Radiat Oncol 2008, 3: 41. 10.1186/1748-717X-3-41
Lips IM, Dehnad H, van Gils CH, Boeken Kruger AE, Heide UA, van Vulpen M: High-dose intensity-modulated radiotherapy for prostate cancer using daily fiducial marker-based position verification: acute and late toxicity in 331 patients. Radiat Oncol 2008, 3: 15. 10.1186/1748-717X-3-15
Menkarios C, Azria D, Laliberte B, Moscardo CL, Gourgou S, Lemanski C, Dubois JB, Ailleres N, Fenoglietto P: Optimal organ-sparing intensity-modulated radiation therapy (IMRT) regimen for the treatment of locally advanced anal canal carcinoma: a comparison of conventional and IMRT plans. Radiat Oncol 2007, 2: 41. 10.1186/1748-717X-2-41
Baumert BG, Norton IA, Davis JB: Intensity-modulated stereotactic radiotherapy vs. stereotactic conformal radiotherapy for the treatment of meningioma located predominantly in the skull base. Int J Radiat Oncol Biol Phys 2003,57(2):580-592. 10.1016/S0360-3016(03)00587-X
Milker-Zabel S, Zabel-du Bois A, Huber P, Schlegel W, Debus J: Intensity-modulated radiotherapy for complex-shaped meningioma of the skull base: long-term experience of a single institution. Int J Radiat Oncol Biol Phys 2007,68(3):858-863.
Uy NW, Woo SY, Teh BS, Mai WY, Carpenter LS, Chiu JK, Lu HH, Gildenberg P, Trask T, Grant WH, et al.: Intensity-modulated radiation therapy (IMRT) for meningioma. Int J Radiat Oncol Biol Phys 2002,53(5):1265-1270. 10.1016/S0360-3016(02)02823-7
Pirzkall A, Debus J, Haering P, Rhein B, Grosser KH, Hoss A, Wannenmacher M: Intensity modulated radiotherapy (IMRT) for recurrent, residual, or untreated skull-base meningiomas: preliminary clinical experience. Int J Radiat Oncol Biol Phys 2003,55(2):362-372.
Clark BG, Candish C, Vollans E, Gete E, Lee R, Martin M, Ma R, McKenzie M: Optimization of stereotactic radiotherapy treatment delivery technique for base-of-skull meningiomas. Med Dosim 2008,33(3):239-247. 10.1016/j.meddos.2008.03.003
Sajja R, Barnett GH, Lee SY, Harnisch G, Stevens GH, Lee J, Suh JH: Intensity-modulated radiation therapy (IMRT) for newly diagnosed and recurrent intracranial meningiomas: preliminary results. Technol Cancer Res Treat 2005,4(6):675-682.
Ganswindt U, Paulsen F, Corvin S, Eichhorn K, Glocker S, Hundt I, Birkner M, Alber M, Anastasiadis A, Stenzl A, et al.: Intensity modulated radiotherapy for high risk prostate cancer based on sentinel node SPECT imaging for target volume definition. BMC Cancer 2005, 5: 91. 10.1186/1471-2407-5-91
Ganswindt U, Paulsen F, Corvin S, Hundt I, Alber M, Frey B, Stenzl A, Bares R, Bamberg M, Belka C: Optimized coverage of high-risk adjuvant lymph node areas in prostate cancer using a sentinel node-based, intensity-modulated radiation therapy technique. Int J Radiat Oncol Biol Phys 2007,67(2):347-355.
Deantonio L, Beldi D, Gambaro G, Loi G, Brambilla M, Inglese E, Krengli M: FDG-PET/CT imaging for staging and radiotherapy treatment planning of head and neck carcinoma. Radiat Oncol 2008, 3: 29. 10.1186/1748-717X-3-29
Rothschild S, Studer G, Seifert B, Huguenin P, Glanzmann C, Davis JB, Lutolf UM, Hany TF, Ciernik IF: PET/CT staging followed by Intensity-Modulated Radiotherapy (IMRT) improves treatment outcome of locally advanced pharyngeal carcinoma: a matched-pair comparison. Radiat Oncol 2007, 2: 22. 10.1186/1748-717X-2-22
Weber DC, Zilli T, Buchegger F, Casanova N, Haller G, Rouzaud M, Nouet P, Dipasquale G, Ratib O, Zaidi H, et al.: [(18)F]Fluoroethyltyrosine- positron emission tomography-guided radiotherapy for high-grade glioma. Radiat Oncol 2008, 3: 44. 10.1186/1748-717X-3-44
Singh AK, Guion P, Sears-Crouse N, Ullman K, Smith S, Albert PS, Fichtinger G, Choyke PL, Xu S, Kruecker J, et al.: Simultaneous integrated boost of biopsy proven, MRI defined dominant intra-prostatic lesions to 95 Gray with IMRT: early results of a phase I NCI study. Radiat Oncol 2007, 2: 36. 10.1186/1748-717X-2-36
Sharma N, Neumann D, Macklis R: The impact of functional imaging on radiation medicine. Radiat Oncol 2008, 3: 25. 10.1186/1748-717X-3-25
Dutour A, Kumar U, Panetta R, Ouafik L, Fina F, Sasi R, Patel YC: Expression of somatostatin receptor subtypes in human brain tumors. Int J Cancer 1998,76(5):620-627. 10.1002/(SICI)1097-0215(19980529)76:5<620::AID-IJC2>3.0.CO;2-S
Henze M, Schuhmacher J, Hipp P, Kowalski J, Becker DW, Doll J, Macke HR, Hofmann M, Debus J, Haberkorn U: PET imaging of somatostatin receptors using [68Ga]DOTA-D-Phe1-Tyr3-octreotide: first results in patients with meningiomas. J Nucl Med 2001,42(7):1053-1056.
