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Somatostatin receptor scintigraphy accurately confirms optic nerve sheath meningioma
Ophthalmology. 2009;116(8):1581-1586.
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Somatostatin receptor scintigraphy proved effective in confirming clinical diagnoses of optic nerve sheath meningioma, according to a study.
Previous studies showed that optic nerve sheath meningioma and other pathologies had high somatostatin expression and indium-111-octreotide (111In-octreotide) uptake, the authors said.
The prospective, comparative case series included 68 orbits of 61 patients diagnosed with orbital tumors based on clinical examination and tumor imaging with CT or MRI. Patients received a 200 MBq intravenous injection of 111In-octreotide and underwent single photon-emission computed tomography 24 hours later.
Based on histology and imaging, orbital tumors were classified as meningioma, vascular tumor, non-Hodgkin's lymphoma, optic nerve glioma, idiopathic orbital inflammation, sarcoidosis, schwannoma, adenocarcinoma and miscellaneous types.
Study data showed that patients with optic nerve sheath meningiomas had an 111In-octreotide uptake ratio of 7.2. Patients with spheno-orbital meningiomas had an 111In-octreotide uptake ratio of 16.3. The difference in uptake ratios between the optic nerve sheath meningioma group and other groups, apart from meningiomas, was statistically significant (P < .001).
At a threshold uptake ratio of 5.9, somatostatin receptor scintigraphy had sensitivity of 100% and specificity of 97.2%, the authors said.
They noted that some cases may still require biopsies to confirm preliminary diagnoses of optic nerve sheath meningioma.
"Unfortunately, [somatostatin receptor scintigraphy] cannot completely replace histopathologic diagnosis at present because there are atypical cases in which biopsy is required, despite its risks," they said.