Research Center for Nuclear Medicine, Shariati Hospital.
Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Nucl Med Commun. 2024 Mar 1;45(3):221-228. doi: 10.1097/MNM.0000000000001806. Epub 2024 Jan 12.
To evaluate the diagnostic value of [ 68 Ga] Ga-Pentixafor in malignant melanoma patients.
In this prospective study, patients with histology-proven melanoma were included and underwent [ 18 F]fluoro-D-glucose ([ 18 F]FDG) and [ 68 Ga] Ga-Pentixafor PET/computed tomography (CT) within a week. Suspicious lesions were interpreted as benign vs. malignant, and the corresponding semi-quantitative PET/CT parameters were recorded and compared.
Twelve consecutive melanoma patients (mean age: 60 ± 6) were included. Two patients were referred for initial staging, two for detecting recurrence and eight for evaluating the extent of metastases. Overall, [ 18 F]FDG PET/CT showed 236 tumoral lesions, including two primary tumors, two recurrent lesions, 29 locoregional metastases and 203 distant metastases. In [ 68 Ga]Ga-Pentixafor PET/CT, 101 tumoral lesions were detected, including two primary tumors, one recurrence, 16 locoregional metastases and 82 distant metastases. Notably, a documented brain metastasis was only visualized on [ 68 Ga]Ga-Pentixafor PET/CT images. Compared with [ 18 F]FDG, [ 68 Ga]Ga-Pentixafor PET/CT provided a 42% detection rate. Regarding semi-quantitative measures, the intensity of uptake and tumor-to-background ratios were significantly lower on [ 68 Ga]Ga-Pentixafor PET/CT [average maximum standard uptake value (SUV max ) of 2.72 ± 1.33 vs. 11.41 ± 14.79; P value <0.001 and 1.17 ± 0.53 vs. 5.32 ± 7.34; P value <0.001, respectively].
When comparing [ 68 Ga]Ga-Pentixafor PET/CT with [ 18 F]FDG PET/CT, not only did [ 68 Ga]Ga-Pentixafor PET/CT detect fewer lesions, but the intensity of uptake and the TBRs were also lower on [ 68 Ga]Ga-Pentixafor PET/CT. Thus, our results may indicate a limited potential of this novel tracer in cutaneous melanoma patients compared to [ 18 F]FDG PET/CT. Given the lower TBRs, applying this radiotracer in radioligand therapies is also questionable.
评估[68Ga]Ga-Pentixafor 在恶性黑色素瘤患者中的诊断价值。
在这项前瞻性研究中，纳入了经组织学证实的黑色素瘤患者，并在一周内进行[18F]氟代-D-葡萄糖([18F]FDG)和[68Ga]Ga-Pentixafor PET/CT 检查。可疑病变被解释为良性与恶性，并记录相应的半定量 PET/CT 参数并进行比较。
连续纳入 12 例黑色素瘤患者（平均年龄：60±6 岁）。2 例患者为初始分期，2 例为复发检测，8 例为评估转移范围。总的来说，[18F]FDG PET/CT 显示 236 个肿瘤病灶，包括 2 个原发肿瘤、2 个复发性肿瘤、29 个局部转移和 203 个远处转移。在[68Ga]Ga-Pentixafor PET/CT 中，共检测到 101 个肿瘤病灶，包括 2 个原发肿瘤、1 个复发性肿瘤、16 个局部转移和 82 个远处转移。值得注意的是，一个有记录的脑转移仅在[68Ga]Ga-Pentixafor PET/CT 图像上显示。与[18F]FDG 相比，[68Ga]Ga-Pentixafor PET/CT 的检出率提高了 42%。关于半定量指标，[68Ga]Ga-Pentixafor PET/CT 的摄取强度和肿瘤与背景的比值明显低于[18F]FDG PET/CT [平均最大标准摄取值（SUV max）分别为 2.72±1.33 与 11.41±14.79；P 值均<0.001 和 1.17±0.53 与 5.32±7.34；P 值均<0.001]。
与[18F]FDG PET/CT 相比，当比较[68Ga]Ga-Pentixafor PET/CT 与[18F]FDG PET/CT 时，[68Ga]Ga-Pentixafor PET/CT 不仅检测到的病灶更少，而且[68Ga]Ga-Pentixafor PET/CT 的摄取强度和 TBRs 也更低。因此，与[18F]FDG PET/CT 相比，我们的结果可能表明这种新型示踪剂在皮肤黑色素瘤患者中的应用潜力有限。鉴于较低的 TBR，在放射性配体治疗中应用这种放射性示踪剂也值得怀疑。
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