Henze M, Dimitrakopoulou-Strauss A, Milker-Zabel S, Schuhmacher J, Strauss LG, Doll J, Macke HR, Eisenhut M, Debus J, Haberkorn U: Characterization of 68Ga-DOTA-D-Phe1-Tyr3-octreotide kinetics in patients with meningiomas. J Nucl Med 2005,46(5):763-769.
Astner ST, Dobrei-Ciuchendea M, Essler M, Bundschuh RA, Sai H, Schwaiger M, Molls M, Weber WA, Grosu AL: Effect of 11C-methionine-positron emission tomography on gross tumor volume delineation in stereotactic radiotherapy of skull base meningiomas. Int J Radiat Oncol Biol Phys 2008,72(4):1161-1167.
Grosu AL, Weber WA, Astner ST, Adam M, Krause BJ, Schwaiger M, Molls M, Nieder C: 11C-methionine PET improves the target volume delineation of meningiomas treated with stereotactic fractionated radiotherapy. Int J Radiat Oncol Biol Phys 2006,66(2):339-344.
Rutten I, Cabay JE, Withofs N, Lemaire C, Aerts J, Baart V, Hustinx R: PET/CT of skull base meningiomas using 2-18F-fluoro-L-tyrosine: initial report. J Nucl Med 2007,48(5):720-725. 10.2967/jnumed.106.038216
Milker-Zabel S, Zabel-du Bois A, Henze M, Huber P, Schulz-Ertner D, Hoess A, Haberkorn U, Debus J: Improved target volume definition for fractionated stereotactic radiotherapy in patients with intracranial meningiomas by correlation of CT, MRI, and [68Ga]-DOTATOC-PET. Int J Radiat Oncol Biol Phys 2006,65(1):222-227.
Astner ST, Bundschuh RA, Beer AJ, Ziegler SI, Krause BJ, Schwaiger M, Molls M, Grosu AL, Essler M: Assessment of tumor volumes in skull base glomus tumors using Gluc-Lys[(18)F]-TOCA positron emission tomography. Int J Radiat Oncol Biol Phys 2009,73(4):1135-1140.
Schulz S, Pauli SU, Handel M, Dietzmann K, Firsching R, Hollt V: Immunohistochemical determination of five somatostatin receptors in meningioma reveals frequent overexpression of somatostatin receptor subtype sst2A. Clin Cancer Res 2000,6(5):1865-1874.
Hildebrandt G, Scheidhauer K, Luyken C, Schicha H, Klug N, Dahms P, Krisch B: High sensitivity of the in vivo detection of somatostatin receptors by 111 indium (DTPA-octreotide)-scintigraphy in meningioma patients. Acta Neurochir (Wien) 1994,126(2-4):63-71. 10.1007/BF01476412
Barth A, Haldemann AR, Reubi JC, Godoy N, Rosler H, Kinser JA, Seiler RW: Noninvasive differentiation of meningiomas from other brain tumours using combined 111 Indium-octreotide/99 mtechnetium-DTPA brain scintigraphy. Acta Neurochir (Wien) 1996,138(10):1179-1185. 10.1007/BF01809748
Nyberg G, Bergstrom M, Enblad P, Lilja A, Muhr C, Langstrom B: PET-methionine of skull base neuromas and meningiomas. Acta Otolaryngol 1997,117(4):482-489. 10.3109/00016489709113425
Ericson K, Lilja A, Bergstrom M, Collins VP, Eriksson L, Ehrin E, von Holst H, Lundqvist H, Langsrom BB, Mosskin M: Positron emission tomography with ([11C]methyl)-L-methionine, [11C]D-glucose, and [68Ga]EDTA in supratentorial tumors. J Comput Assist Tomogr 1985,9(4):683-689. 10.1097/00004728-198507010-00005