Consensus Radiation Treatment Planning Guidelines Using (68)Ga-DOTATATE PET/CT For Resected Meningiomas.

Area of Science:

• Neuro-oncology
• Radiology
• Radiation Oncology

Background:

• Meningiomas are the most common primary intracranial tumors.
• Somatostatin receptor 2 is highly expressed in meningioma tissue.
• (68)Ga-DOTATATE PET imaging detects residual disease missed by MRI.

Purpose of the Study:

• To establish consensus guidelines for PET-guided treatment planning in meningioma management.
• To leverage (68)Ga-DOTATATE PET/CT for improved radiation therapy precision.
• To standardize treatment planning for meningioma patients requiring adjuvant radiation.

Main Methods:

• Five postoperative meningioma cases were analyzed.
• Preoperative/postoperative MRI and (68)Ga-DOTATATE PET/CT were utilized for target delineation.
• Nineteen international experts developed consensus recommendations based on case reviews.

Main Results:

• Consensus recommendations for PET-guided contouring were established.
• PET-based planning allowed for precise dose-escalation to residual disease (66-70 Gy).
• Smaller clinical target volume expansions were recommended compared to standard guidelines when invasion was absent.

Conclusions:

• Consensus guidelines for PET-guided target volume delineation in meningioma radiation were developed.
• Implementing these guidelines can enhance biomarker-guided radiation precision.
• Standardization of radiation therapy for meningioma clinical trials is facilitated.