Reduction in the recurrence of meningiomas by combining somatostatin receptor scintigraphy of (99m)Tc-HYNIC-octreotide SPECT/CT and radio guidance with a hand-held γ-probe during surgery.

PURPOSE: The aim of this study was to determine whether recurrence of meningiomas could be reduced by combining somatostatin receptor scintigraphy (SRS) of Tc-HYNIC-octreotide SPECT/CT and radio guidance with a hand-held γ-probe during surgery.

MATERIALS AND

METHODS

Thirty patients with meningiomas diagnosed by MRI and considered as the study group were treated with Tc-HYNIC-octreotide SPECT/CT preoperatively and pathologically examined postoperatively. Another 60 patients considered as the control group underwent only an MRI preoperatively and a pathological examination postoperatively. For the patients in the study group, meningiomas were removed by a hand-held γ-probe 4-12 h after SRS; these patients were followed up by MRI examination each year for 5 years to monitor the recurrence rate of the meningiomas. For the control group, routine operations without radio guidance were performed and followed up with MRI examination simultaneously.

RESULTS

All patients in the study group, comprising 20 with grade I and 10 with grade II meningiomas, showed high Tc-HYNIC-octreotide accumulation with a sensitivity of 100% for SRS; four patients (13.3%) relapsed after a 5-year follow-up, including one (5%) patient with a grade I and three (30%) patients with a grade II meningioma. However, among the 60 control patients, 30 were of grade I and 30 were of grade II; 18 patients (30%) experienced recurrence, including five (16.7%) grade I patients and 13 (43.3%) grade II patients. There were significant differences in recurrence between the study group and the control group when considering all the patients and those in grade I and grade II (all P values were below 0.001).

CONCLUSION

Tc-HYNIC-octreotide SPECT/CT SRS is a sensitive technique for detecting meningiomas, and radio guidance using a hand-held γ-probe with Tc-HYNIC-octreotide during surgery can significantly reduce the recurrence of meningiomas.