ArticleRadiation oncology (London, England)2025
SSTR PET/CT for skull base low-grade meningioma: a critical tool for accurate gross tumor volume delineation in radiotherapy?
Article in Radiation oncology (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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13 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundPrecise delineation of gross tumor volume (GTV) is fundamental for effective radiation therapy in low-grade skull base meningiomas. Magnetic resonance imaging (MRI) serves as the primary imaging tool but may not fully represent tumor extent. This study investigates the additional value of incorporating Somatostatin receptor (SSTR)-directed PET/CT in radiation therapy planning.
methodsA retrospective analysis was conducted with four experienced radiation oncologists contouring GTVs for skull base meningiomas using MRI alone (GTV_MRI), PET/CT alone (GTV_PET/CT), and both modalities combined (GTV_ALL). Consensus ground truth volumes were generated for each modality through a STAPLE algorithm. Agreement between modalities, excluding observer variability, was assessed using statistical metrics including Dice Similarity Coefficient (DSC), Jaccard Index (JCI), Hausdorff distance (HD95), Geographical Miss Index (GMI), sensitivity, and kappa statistics.
resultsThe study included 25 patients (15 females, 10 males; median age 56 years (range: 23-74 years), with 96% achieving local control post-radiotherapy over a median follow-up of 64 months (range: 28-135 months). Substantial interobserver agreement was observed, with median kappa values of 0.74 for GTV_MRI, 0.68 for GTV_PET/CT, and 0.77 for GTV_ALL. Median consensus volumes were 6.65 cc (MRI
conclusionCombining MRI and PET/CT improves GTV delineation in low-grade skull base meningiomas, as PET/CT can reveal regions missed by MRI, which may slightly underestimate tumor size. This multimodal imaging approach enhances consensus and supports its role in radiotherapy planning. Standardized protocols and technical integration remain key future goals.
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