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PT  - JOURNAL ARTICLE
AU  - Kim, Joon Tae
AU  - Chang, Se Jung Chris
AU  - Haghdel, Arsalan
AU  - Ramakrishna, Rohan R.
AU  - Pannullo, Susan C.
AU  - Schwartz, Theodore H.
AU  - Osborne, Joseph R.
AU  - Magge, Rajiv S.
AU  - Fine, Howard A.
AU  - Cisse, Babacar
AU  - Stieg, Philip
AU  - Lin, Eaton
AU  - Roytman, Michelle
AU  - Palmer, Joshua D.
AU  - Karakatsanis, Nicolas A.
AU  - Pisapia, David
AU  - Liechty, Benjamin
AU  - Knisely, Jonathan P.S.
AU  - Ivanidze, Jana
TI  - DOTATATE PET/MR Imaging Differentiates Secondary-Progressive from de Novo World Health Organization Grade 3 Meningiomas
AID  - 10.3174/ajnr.A8219
DP  - 2024 Jun 01
TA  - American Journal of Neuroradiology
PG  - 773--780
VI  - 45
IP  - 6
4099  - http://www.ajnr.org/content/45/6/773.short
4100  - http://www.ajnr.org/content/45/6/773.full
SO  - Am. J. Neuroradiol.2024 Jun 01; 45
AB  - BACKGROUND AND PURPOSE: WHO grade 3 meningiomas are rare and poorly understood and have a higher propensity for recurrence, metastasis, and worsened clinical outcomes compared with lower-grade meningiomas. The purpose of our study was to prospectively evaluate the molecular profile, PET characteristics, and outcomes of patients with World Health Organization grade 3 meningiomas who were imaged with gallium 68 (68Ga) DOTATATE PET/MR imaging.MATERIALS AND METHODS: Patients with World Health Organization grade 3 meningiomas enrolled in our prospective observational cohort evaluating the utility of (68Ga) DOTATATE PET/MR imaging in somatostatin receptor positive brain tumors were included. We stratified patients by de novo–versus–secondary-progressive status and evaluated the differences in the PET standard uptake value, molecular profiles, and clinical outcomes.RESULTS: Patients met the inclusion criteria (secondary-progressive: 7/14; de novo: 7/14). The secondary-progressive cohort had a significantly higher per-patient number of surgeries (4.1 versus 1.6; P = .011) and trended toward a higher number of radiation therapy courses (2.4 versus 1.6; P = .23) and cumulative radiation therapy doses (106Gy versus 68.3Gy; P = .31). The secondary-progressive cohort had a significantly lower progression-free survival compared with the de novo cohort (4.8 versus 37.7 months; P = .004). Secondary-progressive tumors had distinct molecular pathology profiles with higher numbers of mutations (3.5 versus 1.2; P = .024). Secondary-progressive tumors demonstrated higher PET standard uptake values (17.1 versus 12.4; P = .0021).CONCLUSIONS: Our study confirms prior work illustrating distinct clinical outcomes in secondary-progressive and de novo World Health Organization grade 3 meningiomas. Furthermore, our findings support (68Ga) DOTATATE PET/MR imaging as a useful management strategy in World Health Organization grade 3 meningiomas and provide insight into meningioma biology, as well as clinical management implications.GTRgross total resectionPFSprogression-free survivalRANOResponse Assessment in Neuro-OncologyRTradiation therapySSSsuperior sagittal sinusSSTRsomatostatin-receptorSUVstandard uptake valueSUVRSUV ratioWHOWorld Health Organization