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Article Abstract
Purpose: Somatostatin receptor (SSTR)-targeted PET/CT provides valuable clinical insights beyond standard imaging in meningioma patients. Due to its excellent diagnostic capabilities and favorable logistics, the F-labeled SSTR-targeting peptide SiTATE is increasingly in demand. We aimed to validate a recently proposed standard uptake value (SUV) threshold for accurate meningioma delineation in a clinically diverse patient cohort, including complex anatomical locations and lesions with prior surgical intervention.
Methods: Consecutive patients with known or suspected meningioma who underwent [F]SiTATE PET/CT and contrast enhanced cerebral MRI were included. Lesions were semi-automatically segmented on PET images using an individualized minimal SUV (SUV) within a manually defined volume of interest. Correlative CT and MRI images were used to refine segmentations for each lesion, identifying the optimal lesion-specific SUV to accurately capture the true volume of the meningioma. All lesions were additionally segmented using the recently proposed threshold of 4.0, and resulting volumes were compared.
Results: 61 patients with 109 lesions were analyzed: 40 (37%) extraosseous, 32 (29%) partial trans-osseous, and 37 (34%) predominantly intraosseous. The median optimal SUV for lesion delineation was 4.2. Osseous involvement did not significantly affect the median SUV (p = 0.1). Individualized SUV volumes showed excellent absolute agreement with those obtained using the fixed threshold of 4.0 (ICC[A,1] = 0.967; 95% CI: 0.952-0.977; p < 0.0001). However, 17 lesions (SUV < 4.2) were not captured by the fixed threshold.
Conclusion: The proposed SUV threshold of 4.0 showed promising results, supporting its suitability for clinical practice. Although limitations were evident, with 16% of lesions - primarily very small - showing reduced uptake and therefore not captured by this threshold, the study underscores its applicability in clinical practice.
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| http://dx.doi.org/10.1007/s00259-025-07476-9 | DOI Listing |
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