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.
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.
Authors: Marta Braga; Chee Hau Leow; Javier Hernandez Gil; Jin H Teh; Laurence Carroll; Nicholas J Long; Meng-Xing Tang; Eric O Aboagye Journal: PLoS One Date: 2021-11-18 Impact factor: 3.240
Authors: Andreas K Buck; Rudolf A Werner; Sebastian E Serfling; Constantin Lapa; Niklas Dreher; Philipp E Hartrampf; Steven P Rowe; Takahiro Higuchi; Andreas Schirbel; Alexander Weich; Stefanie Hahner; Martin Fassnacht Journal: Mol Imaging Biol Date: 2022-03-21 Impact factor: 3.484
Authors: Andreas K Buck; Sebastian E Serfling; Thomas Lindner; Heribert Hänscheid; Andreas Schirbel; Stefanie Hahner; Martin Fassnacht; Hermann Einsele; Rudolf A Werner Journal: Eur J Nucl Med Mol Imaging Date: 2022-06-08 Impact factor: 10.057
Authors: Marius E Mayerhoefer; Markus Raderer; Wolfgang Lamm; Michael Weber; Barbara Kiesewetter; Johannes Rohrbeck; Ingrid Simonitsch-Klupp; Marcus Hacker; Asha Leisser; Lukas Nics; Stefan Schmitl; Hans-Juergen Wester; Alexander Haug Journal: Blood Date: 2022-01-13 Impact factor: 22.113