Meningioma Guidelines for the Use of Radiolabeled Somatostatin Receptor Ligands (SSTRs) (EANM/EANO/RANO/SNMMI, 2024)

Guidelines for the diagnosis and therapy (theranostics) of meningiomas using radioactively labeled somatostatin receptor ligands were published in June 2024 by the European Association of Nuclear Medicine (EANM), the Society of Nuclear Medicine and Molecular Imaging (SNMMI), the European Association of Neurooncology (EANO) published. and the Response Assessment in Neurooncology Working Group (PET/RANO) PET Task Force in the European Journal of Nuclear Medicine and Molecular Imaging.⁽¹⁾

Because of its high sensitivity and specificity, which exceeds conventional MRI, somatostatin receptor (SSTR)-guided PET imaging should be used to detect meningioma tissue.

Combine SSTR-PET imaging with MRI or CT for comprehensive diagnosis and treatment planning, especially for challenging cases such as optic nerve sheath meningiomas.

Use (^68Ga)Ga-DOTATATE or (^68Ga)Ga-DOTATOC for PET imaging as they provide excellent lesion-background contrast.

SSTR-PET imaging is recommended to assess the extent of meningiomas, especially in complex cases with skull base or bone involvement, to aid precise surgical and radiotherapy planning.

SSTR-PET is recommended to differentiate meningioma recurrence from post-therapeutic changes, which can be challenging with conventional imaging alone.

SSTR-PET imaging should be performed to identify patients eligible for peptide receptor radionuclide therapy (PRRT), particularly those with meningiomas expressing SSTR type 2.

Post-treatment PET imaging is critical for assessing residual tumor activity and guiding subsequent therapeutic decisions.

Avoid PRRT in cases such as pregnancy, severe acute illness, or serious psychiatric disorders.

Carefully consider the risks of PRRT in patients with brainstem mass effect, impaired renal function, or severe liver failure.

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Cite this: Meningioma Guidelines for the Use of Radiolabeled Somatostatin Receptor Ligands (SSTRs) (EANM/EANO/RANO/SNMMI, 2024) – Medscape – December 3, 2024.