期刊
JOURNAL OF NUCLEAR MEDICINE
卷 62, 期 10, 页码 1415-1421出版社
SOC NUCLEAR MEDICINE INC
DOI: 10.2967/jnumed.120.257279
关键词
molecular imaging; primary diagnosis; CXCR4; PET; theranostics
CXCR4 PET/CT is a valuable tool in the primary staging of MZL, accurately identifying patients with viable MZL and significantly impacting staging results and treatment protocols.
PET/CTwith F-18-FDGis an integral component in the primary staging of most lymphomas. However, its utility is limited in marginal-zone lymphoma (MZL) because of inconsistent F-18-FDG avidity. One diagnostic alternative could be the targeting of C-X-Cmotif chemokine receptor 4 (CXCR4), shown to be expressed by MZL cells. This study investigated the value of adding CXCR4-directed Ga-68-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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