Evaluating diagnostic accuracy and determining optimal diagnostic thresholds of different approaches to [68Ga]-DOTATATE PET/MRI analysis in patients with meningioma
Abstract Multiple approaches with [68Ga]-DOTATATE, a somatostatin analog PET radiotracer, have demonstrated clinical utility in evaluation of meningioma but have not been compared directly. Our purpose was to compare diagnostic performance of different approaches to quantitative brain [68Ga]-DOTATAT...
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| Format: | Article |
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Nature Portfolio
2022-06-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-022-13467-9 |
| _version_ | 1828328773544574976 |
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| author | Sean H. Kim Michelle Roytman Gabriela Madera Rajiv S. Magge Benjamin Liechty Rohan Ramakrishna Susan C. Pannullo Theodore H. Schwartz Nicolas A. Karakatsanis Joseph R. Osborne Eaton Lin Jonathan P. S. Knisely Jana Ivanidze |
| author_facet | Sean H. Kim Michelle Roytman Gabriela Madera Rajiv S. Magge Benjamin Liechty Rohan Ramakrishna Susan C. Pannullo Theodore H. Schwartz Nicolas A. Karakatsanis Joseph R. Osborne Eaton Lin Jonathan P. S. Knisely Jana Ivanidze |
| author_sort | Sean H. Kim |
| collection | DOAJ |
| description | Abstract Multiple approaches with [68Ga]-DOTATATE, a somatostatin analog PET radiotracer, have demonstrated clinical utility in evaluation of meningioma but have not been compared directly. Our purpose was to compare diagnostic performance of different approaches to quantitative brain [68Ga]-DOTATATE PET/MRI analysis in patients with suspected meningioma recurrence and to establish the optimal diagnostic threshold for each method. Patients with suspected meningioma were imaged prospectively with [68Ga]-DOTATATE brain PET/MRI. Lesions were classified as meningiomas and post-treatment change (PTC), using follow-up pathology and MRI as reference standard. Lesions were reclassified using the following methods: absolute maximum SUV threshold (SUV), SUV ratio (SUVR) to superior sagittal sinus (SSS) (SUVRsss), SUVR to the pituitary gland (SUVRpit), and SUVR to the normal brain parenchyma (SUVRnorm). Diagnostic performance of the four methods was compared using contingency tables and McNemar’s test. Previously published pre-determined thresholds were assessed where applicable. The optimal thresholds for each method were identified using Youden’s J statistics. 166 meningiomas and 41 PTC lesions were identified across 62 patients. SUV, SUVRsss, SUVRpit, and SUVRnorm of meningioma were significantly higher than those of PTC (P < 0.0001). The optimal thresholds for SUV, SUVRsss, SUVRpit, and SUVRnorm were 4.7, 3.2, 0.3, and 62.6, respectively. At the optimal thresholds, SUV had the highest specificity (97.6%) and SUVRsss had the highest sensitivity (86.1%). An ROC analysis of SUV, SUVRsss, SUVRpit, and SUVRnorm revealed AUC of 0.932, 0.910, 0.915, and 0.800, respectively (P < 0.0001). Developing a diagnostic threshold is key to wider clinical translation of [68Ga]-DOTATATE PET/MRI in meningioma evaluation. We found that the SUVRsss method may have the most robust combination of sensitivity and specificity in the diagnosis of meningioma in the post-treatment setting, with the optimal threshold of 3.2. Future studies validating our findings in different patient populations are needed to continue optimizing the diagnostic performance of [68Ga]-DOTATATE PET/MRI in meningioma patients. Trial registration: ClinicalTrials.gov Identifier: NCT04081701. Registered 9 September 2019. https://clinicaltrials.gov/ct2/show/NCT04081701 . |
| first_indexed | 2024-04-13T20:14:43Z |
| format | Article |
| id | doaj.art-aa12fb2bcd114f789132a24d29e67340 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-13T20:14:43Z |
| publishDate | 2022-06-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-aa12fb2bcd114f789132a24d29e673402022-12-22T02:31:45ZengNature PortfolioScientific Reports2045-23222022-06-0112111210.1038/s41598-022-13467-9Evaluating diagnostic accuracy and determining optimal diagnostic thresholds of different approaches to [68Ga]-DOTATATE PET/MRI analysis in patients with meningiomaSean H. Kim0Michelle Roytman1Gabriela Madera2Rajiv S. Magge3Benjamin Liechty4Rohan Ramakrishna5Susan C. Pannullo6Theodore H. Schwartz7Nicolas A. Karakatsanis8Joseph R. Osborne9Eaton Lin10Jonathan P. S. Knisely11Jana Ivanidze12Department of Radiology, Weill Cornell MedicineDepartment of Radiology, Weill Cornell MedicineDepartment of Radiology, Weill Cornell