医学
CXCR4型
淋巴瘤
核医学
PET-CT
活检
放射科
正电子发射断层摄影术
病理
内科学
趋化因子
受体
作者
Johannes Duell,Franziska Krummenast,Andreas Schirbel,Philipp Klassen,Samuel Samnick,Hilka Rauert-Wunderlich,Leo Rasche,Andreas K. Buck,Hans‐Jürgen Wester,Andreas Rosenwald,H. Einsele,Max S. Topp,Constantin Lapa,Malte Kircher
标识
DOI:10.2967/jnumed.120.257279
摘要
PET/CT with 18F-FDG is an integral component in the primary staging of most lymphomas. However, its utility is limited in marginal-zone lymphoma (MZL) because of inconsistent 18F-FDG avidity. One diagnostic alternative could be the targeting of C-X-C motif chemokine receptor 4 (CXCR4), shown to be expressed by MZL cells. This study investigated the value of adding CXCR4-directed 68Ga-pentixafor PET/CT to conventional staging. Methods: Twenty-two newly diagnosed MZL patients were staged conventionally and with CXCR4 PET/CT. Lesions identified exclusively by CXCR4 PET/CT were biopsied as the standard of reference and compared with imaging results. The impact of CXCR4-directed imaging on staging results and treatment protocol was assessed. Results: CXCR4 PET/CT correctly identified all patients with viable MZL and was superior to conventional staging (P < 0.001). CXCR4-directed imaging results were validated by confirmation of MZL in 16 of 18 PET-guided biopsy samples. Inclusion of CXCR4 PET/CT in primary staging significantly impacted staging results in almost half of patients and treatment protocols in a third (upstaging, n = 7; downstaging, n = 3; treatment change, n = 8; P < 0.03). Conclusion: CXCR4 PET/CT is a suitable tool in primary staging of MZL and holds the potential to improve existing diagnostic algorithms.
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