• Eric B Hintz, David J Park, Daniel Ma, Sirisha Devi Viswanatha, Josephine N Rini, Michael Schulder, and Anuj Goenka.
• Department of Neurosurgery, Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA.
• Neurosurgery. 2023 Jul 1; 93 (1): 9510195-101.

BackgroundFor patients with either an incompletely resected meningioma or recurrence after surgery, stereotactic radiosurgery is frequently used. MRI is typically used for stereotactic radiosurgery targeting, but differentiating tumor growth from postoperative change can be challenging. 68 Ga-DOTATATE, a positron emission tomography (PET) radiotracer targeting the somatostatin receptor type 2, has been shown to be a reliable meningioma biomarker.ObjectiveTo evaluate the impact of 68 Ga-DOTATATE on treatment planning in patients who had previously undergone meningioma resection.MethodsWe present a consecutive case series of 12 patients with pathology-proven meningioma who received a 68 Ga-DOTATATE PET between April 2019 and April 2021. Treatment planning was performed first using MRI. DOTATATE-PET images were then used to assess accurate tumor identification.ResultsTen patients had WHO Grade 2 meningioma, and 2 patients had Grade 1 tumor. Eight patients had recurrent meningiomas, and 4 patients had newly diagnosed disease. Overall, 68 Ga-DOTATATE PET scans altered previously formulated treatment plans in 5 of 12 patients. In addition, 9 of 12 patients had disease foci not appreciated on MRI.ConclusionIn this series, incorporating 68 Ga-DOTATATE PET imaging had clinical utility for most patients in whom it was used. It proved particularly adept in demonstrating intraosseous meningiomas, differentiating recurrence from postoperative changes, and identifying subcentimeter disease foci. It is an imaging modality that our center will continue to use as a means of improving postoperative treatment plans after the surgical resection of meningiomas.Copyright © Congress of Neurological Surgeons 2023. All rights reserved.

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