MedicineDepartment of Neurology, Weill Cornell MedicineDepartment of Pathology and Laboratory Medicine, Weill Cornell MedicineDepartment of Neurological Surgery, Weill Cornell MedicineDepartment of Neurological Surgery, Weill Cornell MedicineDepartment of Neurological Surgery, Weill Cornell MedicineDepartment of Radiology, Weill Cornell MedicineDepartment of Radiology, Weill Cornell MedicineDepartment of Radiology, Weill Cornell MedicineDepartment of Radiation Oncology, Stich Radiation Center, Weill Cornell MedicineDepartment of Radiology, Weill Cornell MedicineAbstract Multiple approaches with [68Ga]-DOTATATE, a somatostatin analog PET radiotracer, have demonstrated clinical utility in evaluation of meningioma but have not been compared directly. Our purpose was to compare diagnostic performance of different approaches to quantitative brain [68Ga]-DOTATATE PET/MRI analysis in patients with suspected meningioma recurrence and to establish the optimal diagnostic threshold for each method. Patients with suspected meningioma were imaged prospectively with [68Ga]-DOTATATE brain PET/MRI. Lesions were classified as meningiomas and post-treatment change (PTC), using follow-up pathology and MRI as reference standard. Lesions were reclassified using the following methods: absolute maximum SUV threshold (SUV), SUV ratio (SUVR) to superior sagittal sinus (SSS) (SUVRsss), SUVR to the pituitary gland (SUVRpit), and SUVR to the normal brain parenchyma (SUVRnorm). Diagnostic performance of the four methods was compared using contingency tables and McNemar’s test. Previously published pre-determined thresholds were assessed where applicable. The optimal thresholds for each method were identified using Youden’s J statistics. 166 meningiomas and 41 PTC lesions were identified across 62 patients. SUV, SUVRsss, SUVRpit, and SUVRnorm of meningioma were significantly higher than those of PTC (P < 0.0001). The optimal thresholds for SUV, SUVRsss, SUVRpit, and SUVRnorm were 4.7, 3.2, 0.3, and 62.6, respectively. At the optimal thresholds, SUV had the highest specificity (97.6%) and SUVRsss had the highest sensitivity (86.1%). An ROC analysis of SUV, SUVRsss, SUVRpit, and SUVRnorm revealed AUC of 0.932, 0.910, 0.915, and 0.800, respectively (P < 0.0001). Developing a diagnostic threshold is key to wider clinical translation of [68Ga]-DOTATATE PET/MRI in meningioma evaluation. We found that the SUVRsss method may have the most robust combination of sensitivity and specificity in the diagnosis of meningioma in the post-treatment setting, with the optimal threshold of 3.2. Future studies validating our findings in different patient populations are needed to continue optimizing the diagnostic performance of [68Ga]-DOTATATE PET/MRI in meningioma patients. Trial registration: ClinicalTrials.gov Identifier: NCT04081701. Registered 9 September 2019. https://clinicaltrials.gov/ct2/show/NCT04081701 .https://doi.org/10.1038/s41598-022-13467-9 |
| spellingShingle | Sean H. Kim Michelle Roytman Gabriela Madera Rajiv S. Magge Benjamin Liechty Rohan Ramakrishna Susan C. Pannullo Theodore H. Schwartz Nicolas A. Karakatsanis Joseph R. Osborne Eaton Lin Jonathan P. S. Knisely Jana Ivanidze Evaluating diagnostic accuracy and determining optimal diagnostic thresholds of different approaches to [68Ga]-DOTATATE PET/MRI analysis in patients with meningioma Scientific Reports |
| title | Evaluating diagnostic accuracy and determining optimal diagnostic thresholds of different approaches to [68Ga]-DOTATATE PET/MRI analysis in patients with meningioma |
| title_full | Evaluating diagnostic accuracy and determining optimal diagnostic thresholds of different approaches to [68Ga]-DOTATATE PET/MRI analysis in patients with meningioma |
| title_fullStr | Evaluating diagnostic accuracy and determining optimal diagnostic thresholds of different approaches to [68Ga]-DOTATATE PET/MRI analysis in patients with meningioma |
| title_full_unstemmed | Evaluating diagnostic accuracy and determining optimal diagnostic thresholds of different approaches to [68Ga]-DOTATATE PET/MRI analysis in patients with meningioma |
| title_short | Evaluating diagnostic accuracy and determining optimal diagnostic thresholds of different approaches to [68Ga]-DOTATATE PET/MRI analysis in patients with meningioma |
| title_sort | evaluating diagnostic accuracy and determining optimal diagnostic thresholds of different approaches to 68ga dotatate pet mri analysis in patients with meningioma |
| url | https://doi.org/10.1038/s41598-022-13467-9 |
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