Wang Weichen, Huang Mingxing, Tian Rong, Shen Guohua
Department of Nuclear Medicine, West China Hospital, Sichuan University, 37 Guoxue Alley, Chengdu 610041, Sichuan, China.
AJR Am J Roentgenol. 2025 Aug;225(2):e2532708. doi: 10.2214/AJR.25.32708. Epub 2025 May 14.
. Numerous studies have shown the superiority of PET/CT performed with the use of chemokine-targeted tracer Ga-boclatixafortide (Ga-PentixaFor, Pentixapharm) compared with FDG PET/CT for oncologic evaluation, although outcomes have varied across tumor types. . This study aimed to conduct a head-to-head comparison of Ga-PentixaFor PET/CT and FDG PET/CT for detecting hematologic malignancies and solid tumors. . The PubMed and Embase databases were searched through March 4, 2024, for studies reporting a head-to-head comparison of the detection performance of Ga-PentixaFor PET/CT versus FDG PET/CT in patients with cancer. Data were extracted from studies on a patient basis for each test in terms of the detection rate, SUV, and target-to-background ratio (TBR). The two tests were compared separately for hematologic malignancies and solid tumors. . The meta-analysis included 28 studies (15 studies of hematologic malignancies and 13 of solid cancers), with a total of 493 patients who underwent both tests. For hematologic malignancies, Ga-PentixaFor PET/CT, compared with FDG PET/CT, showed a significantly higher detection rate overall (relative risk [RR] = 1.19, < .001) and for bone marrow involvement (RR = 1.69, < .001), but it showed no significant difference for extramedullary involvement (RR = 1.10, = .88); Ga-PentixaFor PET/CT, compared with FDG PET/CT, showed a significantly higher SUV overall (mean difference [MD] = 2.26, < .001) for bone marrow involvement (MD = 4.75, < .001) and for extramedullary involvement (MD = 5.88, < .001), as well as a significantly higher TBR (MD = 1.28, = .03). For solid tumors, Ga-PentixaFor PET/CT, compared with FDG PET/CT, showed a significantly lower detection rate overall (RR = 0.73, = .005) but no significant difference for primary lesions (RR = 0.83, = .11), lymph node metastases (RR = 0.86, = .04), or distant metastases (RR = 0.64, = .13); Ga-PentixaFor PET/CT, compared with FDG PET/CT, showed a significantly lower SUV (MD = -8.79, < .001) and TBR (MD = -3.35, < .001). . In a head-to-head comparison of diagnostic performance, Ga-PentixaFor PET/CT outperformed FDG PET/CT for hematologic malignancies, whereas FDG PET/CT outperformed Ga-PentixaFor PET/CT for solid tumors. . The findings of this study can help guide the selection of optimal imaging strategies in patients with cancer.
多项研究表明，与氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG PET/CT）相比，使用趋化因子靶向示踪剂镓-博克拉替沙肽（镓-喷替沙福，Pentixapharm）进行的PET/CT在肿瘤评估方面具有优势，尽管不同肿瘤类型的结果有所不同。本研究旨在对镓-喷替沙福PET/CT和FDG PET/CT在检测血液系统恶性肿瘤和实体瘤方面进行直接比较。通过检索截至2024年3月4日的PubMed和Embase数据库，查找报告镓-喷替沙福PET/CT与FDG PET/CT在癌症患者中检测性能直接比较的研究。从各项研究中按患者提取每次检查的检测率、标准化摄取值（SUV）和靶本比（TBR）数据。分别对血液系统恶性肿瘤和实体瘤进行两种检查的比较。荟萃分析纳入了28项研究（15项血液系统恶性肿瘤研究和13项实体癌研究），共有493例患者接受了两种检查。对于血液系统恶性肿瘤，与FDG PET/CT相比，镓-喷替沙福PET/CT总体检测率显著更高（相对危险度[RR]=1.19，P<.001），骨髓受累检测率也显著更高（RR=1.69，P<.001），但髓外受累方面无显著差异（RR=1.10，P=.88）；与FDG PET/CT相比，镓-喷替沙福PET/CT骨髓受累（平均差值[MD]=4.75，P<.001）和髓外受累（MD=5.88，P<.001）的SUV总体显著更高，TBR也显著更高（MD=1.28，P=.03）。对于实体瘤，与FDG PET/CT相比，镓-喷替沙福PET/CT总体检测率显著更低（RR=0.73，P=.005），但原发灶（RR=0.83，P=.11）、淋巴结转移（RR=0.86，P=.04）或远处转移（RR=0.64，P=.13）方面无显著差异；与FDG PET/CT相比，镓-喷替沙福PET/CT的SUV（MD=-8.79，P<.001）和TBR（MD=-3.35，P<.001）显著更低。在诊断性能的直接比较中，镓-喷替沙福PET/CT在血液系统恶性肿瘤方面优于FDG PET/CT，而FDG PET/CT在实体瘤方面优于镓-喷替沙福PET/CT。本研究结果有助于指导癌症患者最佳成像策略的选择。
