18F-Fluoride PET/CT allows detection of hyperostosis and osseous involvement in meningioma: initial experience

The present study was conducted to assess the diagnostic performance of (18)F-fluoride PET/CT in evaluating hyperostosis and osseous involvement in patients with meningioma.

Thirty-four patients with meningioma (mean age, 61 years) underwent (18)F-fluoride PET/CT before surgery. In 24 patients (71%), (18)F-FDG PET/CT was also given before surgery, and the results were compared. The images were reviewed by 2 board-certified nuclear medicine specialists who were unaware of any clinical information and a consensus was reached. Uptake patterns and measurements of tracers were compared with pathological findings from resected specimens, with hyperostosis and osseous involvement as the reference standard.

There were 27 grade I tumors (79%) and 7 grade II tumors (21%). The primary tumor focus was identified in each patient using both (18)`F-fluoride PET/CT and (18)F-FDG PET/CT, but there were no significant correlations in the degree of uptake between the 2 tracers. The SUV(max), SUV(max) corrected for lean body mass (SUL(max)), and tumor metabolic volume (TMV) for (18)F-fluoride and (18)F-FDG were greater in grade II tumors than in grade I tumors. Hyperostosis and osseous involvement was identified in 12 tumors (38%). The SUV(max), SUL(max), and TMV of tumors visualized with (18)F-fluoride PET/CT were greater in tumors with hyperostosis and osseous involvement than in those without (P = 0.005, P = 0.003, and P = 0.006, respectively). In contrast, the SUV(max), SUL(max), and TMV of tumors visualized with (18)F-FDG PET/CT were similar regardless of hyperostosis or osseous involvement.

(18)F-fluoride PET/CT may improve detection of hyperostosis and osseous involvement in patients with meningioma.