Abstract
18F-FDG PET/CT has some limitations in the evaluation of Waldenström macroglobulinemia/lymphoplasmacytic lymphoma (WM/LPL), an indolent B-cell lymphoma that primarily involves the bone marrow. Since there is a high level of chemokine receptor-4 expression in the B cells of WM/LPL patients, we performed a prospective cohort study to evaluate the performance of 68Ga-Pentixafor, which targets chemokine receptor-4 in WM/LPL, and compared it to the performance of 18F-FDG. Methods: Seventeen patients with WM/LPL were recruited. All patients underwent both 68Ga-Pentixafor and 18F-FDG PET/CT. A positive PET/CT was defined as the presence of focal PET-positive lesions or diffuse bone marrow patterns (uptake >liver). The positive rates of the PET/CT scans of bone marrow, lymph nodes and other extramedullary involvement were statistically compared. Results: 68Ga-Pentixafor PET/CT had a higher positive rate than 18F-FDG PET/CT (100% vs. 58.8%, P = 0.023) in the recruited WM/LPL patients. The sensitivities in detecting bone marrow involvement with 68Ga-Pentixafor and 18F-FDG PET/CT were 94.1% and 58.8%, respectively (P = 0.077). In terms of detecting lymph node involvement, 68Ga-Pentixafor PET/CT showed a significantly higher positive rate than 18F-FDG PET/CT (76.5% vs. 11.8%, P = 0.003). In addition, 68Ga-Pentixafor also detected more paramedullary and central nervous system involvement than 18F-FDG. Conclusion: 68Ga-Pentixafor might be a promising imaging agent in the assessment of WM/LPL.
- Molecular Imaging
- Oncology: Lymphoma
- PET/CT
- 68Ga-Pentixafor
- CXCR4
- PET/CT
- Waldenström macroglobulinemia
- lymphoplasmacytic lymphoma
- Copyright © 2019 by the Society of Nuclear Medicine and Molecular Imaging, Inc.