RU-2861548-C1 - METHOD FOR RADIONUCLIDE DIAGNOSIS OF MENINGIOMAS IN PATIENTS AFTER TREATMENT

Abstract

FIELD: medicine; radionuclide diagnostics. SUBSTANCE: invention can be used in the diagnosis of meningiomas. After administration of the radiopharmaceutical [ 68 Ga]-“ФАПИ”-04, performing PET/CT of the brain. Assessing the maximum value of the standardised uptake value of the radiopharmaceutical [ 68 Ga]-“ФАПИ”-04 in the tumour (SUV meningioma ), in the contralateral cortex (SUV contralateral cortex ) and in the region of the sagittal sinus (SUV sagittal sinus ). Calculating the uptake index (UI) using a developed mathematical formula. When the UI value is equal to or exceeds 2.0, diagnosing the presence of a meningioma. EFFECT: qualitative and quantitative assessment of the presence of a formation, determining its prevalence and differentiating active growth of a meningioma from post-treatment changes, which helps optimise patient management by using a combined assessment of background structures. 1 cl, 2 ex

Inventors

• Melnikova Marina Konstantinovna
• Artemov Maksim Vladimirovich
• IVANOVA ANNA ALEKSANDROVNA
• Stanzhevskii Andrei Alekseevich

Dates

Publication Date

20260505

Application Date

20251203

Claims (2)

1. A method for radionuclide diagnostics of meningiomas in patients after treatment, including intravenous administration of a radiopharmaceutical [ 68 Ga]-FAPI-04 to the patient, performing positron emission tomography combined with computed tomography (PET/CT) of the brain, assessing the maximum value of the standardized level of accumulation of the radiopharmaceutical [ 68 Ga]-FAPI-04 in the tumor (SUV meningioma ) and the contralateral cortex (SUV contralateral cortex ), followed by determining the accumulation index (AI), characterized in that the value of the standardized level of accumulation of the radiopharmaceutical in the sagittal sinus region (SUV sagittal sinus ) is additionally assessed, after which the accumulation index (AI) is calculated using the formula
2. and if the HI value is equal to or greater than 2.0, the presence of meningioma is diagnosed.

Description

The invention relates to medicine, in particular to radionuclide diagnostics of meningiomas using positron emission computed tomography. Meningiomas are the most common primary tumors of the central nervous system, accounting for up to 36% of all intracranial neoplasms, and are most often diagnosed in individuals over 35 years of age, predominantly women (Nowosielski M, Stadlbauer A, Hutterer M, Stockhammer F, Preusser M, Wöhrer A, et al. Diagnostic challenges in meningioma: role of advanced imaging techniques. Neuro Oncol. 2017;19(12):1588-1599. doi:10.1093/neuonc/nox101). In recent decades, accumulated clinical data and the results of molecular genetic studies have led to a revision of the concepts regarding the biological behavior of meningiomas. Although meningiomas are traditionally considered benign neoplasms, their histological and clinical diversity is significantly wider. According to current WHO classifications, up to 20% of meningiomas are classified as atypical and anaplastic forms, characterized by aggressive growth, invasiveness, and a high risk of recurrence, which requires a more differentiated approach to their diagnosis and treatment (Louis DN, Perry A, Wesseling P, et al. The 2021 WHO Classification of Tumors of the Central Nervous System: a summary. // Neuro Oncol. 2021;23(8):1231-1251). The leading role in the recognition of meningiomas is given to radiological examination, in particular, the radiological method, X-ray computed tomography (CT) and magnetic resonance imaging (MRI), (Antonova O. G., Khazov P. D. Comprehensive radiological diagnostics of meningiomas // Russian Medical-Biological Herald named after Academician I.P. Pavlov. 2004. No. 1-2). Computed tomography (CT) is useful for detecting hyperostosis, calcifications, and assessing the condition of bone structures adjacent to the tumor. However, CT's ability to diagnose meningiomas is limited due to low soft tissue contrast and the inability to reliably distinguish tumor tissue from edema or normal brain structures. CT's sensitivity for diagnosing meningiomas is inferior to MRI's, but its advantages remain its high speed, wide availability, and effectiveness in detecting bone changes and calcifications (Ternovoy SK, Sinitsyn VE. Development of computed tomography and progress in radiation diagnostics. // Radiology - practice. 2005; 4:23-29). Magnetic resonance imaging (MRI) remains the gold standard in meningiomas imaging due to its high spatial and tissue resolution, as well as the ability to assess tumor location, extent of its spread, and relationship with surrounding structures (Nowosielski M et al. Diagnostic challenges in meningioma: role of advanced imaging techniques. Neuro Oncol. 2017; Bashir A, Thiel CS, Zimmer C, Shah K, Ebrahimi A, Galldiks N. Meningioma grading based on positron emission tomography: A systematic review and meta-analysis. Neuro Oncol Adv. 2023). MRI allows for highly accurate detection of extracerebral lesions, determining their size, topography, relationship to the dura mater, and vascular structures. However, in most cases, MRI data are not accompanied by histological verification, as biopsy of meningiomas is inappropriate given the typical presentation, and therefore the morphological type and biological activity of the lesion often remain tentative. Furthermore, similar MRI findings can be observed in other conditions, such as neurinomas, ependymomas, chordomas, as well as in rare cases of leptomeningeal metastases or chronic meningitis, limiting the differential diagnostic capabilities of the method. It should also be noted that meningiomas are tumors characterized by significant clinical variability, and the choice of treatment tactics depends on the location, size of the lesion, morphological variant, and neurological symptoms. Surgical removal of the tumor remains the primary and most common treatment method, allowing for radical control of the process in most cases of benign meningiomas (WHO grade I) (Goldbrunner R., Minniti G., Preusser M. et al. EANO guidelines for the diagnosis and treatment of meningiomas. Lancet Oncol. 2021). However, in some clinical situations, complete surgical removal is impossible or associated with a high risk of complications. Difficulties arise when the tumor is located in anatomically complex areas of the skull base, parasagittal region, cavernous sinus, optic nerve, as well as when there is invasion of vascular structures. In such cases, radiation therapy, including fractionated irradiation and stereotactic radiosurgery, becomes the method of choice (Minniti G., Clarke E., Scaringi C. et al. Radiation therapy for intracranial meningiomas. Neurosurg Clin N Am. 2016). Stereotactic gamma knife radiosurgery is widely used as primary treatment for small, well-defined meningiomas located in functionally significant areas where surgery is associated with high risk; as an adjunctive treatment after partial tumor resection; and for the treatment of recurrent tumors,