Pittsburgh compound B (PiB) PET imaging of meningioma and other intracranial tumors

Derek R. Johnson, Christopher H. Hunt, Mark A. Nathan, Joseph E Parisi, Bradley F Boeve, Melissa E Murray, David S Knopman, Clifford R Jr. Jack, Ronald Carl Petersen, Val Lowe, Geoffrey B. Johnson

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Meningiomas are the most common intracranial tumors. Diagnosis by MRI is generally straightforward, but lack of imaging specificity can present a diagnostic dilemma, particularly in patients with cancer. We report our experience with meningioma identification on Pittsburgh compound B (PiB) PET/CT. Patients who underwent PiB PET/CT from 2006 to 2015 were reviewed to identify those with intracranial tumors. Tumor types were classified by MR appearance, or by pathology when available. Maximum standardized uptake value (SUVmax) measurements of tumor PiB activity were compared across tumor types. 2472 patients underwent PiB PET/CT in the period of interest; 45 patients (1.8%) had probable or definite intracranial tumor. Tumor types were meningioma (29/45, 64%), vestibular schwannoma (7/45, 16%), pituitary macroadenoma (4/45, 9%), metastatic disease (2/45, 4%), and others (3/45, 7%). In patients with meningioma, the mean lesion SUVmax was 2.05 (SD 1.37), versus 1.00 (SD 0.42) in patients with non-meningioma tumors (p < 0.01). A receiver operating curve was created for lesion:cerebellum SUVmax ratio, with an area under the curve of 0.91 for a value of 1.68. At or above this ratio, specificity for meningioma was 100% (95% CI 79–100%) and sensitivity was 76% (95% CI 57–90%). PiB PET activity within an intracranial tumor is a highly specific and reasonably sensitive marker of meningioma. Further prospective evaluation is warranted to validate this result as well as to assess the performance of commercially available beta-amyloid radiotracers in meningioma identification.

Original languageEnglish (US)
Pages (from-to)1-6
Number of pages6
JournalJournal of Neuro-Oncology
DOIs
StateAccepted/In press - Nov 8 2017

Fingerprint

Meningioma
Neoplasms
2-(4'-(methylamino)phenyl)-6-hydroxybenzothiazole
Acoustic Neuroma
Amyloid
Cerebellum
Area Under Curve
Pathology

Keywords

  • Beta-amyloid
  • Meningioma
  • Metastasis
  • PiB
  • Positron emission tomography (PET)

ASJC Scopus subject areas

  • Oncology
  • Neurology
  • Clinical Neurology
  • Cancer Research

Cite this

Pittsburgh compound B (PiB) PET imaging of meningioma and other intracranial tumors. / Johnson, Derek R.; Hunt, Christopher H.; Nathan, Mark A.; Parisi, Joseph E; Boeve, Bradley F; Murray, Melissa E; Knopman, David S; Jack, Clifford R Jr.; Petersen, Ronald Carl; Lowe, Val; Johnson, Geoffrey B.

In: Journal of Neuro-Oncology, 08.11.2017, p. 1-6.

Research output: Contribution to journalArticle

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abstract = "Meningiomas are the most common intracranial tumors. Diagnosis by MRI is generally straightforward, but lack of imaging specificity can present a diagnostic dilemma, particularly in patients with cancer. We report our experience with meningioma identification on Pittsburgh compound B (PiB) PET/CT. Patients who underwent PiB PET/CT from 2006 to 2015 were reviewed to identify those with intracranial tumors. Tumor types were classified by MR appearance, or by pathology when available. Maximum standardized uptake value (SUVmax) measurements of tumor PiB activity were compared across tumor types. 2472 patients underwent PiB PET/CT in the period of interest; 45 patients (1.8{\%}) had probable or definite intracranial tumor. Tumor types were meningioma (29/45, 64{\%}), vestibular schwannoma (7/45, 16{\%}), pituitary macroadenoma (4/45, 9{\%}), metastatic disease (2/45, 4{\%}), and others (3/45, 7{\%}). In patients with meningioma, the mean lesion SUVmax was 2.05 (SD 1.37), versus 1.00 (SD 0.42) in patients with non-meningioma tumors (p < 0.01). A receiver operating curve was created for lesion:cerebellum SUVmax ratio, with an area under the curve of 0.91 for a value of 1.68. At or above this ratio, specificity for meningioma was 100{\%} (95{\%} CI 79–100{\%}) and sensitivity was 76{\%} (95{\%} CI 57–90{\%}). PiB PET activity within an intracranial tumor is a highly specific and reasonably sensitive marker of meningioma. Further prospective evaluation is warranted to validate this result as well as to assess the performance of commercially available beta-amyloid radiotracers in meningioma identification.",
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AU - Murray, Melissa E

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AB - Meningiomas are the most common intracranial tumors. Diagnosis by MRI is generally straightforward, but lack of imaging specificity can present a diagnostic dilemma, particularly in patients with cancer. We report our experience with meningioma identification on Pittsburgh compound B (PiB) PET/CT. Patients who underwent PiB PET/CT from 2006 to 2015 were reviewed to identify those with intracranial tumors. Tumor types were classified by MR appearance, or by pathology when available. Maximum standardized uptake value (SUVmax) measurements of tumor PiB activity were compared across tumor types. 2472 patients underwent PiB PET/CT in the period of interest; 45 patients (1.8%) had probable or definite intracranial tumor. Tumor types were meningioma (29/45, 64%), vestibular schwannoma (7/45, 16%), pituitary macroadenoma (4/45, 9%), metastatic disease (2/45, 4%), and others (3/45, 7%). In patients with meningioma, the mean lesion SUVmax was 2.05 (SD 1.37), versus 1.00 (SD 0.42) in patients with non-meningioma tumors (p < 0.01). A receiver operating curve was created for lesion:cerebellum SUVmax ratio, with an area under the curve of 0.91 for a value of 1.68. At or above this ratio, specificity for meningioma was 100% (95% CI 79–100%) and sensitivity was 76% (95% CI 57–90%). PiB PET activity within an intracranial tumor is a highly specific and reasonably sensitive marker of meningioma. Further prospective evaluation is warranted to validate this result as well as to assess the performance of commercially available beta-amyloid radiotracers in meningioma identification.

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