Yang Qiao, Zhang Fujing, Hao Zhixin, Zhuang Junling, Huo Li
Department of Nuclear Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Center for Rare Diseases Research Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, 1# Shuaifuyuan, Dongcheng District, Beijing, 100730, China.
Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, 1# Shuaifuyuan, Dongcheng District, Beijing, 100730, China.
Mol Imaging Biol. 2024 Dec;26(6):986-994. doi: 10.1007/s11307-024-01953-7. Epub 2024 Sep 20.
This study aimed to compare the detection rate of [Ga]pentixather PET/CT and [Ga]pentixafor PET/CT in newly diagnosed multiple myeloma (NDMM) patients, and to explore the value of [Ga]pentixather PET/CT for tumor load assessment.
Nineteen NDMM Patients were prospectively recruited and underwent both [Ga]pentixather PET/CT and [Ga]pentixafor PET/CT. A positive PET scan was defined as the presence of PET-positive focal bone lesions, paraskeletal disease, extramedullary plasmacytoma, or diffuse bone marrow uptake. Lesion numbers, SUVmax and PET-related tumor burden values were compared. The correlations between PET-related tumor burden and clinical risk stratification were analyzed.
[Ga]pentixather PET/CT showed a tendency of higher positive rate compared with [Ga]pentixafor PET/CT [94.7% (18/19) vs. 78.9% (15/19), p > 0.05]. Among 14 patients with 151 matched focal bone lesions, [Ga]pentixather PET detected more or equal number of lesions in 13 patients, and demonstrated higher uptake value than Ga-pentixafor PET [SUVmax, 16.8 (9.0, 23.8) vs. 13.4 (6.5, 20.4), p < 0.001]. For PET related-tumor burden, positive correlations of total bone marrow uptake (TBmU) (r = 0.9540, p < 0.0001) and SUVmean of total bone marrow (r = 0.9632, p < 0.0001) in two PET scans were observed. Higher TBmU [7864.9 (5549.2, 11,616.2) vs. 5383.4(4102.7, 11,041.8), p < 0.001], SUVmean of total bone marrow [1.4 (1.1, 2.2) vs. 1.1 (0.7, 2.1), p < 0.001] were demonstrated on [Ga]pentixather PET than [Ga]pentixafor PET. And the level of TBmU in [Ga]pentixather PET and [Ga]pentixafor PET were both elevated in Durie-Salmon Staging (DSS) III than DSS I (p < 0.01).
[Ga]pentixather PET/CT performed a non-inferior capability for tumor detection compared to [Ga]pentixafor PET/CT in NDMM patients. [Ga]pentixather PET/CT can assess tumor load in MM patients and depict a significantly higher PET-related total tumor burden than [Ga]pentixafor PET/CT.
本研究旨在比较[镓]喷替酸盐PET/CT和[镓]喷替沙福PET/CT在新诊断的多发性骨髓瘤（NDMM）患者中的检出率，并探讨[镓]喷替酸盐PET/CT在肿瘤负荷评估中的价值。
前瞻性招募19例NDMM患者，均接受[镓]喷替酸盐PET/CT和[镓]喷替沙福PET/CT检查。PET扫描阳性定义为存在PET阳性的局灶性骨病变、骨旁疾病、髓外浆细胞瘤或弥漫性骨髓摄取。比较病变数量、SUVmax和PET相关肿瘤负荷值。分析PET相关肿瘤负荷与临床风险分层之间的相关性。
与[镓]喷替沙福PET/CT相比，[镓]喷替酸盐PET/CT显示出更高的阳性率趋势[94.7%（18/19）对78.9%（15/19），p＞0.05]。在14例有151个匹配局灶性骨病变的患者中，[镓]喷替酸盐PET在13例患者中检测到的病变数量更多或相等，且摄取值高于[镓]喷替沙福PET[SUVmax，16.8（9.0，23.8）对13.4（6.5，20.4），p＜0.001]。对于PET相关肿瘤负荷，观察到两次PET扫描中全骨髓摄取（TBmU）（r = 0.9540，p＜0.0001）和全骨髓SUVmean（r = 0.9632，p＜0.0001）呈正相关。[镓]喷替酸盐PET显示出比[镓]喷替沙福PET更高的TBmU[7864.9（5549.2，11,616.2）对5383.4（4102.7，11,041.8），p＜0.001]、全骨髓SUVmean[1.4（1.1，2.2）对1.1（0.7，2.1），p＜0.001]。并且在Durie-Salmon分期（DSS）III期患者中，[镓]喷替酸盐PET和[镓]喷替沙福PET的TBmU水平均高于DSS I期（p＜0.01）。
在NDMM患者中，与[镓]喷替沙福PET/CT相比，[镓]喷替酸盐PET/CT在肿瘤检测方面具有非劣效性。[镓]喷替酸盐PET/CT可以评估MM患者的肿瘤负荷，并且描绘出比[镓]喷替沙福PET/CT显著更高的PET相关总肿瘤负荷。
