肿瘤切除是治疗症状性脑膜瘤的一线疗法，切除程度已被证明对预后具有重要意义。使用生长抑素受体PET评估肿瘤残留物的效果优于手术中的Simpson分级或MRI估计。在这项初步研究中，我们评估了术后PET对脑膜瘤无进展生存的预后相关性。我们对一组已手术切除WHO一级脑膜瘤的患者进行后续分析。患者接受术后MRI和[68Ga]Ga-DOTA-TATE PET/CT检查，并定期进行MRI监测以检测肿瘤复发/进展。我们纳入了46例患者的49个肿瘤。诊断时的平均年龄为57.8±1.7岁，男女比例为1：1.7。在中位随访52个月后，7/49例患者（14％）出现局部肿瘤进展。阳性PET与进展风险增加相关（*p= 0.015），无进展生存率降低（*p= 0.029），而MRI与之无关。20例（100％）PET阴性的患者未复发。MRI上的复发/进展位置均毗邻术后PET指示的肿瘤残留区域。PET上的肿瘤体积较MRI更大（*p= 0.032）。我们的数据显示，[68Ga]Ga-DOTA-TATE PET/CT对于揭示WHO一级脑膜瘤患者的肿瘤残留物非常敏感。PET阴性结果与更高的无进展生存率相关，因此可以提高监测的准确性。在有肿瘤残留的患者中，额外的PET可以优化手术切除脑膜瘤后的辅助放疗靶区规划。©2023. 作者。

Tumor resection represents the first-line treatment for symptomatic meningiomas, and the extent of resection has been shown to be of prognostic importance. Assessment of tumor remnants with somatostatin receptor PET proves to be superior to intraoperative estimation with Simpson grading or MRI. In this preliminary study, we evaluate the prognostic relevance of postoperative PET for progression-free survival in meningiomas.We conducted a post hoc analysis on a prospective patient cohort with resected meningioma WHO grade 1. Patients received postoperative MRI and [68Ga]Ga-DOTA-TATE PET/CT and were followed regularly with MRI surveillance scans for detection of tumor recurrence/progression.We included 46 patients with 49 tumors. The mean age at diagnosis was 57.8 ± 1.7 years with a male-to-female ratio of 1:1.7. Local tumor progression occurred in 7/49 patients (14%) after a median follow-up of 52 months. Positive PET was associated with an increased risk for progression (*p = 0.015) and a lower progression-free survival (*p = 0.029), whereas MRI was not. 20 out of 20 patients (100%) with negative PET findings remained recurrence-free. The location of recurrence/progression on MRI was adjacent to regions where postoperative PET indicated tumor remnants in all cases. Gross tumor volumes were higher on PET compared to MRI (*p = 0.032).Our data show that [68Ga]Ga-DOTA-TATE PET/CT is highly sensitive in revealing tumor remnants in patients with meningioma WHO grade 1. Negative PET findings were associated with a higher progression-free survival, thus improving surveillance. In patients with tumor remnants, additional PET can optimize adjuvant radiotherapy target planning of surgically resected meningiomas.© 2023. The Author(s).