Intraarterial Administration Boosts <sup>177</sup>Lu-HA-DOTATATE Accumulation in Salvage Meningioma Patients
Evert‐Jan Vonken, Rutger C. G. Bruijnen, Tom J. Snijders, Tatjana Seute, Marnix G. E. H. Lam, Bart de Keizer, Arthur J. A. T. Braat
Abstract
<b>INTRODUCTION:</b> Intravenous <sup>177</sup>Lu-(HA-)DOTATATE has shown promising results for the treatment of surgery- and radiotherapy-refractory meningiomas. We aimed to investigate the added value of intra-arterial administration. <b>METHODS:</b> Patients underwent at least one intravenous <sup>177</sup>Lu-HA-DOTATATE treatment first and subsequent intra-arterial cycles. In(tra)-patient comparison was based on post-treatment <sup>177</sup>Lu-HA-DOTATATE imaging 24 hours post-injection. Technical success rates and adverse events were recorded. <b>RESULTS:</b> Four patients provided informed consent. Technical success rate was 100% and no angiography related or unexpected adverse events occurred. Intra-patient comparison showed an increased target lesion accumulation on both planar imaging (mean +220%) and SPECT/CT (mean +398%) after intra-arterial administration compared to intravenous. No unexpected adverse events during follow-up occurred. <b>CONCLUSION:</b> Intra-arterial PRRT significantly increases tracer accumulation, and is a safe and promising improvement for salvage meningioma patients. Future prospective studies on intra-arterial PRRT are needed to determine gain on efficacy and survival.