Kar Siven, Gupta Harshita, Shaikh Nusrat, Lele Vikram R
Jaslok Hospital and Research Centre, Clinic of Nuclear Medicine and PET-CT, Mumbai, India.
Mol Imaging Radionucl Ther. 2025 Jun 3;34(2):162-164. doi: 10.4274/mirt.galenos.2025.94557.
We present a case of a 40-year-old male with refractory multiple myeloma, assessed using Gallium-PENTIXAFOR positron emission tomography/computed tomography (Ga-PENTIXAFOR PET/CT), revealing widespread and intense C-X-C motif chemokine receptor 4 (CXCR4) expression in multiple osteolytic lesions across axial and appendicular skeletons, including bone marrow deposits. Despite undergoing autologous hematopoietic stem cell transplantation and multiple lines of maintenance therapy, the patient experienced disease relapse and progression. The term "superscan" typically refers to diffuse skeletal uptake in conventional bone scans, primarily seen in advanced metastatic cancers or metabolic bone diseases. CXCR4, crucial for tumor growth and metastasis, binds C-X-C motif chemokine 12 (CXCL12) to promote cancer progression. PENTIXAFOR, a CXCR4-targeted PET agent, facilitates imaging of such malignancies. While superscans using PET/CT are rare, our case underscores the utility of Ga-PENTIXAFOR PET/CT in evaluating CXCR4 expression in multiple myeloma, highlighting its potential as a diagnostic and prognostic tool in refractory disease management.
我们报告一例40岁男性难治性多发性骨髓瘤病例，通过镓标记的PENTIXAFOR正电子发射断层扫描/计算机断层扫描（Ga-PENTIXAFOR PET/CT）评估发现，在包括骨髓沉积物在内的轴向和附属骨骼的多个溶骨性病变中广泛且强烈地表达C-X-C基序趋化因子受体4（CXCR4）。尽管接受了自体造血干细胞移植和多线维持治疗，该患者仍出现疾病复发和进展。术语“超级骨显像”通常指传统骨扫描中的弥漫性骨骼摄取，主要见于晚期转移性癌症或代谢性骨病。CXCR4对肿瘤生长和转移至关重要，它与C-X-C基序趋化因子12（CXCL12）结合以促进癌症进展。PENTIXAFOR是一种靶向CXCR4的PET显像剂，有助于对此类恶性肿瘤进行成像。虽然使用PET/CT的超级骨显像很少见，但我们的病例强调了Ga-PENTIXAFOR PET/CT在评估多发性骨髓瘤中CXCR4表达方面的实用性，突出了其作为难治性疾病管理中的诊断和预后工具的潜力。
