Dynamic Ga-DOTATATE PET/MRI in the Diagnosis and Management of Intracranial Meningiomas.

Purpose To evaluate dynamic gallium 68 (Ga) tetraazacyclododecane tetraacetic acid octreotate (DOTATATE) brain PET/MRI as an adjunct modality in meningioma, enabling multiparametric standardized uptake value (SUV) and Patlak net binding rate constant () imaging, and to optimize static acquisition period. Materials and Methods In this prospective study (ClinicalTrials.gov no. NCT04081701, DOMINO-START), Ga-DOTATATE PET/MRI-derived time-activity curves (TACs) were measured in 84 volumes of interest in 19 participants (mean age, 63 years; range, 36-89 years; 13 women; 2019-2021) with meningiomas. Region- and voxel-specific were determined using Patlak analysis with a validated population-based reference tissue TAC model built from an independent data set of nine participants. Mean and maximum absolute and relative-to-superior-sagittal-sinus SUVs were extracted from the entire 50 minutes (SUV) and last 10 minutes (SUV) of acquisition. SUV versus Spearman correlation, SUV and meningioma versus posttreatment-change Mann-Whitney tests, and SUV versus SUV Wilcoxon matched-pairs signed rank tests were performed. Results Absolute and relative maximum SUV demonstrated a strong positive correlation with Patlak in meningioma ( = 0.82, < .001 and = 0.85, < .001, respectively) and posttreatment-change lesions ( = 0.88, = .007 and = 0.83, = .02, respectively). Patlak images yielded higher lesion contrast by mitigating nonspecific background signal. All SUV and SUV metrics differed between meningioma and posttreatment-change regions ( < .001). Within the meningioma group, SUV attained higher mean scores than SUV ( < .001). Conclusion Combined SUV and Patlak Ga-DOTATATE PET/MRI enabled multiparametric evaluation of meningioma, offering the potential to enhance lesion contrast with imaging and optimize the SUV measurement postinjection window. Molecular Imaging-Clinical Translation, Neuro-Oncology, PET/MRI, Dynamic, Patlak ClinicalTrials.gov registration no. NCT04081701 © RSNA, 2022.