Table 1: SPECT and PET radiopharmaceuticals used in meningiomas.

TracerImaging modalityAdvantagesDisadvantagesReferences

Thallium-201SPECT, analog of K+Information of tumor biological characteristicsLimited imaging properties, serial brain SPECT studies[1518]

99mTc-labeled compoundsSPECT, tissue perfusion, cell membrane integrity, and mitochondrial activityViability marker, prediction of anticancer drug resistance related to PgpSmall series of patients, the correlation between tracer uptake and tumor grading or other biological characteristics, needs validation with further studies[19, 2128]

111In-octreotide and 99mTc-depreotideSPECT, SSTRHigh sensitivity and negative predictive value, differential diagnosis from somatostatin receptor-negative and orbital tumours, differentiation between postoperative scar and recurrence, selection of patients for somatostatin analogue-based therapiesSpecificity depends on the BBB integrity, difficulty in detecting small tumors, limited imaging properties of 111In, few studies with 99mTc-depreotide[4259, 65]

18F-FDGPET, brain glucose metabolismPrognostic information (prediction of recurrence and survival)High uptake in normal gray matter not tumor specific[44, 6673]

11C or 18F labeled amino acidsPET, protein synthesisHigh tumor/background ratio, identification of skull base meningiomas, improve target volume definition for RTNot useful for grading[67, 7683]

11C-cholinePET, phospholipid synthesisMeningioma gradingFew studies[87, 88]

1-11C-acetatePETAccurate tumor delineation, guiding the stereotactic biopsy, optimizing treatment planning before radiosurgeryNot useful for grading, few studies[72]

13N-NH3PET, analog of K+High tumor/background ratioNot useful for grading, Few studies[99]

68Ga-DOTATOCPET, SSTRHigh tumor/background ratio, identification of skull base and en plaque meningioma and local osseous invasiveness, improvement of target volume definition for RT, recurrent disease, selection of patients for hormonal treatment or the use of DOTATOC labelled with β-emitting radionuclidesUptake in parasellar lesions[102, 103, 105111]

Pgp: P-glycoprotein, SSTR: somatostatin receptors, BBB: Blood Brain Barrier, RT: Radiation Treatment.