[Ga]Pentixafor 引导的 CXCR4-PET/CT 与 [F]FDG PET/CT 在中枢神经系统淋巴瘤中的比较。
CXCR4-Directed PET/CT with [Ga]Pentixafor in Central Nervous System Lymphoma: A Comparison with [F]FDG PET/CT.
机构信息
Department of Nuclear Medicine, Fujian Province, The First Affiliated Hospital of Fujian Medical University, No. 20 Chazhong Road, Taijiang District, Fuzhou, 350005, People's Republic of China.
Department of Hematology, Fujian Province, the First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, People's Republic of China.
出版信息
Mol Imaging Biol. 2022 Jun;24(3):416-424. doi: 10.1007/s11307-021-01664-3. Epub 2021 Oct 14.
PURPOSE
This study aimed to evaluate the value of [ Ga]Pentixafor PET/CT for the detection of lesions in central nervous system lymphoma (CNSL) patients before chemotherapy, during treatment and suspected CSNL recurrence, compared with 2-deoxy-2-[F]fluoro-D-glucose ([F]FDG) positron emission tomography/computed tomography (PET/CT).
PROCEDURES
Twenty-six patients with newly or previously diagnosed CNSL who underwent [ Ga]Pentixafor PET/CT were included retrospectively. Histopathological results, magnetic resonance imaging (MRI), and follow-up were used as the standard reference. The accuracy of lesion detection, maximum standardized uptake value (SUV) of tumors, and ratio of tumor-to-normal brain (T/N) with [ Ga]Pentixafor PET/CT were calculated and compared to those obtained with [F]FDG PET/CT. CXCR4 expression was analyzed through immunohistochemistry.
RESULTS
Of 26 patients, 18 were newly diagnosed with a total of 23 lesions, 4 had recurrent with 4 lesions, and 4 underwent a mid-term treatment assessment after 4 cycles of chemotherapy (3 achieved complete response (CR), 1 experienced progressive disease (PD) with a total of 8 lesions). Thirty-five lesions were all clearly detected with favorable contrast by [ Ga]Pentixafor PET/CT (accuracy, 100%), consistent with the results of contrast-enhanced magnetic resonance imaging (CE-MRI). The SUV of positive lesions in [ Ga]Pentixafor PET/CT was correlated with tumor size (r = 0.555, P = 0.001). In 21 patients, compared with [F]FDG PET/CT, [ Ga]Pentixafor PET/CT showed a remarkably higher T/N ratio (21.93 ± 10.77 vs 4.29 ± 2.16, P = 0.000) and detected 5 more lesions in the mid-term treatment assessment of patients (P = 0.026). The CXCR4 expression of CNSL lesions was correlated with SUV of [ Ga]Pentixafor PET/CT (r = 0.772, P = 0.000).
CONCLUSIONS
CXCR4-directed PET/CT using [ Ga]Pentixafor, with excellent tumor-to-background contrast, might be a more promising agent for the detection of lesions in CNSL patients than [F]FDG PET/CT.
目的
本研究旨在评估 [^68^Ga]Pentixafor PET/CT 与 2-脱氧-2-[F]氟代-D-葡萄糖 ([^18^F]FDG) 正电子发射断层扫描/计算机断层扫描 (PET/CT) 相比，在化疗前、治疗期间和疑似中枢神经系统淋巴瘤 (CNSL) 复发时对中枢神经系统淋巴瘤患者的病变检测的价值。
方法
回顾性纳入 26 例新诊断或既往诊断为 CNSL 并接受 [^68^Ga]Pentixafor PET/CT 的患者。组织病理学结果、磁共振成像 (MRI) 和随访被用作标准参考。计算并比较了肿瘤的病变检测准确性、肿瘤最大标准化摄取值 (SUV) 和肿瘤与正常脑比值 (T/N)，与 [^18^F]FDG PET/CT 进行比较。通过免疫组织化学分析 CXCR4 的表达。
结果
26 例患者中，18 例为初诊，共 23 个病灶，4 例为复发，4 例在化疗 4 个周期后进行中期治疗评估（3 例达到完全缓解 (CR)，1 例出现进展性疾病 (PD)，共 8 个病灶）。[^68^Ga]Pentixafor PET/CT 可清晰显示 35 个病灶（准确性为 100%），与增强磁共振成像 (CE-MRI) 的结果一致。[^68^Ga]Pentixafor PET/CT 阳性病变的 SUV 与肿瘤大小呈正相关 (r=0.555, P=0.001)。在 21 例患者中，与 [^18^F]FDG PET/CT 相比，[^68^Ga]Pentixafor PET/CT 显示出明显更高的 T/N 比值（21.93±10.77 比 4.29±2.16，P=0.000），并在中期治疗评估中发现了 5 例患者的更多病变（P=0.026）。CNSL 病变的 CXCR4 表达与 [^68^Ga]Pentixafor PET/CT 的 SUV 呈正相关（r=0.772，P=0.000）。
结论
与 [^18^F]FDG PET/CT 相比，使用 [^68^Ga]Pentixafor 的 CXCR4 导向 PET/CT 具有出色的肿瘤与背景对比度，可能是检测 CNSL 患者病变的更有前途的方法。
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