68Ga-DOTANOC PET-CT is a Valuable Tool for Diagnosing an Optic Nerve Sheath Meningioma-A Case Report and Literature Review

Senthamizhan Sundaramoorthy¹, Shyama Prem S¹, Dhanapathi Halanaik², Nirupama Kasturi³, Krishnan Nagarajan⁴, Sunitha Vellathussery Chakkalakkoombil⁴, and Gopalakrishnan Madhavan Sasidharan^5*

¹Department of Radiation Oncology, Regional Cancer Center, JIPMER, Puducherry, India

²Department of Nuclear medicine, JIPMER, Puducherry, India

³Department of Ophthalmology, JIPMER, Puducherry, India

⁴Department of Radiodiagnosis, JIPMER, Puducherry, India

⁵Department of Neurosurgery, JIPMER, Puducherry, India

*Corresponding Author :

Gopalakrishnan Madhavan
Department of Neurosurgery
JIPMER, Puducherry, India

E-mail: gopalakrishnanms@gmail.com

Received: June 30, 2021 Accepted: August 20, 2021 Published: August 27, 2021

Citation: Sundaramoorthy S, Prem SS, Halanaik D, Kasturi N, Nagarajan K, et al. (2021) ⁶⁸Ga-DOTANOC PET-CT is a Valuable Tool for Diagnosing an Optic Nerve Sheath Meningioma-A Case Report and Literature Review. Clin Oncol Case Rep 4:8.

Background: Optic nerve sheath meningiomas (ONSM) are one of the most common tumors affecting the optic nerve. Since operative decompression is known to cause visual loss, a biopsy diagnosis is usually unavailable. Though high-resolution MRI can delineate the tumor extent well, another reliable, non-invasive diagnostic method is desirable. Most meningiomas express somatostatin receptors and PET tracers based on ligands such as ⁶⁸Ga-DOTATATE have high sensitivity in detecting them.

Observations:  We describe the clinical presentation of a patient who presented with a history of recently noticed visual loss. We describe the imaging findings in MRI and the confirmation of the diagnosis with a ⁶⁸Ga-DOTANOC PET scan before we decided on radiation therapy.  The lesion was distinctly seen within the intraorbital area with a maximum standardized uptake value of  2.77. We also review the literature which compares the utility of this modality in comparison to MRI in ruling out alternative diagnoses.

Lessons: Imaging with somatostatin receptor ligands like ⁶⁸Ga-DOTANOC is a valuable tool in the non-invasive diagnosis of orbital lesions. It helps in differentiating meningiomas from other benign and malignant conditions. ⁶⁸Ga-DOTANOC scan should be considered in all patients with equivocal imaging findings in meningiomas.