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Background <p>Somatostatin receptor (SSTR)-targeted PET is valuable for meningioma imaging due to high SSTR expression. [<sup>18</sup>F]SiTATE, a novel tracer, is not only promising for imaging neuroendocrine tumors but also for meningiomas. Standardized delineation methods on [<sup>18</sup>F]SiTATE PET are lacking. This study correlates CT-based volumes with PET-based delineation approaches to identify a threshold for standardized [<sup>18</sup>F]SiTATE PET volume assessment.</p> Methods <p>Patients with well-delineated, extraosseous meningioma on CT (≥ 1mL) who underwent [<sup>18</sup>F]SiTATE PET/CT were included. Volumes were assessed on contrast-enhanced CT and correlated with PET-based delineation approaches: (I) fixed SUV threshold, (II) isocontour thresholding relative to SUV<sub>max</sub> (SUV%), and thresholds relative to (III) bone marrow (SUV<sub>BM</sub>), (IV) parotid gland (SUV<sub>parotis</sub>) and (V) pituitary gland (SUV<sub>sella</sub>).</p> Results <p>19 meningiomas in 17 PET/CT scans (16 patients) were included. A fixed SUV of 4.0 (<i>r</i> = 0.783, <i>p</i> &lt; 0.001) showed good correlation with CT volumes without skewed distribution on Bland-Altman-Plot analysis. Using isocontour-based thresholds, 45% SUV<sub>max</sub> (<i>r</i> = 0.496, <i>p</i> = 0.031) showed the highest concordance. Best reference-based approaches were achieved by 150% SUV<sub>BM</sub> (<i>r</i> = 0.859, <i>p</i> &lt; 0.001), 250% SUV<sub>parotis</sub> (<i>r</i> = 0.460, <i>p</i> = 0.047) and 70% SUV<sub>sella</sub> (<i>r</i> = 0.819, <i>p</i> &lt; 0.001). However, background-based approaches showed a trend towards overestimation of PET-volumes in larger meningiomas as assessed on Bland-Altman-Plot analyses. Uptake intensities of reference tissues (SUV<sub>BM,</sub> SUV<sub>parotis</sub> and SUV<sub>sella</sub>) were not inter-correlated (<i>p</i> &gt; 0.05 each).</p> Conclusion <p>A fixed SUV threshold of 4.0 showed strong agreement with CT-based volumes in well-delineated, extraosseous meningiomas which offers a simple, clinically applicable method without technical requirements. Reference tissue-based methods showed similar correlations but tended to overestimate volumes in larger lesions.</p>

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Feasibility of different meningioma delineation approaches on [18F]SiTATE PET/CT imaging

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月14日

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  • Sophie Carina Kunte,
  • Lena M. Unterrainer,
  • Simon Lindner,
  • Adrien Holzgreve,
  • Wolfgang G. Kunz,
  • Michael Winkelmann,
  • Alexander Nitschmann,
  • Klaus Jurkschat,
  • Carmen Wängler,
  • Björn Wängler,
  • Ralf Schirrmacher,
  • Claus Belka,
  • Niklas Thon,
  • Christian Schichor,
  • Peter Bartenstein,
  • Marcus Unterrainer

摘要

Background

Somatostatin receptor (SSTR)-targeted PET is valuable for meningioma imaging due to high SSTR expression. [18F]SiTATE, a novel tracer, is not only promising for imaging neuroendocrine tumors but also for meningiomas. Standardized delineation methods on [18F]SiTATE PET are lacking. This study correlates CT-based volumes with PET-based delineation approaches to identify a threshold for standardized [18F]SiTATE PET volume assessment.

Methods

Patients with well-delineated, extraosseous meningioma on CT (≥ 1mL) who underwent [18F]SiTATE PET/CT were included. Volumes were assessed on contrast-enhanced CT and correlated with PET-based delineation approaches: (I) fixed SUV threshold, (II) isocontour thresholding relative to SUVmax (SUV%), and thresholds relative to (III) bone marrow (SUVBM), (IV) parotid gland (SUVparotis) and (V) pituitary gland (SUVsella).

Results

19 meningiomas in 17 PET/CT scans (16 patients) were included. A fixed SUV of 4.0 (r = 0.783, p < 0.001) showed good correlation with CT volumes without skewed distribution on Bland-Altman-Plot analysis. Using isocontour-based thresholds, 45% SUVmax (r = 0.496, p = 0.031) showed the highest concordance. Best reference-based approaches were achieved by 150% SUVBM (r = 0.859, p < 0.001), 250% SUVparotis (r = 0.460, p = 0.047) and 70% SUVsella (r = 0.819, p < 0.001). However, background-based approaches showed a trend towards overestimation of PET-volumes in larger meningiomas as assessed on Bland-Altman-Plot analyses. Uptake intensities of reference tissues (SUVBM, SUVparotis and SUVsella) were not inter-correlated (p > 0.05 each).

Conclusion

A fixed SUV threshold of 4.0 showed strong agreement with CT-based volumes in well-delineated, extraosseous meningiomas which offers a simple, clinically applicable method without technical requirements. Reference tissue-based methods showed similar correlations but tended to overestimate volumes in larger lesions.