⁶⁸Ga-DOTATATE PET/CT enables detection of meningioma tissue based on somatostatin receptor 2 expression. Transosseous extension of intracranial meningiomas is known to be an important risk factor for tumor recurrence and patient mortality. We analyzed the diagnostic performance of ⁶⁸Ga-DOTATATE PET/CT and contrast-enhanced MRI (CE-MRI) for the detection of osseous infiltration using qualitative and quantitative imaging parameters. Methods: In this institutional review board–approved retrospective study, subjects were selected from 327 consecutive ⁶⁸Ga-DOTATATE PET/CT examinations for evaluation of confirmed or suspected meningioma. Inclusion criteria were CE-MRI within 30 d and pathology-confirmed meningioma diagnosis with inclusion or exclusion of transosseous extension as the standard of reference. Imaging was analyzed by two readers. Tracer uptake values and meningioma volumes were determined. χ², Mann–Whitney U, Wilcoxon signed rank, and McNemar tests, as well as receiver-operating-characteristic analyses, were performed to compare variables and diagnostic performance. Results: Eighty-two patients fulfilled the inclusion criteria. Patients with transosseous extension of meningioma (n = 67) showed significantly larger lesions (median, 12.8 vs. 3.3 mL; P < 0.001) and significantly higher tracer uptake values (median SUV_max, 14.2 vs. 7.6; P = 0.011) than patients with extraosseous meningiomas (n = 15). ⁶⁸Ga-DOTATATE PET/CT in comparison to CE-MRI performed at a higher sensitivity (98.5% vs. 53.7%) while maintaining high specificity (86.7% vs. 93.3%) in the detection of osseous involvement (P < 0.001). In receiver-operating-characteristic analysis, PET/CT assessment performed better than CE-MRI (area under the curve, 0.932 vs. 0.773). PET/CT- and CE-MRI–based volume estimation yielded comparable results for extraosseous meningiomas (P = 0.132) and the extraosseous part of transosseous meningiomas (P = 0.636), whereas the volume of the intraosseous part was assessed as significantly larger by PET/CT (P < 0.001). Conclusion: ⁶⁸Ga-DOTATATE PET/CT enables improved detection of the transosseous extension of intracranial meningiomas compared with CE-MRI.

⁶⁸ Ga-DOTATATE PET / CT可根据生长抑素受体2的表达检测脑膜瘤组织。颅内脑膜瘤的骨膜转移是肿瘤复发和患者死亡的重要危险因素。我们使用定性和定量成像参数分析了⁶⁸ Ga-DOTATATE PET / CT和对比增强MRI（CE-MRI）对骨浸润的诊断性能。方法：在该机构审查委员会批准的回顾性研究中，从327名连续的⁶⁸名受试者中选择了受试者Ga-DOTATATE PET / CT检查，用于评估已确诊或怀疑的脑膜瘤。纳入标准为30 d内的CE-MRI和经病理证实的脑膜瘤诊断，以包括或不包括经骨性扩展为参考标准。两名读者对成像进行了分析。确定示踪剂摄取值和脑膜瘤体积。χ ²，曼-惠特尼U，Wilcoxon符号秩和检验麦克尼马尔，以及接收器操作特征分析，进行比较的变量和诊断性能。结果： 82例患者符合入选标准。脑膜瘤经骨性扩展的患者（n = 67）表现出明显更大的病变（中位值分别为12.8和3.3 mL；P<0.001）且示踪剂摄取值（骨SUV_最大，14.2 vs. 7.6; P = 0.011）明显高于骨外脑膜瘤患者（n = 15）。与CE-MRI相比，⁶⁸ Ga-DOTATATE PET / CT具有更高的灵敏度（98.5％对53.7％），同时在检测骨累及方面保持了高特异性（86.7％对93.3％）（P <0.001）。在接受者操作特征分析中，PET / CT评估的效果优于CE-MRI（曲线下面积为0.932 vs. 0.773）。PET / CT-和基于CE-MRI体积估计为产生脑膜瘤extraosseous（比较的结果P = 0.132）和穿骨脑膜瘤的extraosseous部分（P= 0.636），而通过PET / CT将骨内部分的体积评估为明显更大（P <0.001）。结论： 与CE-MRI相比，⁶⁸ Ga-DOTATATE PET / CT能够更好地检测颅内脑膜瘤的跨骨延伸。