Role of DOTATATE PET Imaging in Meningiomas with Neuro-Ophthalmic Implications

Meningiomas are the most frequent primary intracranial tumors. Neuroimaging remains a pillar for the diagnosis and the clinical decisions that follow. Magnetic Resonance Imaging (MRI) has been the gold standard tool for evaluating meningiomas, alongside CT scans. However, many obstacles persist, hence the need for new technologies providing functional and molecular information on these tumors. This literature review aims to evaluate the role of ⁶⁸Gallium DOTATATE PET scan in the diagnosis and management of meningiomas, specifically optic nerve sheath meningiomas (ONSM). Studies on this imaging technique found that the ⁶⁸Ga-DOTATATE PET scan was more efficient than MRI in differentiating meningiomas from normal tissues, with a sensitivity of 90.1% compared to 79%. The scan was superior in distinguishing scar tissues from tumoral tissues and could detect a disease recurrence with a better sensitivity than the MRI. The addition of ⁶⁸Ga-DOTATATE to the clinical management of meningiomas with neuro-ophthalmic implications turned out to be beneficial for the diagnosis, surgical planning, post-surgical radiation, and surveillance. This technology could allow to overcome certain limitations found with MRIs and CT scans, such as delineating tumor spread in anatomically challenging areas as well as attributing smaller and more precise radiation volumes.