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Research ArticleTheranostics

CXCR4-Targeted PET Imaging of Central Nervous System B-Cell Lymphoma

Peter Herhaus, Jana Lipkova, Felicitas Lammer, Igor Yakushev, Tibor Vag, Julia Slotta-Huspenina, Stefan Habringer, Constantin Lapa, Tobias Pukrop, Dirk Hellwig, Benedikt Wiestler, Andreas K. Buck, Martina Deckert, Hans-Jürgen Wester, Florian Bassermann, Markus Schwaiger, Wolfgang Weber, Björn Menze and Ulrich Keller
Journal of Nuclear Medicine December 2020, 61 (12) 1765-1771; DOI: https://doi.org/10.2967/jnumed.120.241703
Peter Herhaus
1Internal Medicine III, School of Medicine, Technische Universität München, Munich, Germany
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Jana Lipkova
2Department of Neuroradiology, School of Medicine, Technische Universität München, Munich, Germany
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Felicitas Lammer
3Department of Hematology, Oncology, and Tumor Immunology (Campus Benjamin Franklin), Charité–Universitätsmedizin Berlin, Berlin, Germany
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Igor Yakushev
4Department of Nuclear Medicine, School of Medicine, Technische Universität München, Munich, Germany
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Tibor Vag
4Department of Nuclear Medicine, School of Medicine, Technische Universität München, Munich, Germany
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Julia Slotta-Huspenina
5Institute of Pathology, Technische Universität München, Munich, Germany
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Stefan Habringer
3Department of Hematology, Oncology, and Tumor Immunology (Campus Benjamin Franklin), Charité–Universitätsmedizin Berlin, Berlin, Germany
6Berlin Institute of Health (BIH), Berlin, Germany
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Constantin Lapa
7Department of Nuclear Medicine, Universitätsklinikum Würzburg, Würzburg, Germany
8Department of Nuclear Medicine, University Hospital Augsburg, Augsburg, Germany
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Tobias Pukrop
9Internal Medicine III, Universitätsklinikum Regensburg, Regensburg, Germany
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Dirk Hellwig
10Department of Nuclear Medicine, Universitätsklinikum Regensburg, Regensburg, Germany
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Benedikt Wiestler
2Department of Neuroradiology, School of Medicine, Technische Universität München, Munich, Germany
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Andreas K. Buck
7Department of Nuclear Medicine, Universitätsklinikum Würzburg, Würzburg, Germany
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Martina Deckert
11Insitute of Neuropathology, Faculty of Medicine, University of Cologne, and University Hospital Cologne, Cologne, Germany
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Hans-Jürgen Wester
12Institute of Pharmaceutical Radiochemistry, Technische Universität München, Munich, Germany
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Florian Bassermann
1Internal Medicine III, School of Medicine, Technische Universität München, Munich, Germany
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Markus Schwaiger
4Department of Nuclear Medicine, School of Medicine, Technische Universität München, Munich, Germany
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Wolfgang Weber
2Department of Neuroradiology, School of Medicine, Technische Universität München, Munich, Germany
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Björn Menze
13Informatics Department, Technische Universität München, Munich, Germany
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Ulrich Keller
1Internal Medicine III, School of Medicine, Technische Universität München, Munich, Germany
3Department of Hematology, Oncology, and Tumor Immunology (Campus Benjamin Franklin), Charité–Universitätsmedizin Berlin, Berlin, Germany
14Max Delbrück Center for Molecular Medicine, Berlin, Germany; and
15German Cancer Research Center and German Cancer Consortium, Heidelberg, Germany
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  • FIGURE 1.
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    FIGURE 1.

    Correlation of CXCR4-directed PET with MRI-determined lymphoma lesions. Depicted are representative MR images (T1c and FLAIR sequences) and corresponding CXCR4-directed PET images and fusion of MRI (FLAIR) and PET for 2 patients with primary CNSL (PCNSL) and secondary CNSL (SCNSL), respectively.

  • FIGURE 2.
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    FIGURE 2.

    Ex vivo CXCR4 expression within lymphoma lesions. Shown is CXCR4 expression of CD20-positive lymphoma cells undergoing 68Ga-pentixafor imaging. (Top panel) Representative hematoxylin and eosin (HE) stains of 4 CNSL patients; embedded are PET images of corresponding patients. (Middle panel) Immunohistochemistry for lymphoma-specific CD20 marker. (Bottom panel) Immunohistochemistry for CXCR4 in corresponding lymphoma samples.

  • FIGURE 3.
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    FIGURE 3.

    CXCR4-directed PET prediction of treatment response. Depicted are correlations between η and properties extracted from pretreatment scans: V(T1c) in MRI (A and E), V(PET) (B), max(PET) (C), and ∫(PET) (D and F). A–D depict results from lesion-based approach. Each dot represents 1 of 14 diagnosed lymphoma lesions. In E and F, results from patient-based approach are shown. Each dot represents results from 1 of 7 patients. Pearson correlation coefficient (c) and P value are reported inside each plot. Least-squares regression line is shown in black.

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    TABLE 1

    Patient Characteristics

    PatientSexAge (y)DiagnosisDisease stageNo. of relapses
    1M50PCNSLFirst diagnosis0
    2M67PCNSLFirst diagnosis0
    3F63DLBCLCNS relapse3
    4F55DLBCLCNS relapse1
    5F65PCNSLFirst diagnosis0
    6M80PCNSLFirst diagnosis0
    7M59PCNSLFirst diagnosis0
    8M66PCNSLFirst diagnosis0
    9M58PCNSLFirst diagnosis0
    10M64PCNSLFirst diagnosis0
    11M79DLBCLCNS relapse1
    • PCNSL = primary CNSL; DLBCL = diffuse large B-cell lymphoma.

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    TABLE 2

    SUVmax, SUVmean, and Corresponding Tumor-to-Background Ratio

    PatientSUVmaxSUVmean
    TumorBackgroundRatioTumorBackgroundRatio
    1No lesionNo lesionNo lesionNo lesionNo lesionNo lesion
    24.20.218.32.80.217.3
    323.30.638.816.10.532.2
    45.50.316.23.20.216.2
    57.00.418.44.50.219.6
    64.70.413.43.10.218.2
    76.00.175.14.00.01201.0
    810.10.813.25.60.230.9
    98.30.183.05.40.154.0
    104.60.223.03.20.215.9
    115.40.321.63.40.221.2

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Journal of Nuclear Medicine: 61 (12)
Journal of Nuclear Medicine
Vol. 61, Issue 12
December 1, 2020
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CXCR4-Targeted PET Imaging of Central Nervous System B-Cell Lymphoma
Peter Herhaus, Jana Lipkova, Felicitas Lammer, Igor Yakushev, Tibor Vag, Julia Slotta-Huspenina, Stefan Habringer, Constantin Lapa, Tobias Pukrop, Dirk Hellwig, Benedikt Wiestler, Andreas K. Buck, Martina Deckert, Hans-Jürgen Wester, Florian Bassermann, Markus Schwaiger, Wolfgang Weber, Björn Menze, Ulrich Keller
Journal of Nuclear Medicine Dec 2020, 61 (12) 1765-1771; DOI: 10.2967/jnumed.120.241703

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CXCR4-Targeted PET Imaging of Central Nervous System B-Cell Lymphoma
Peter Herhaus, Jana Lipkova, Felicitas Lammer, Igor Yakushev, Tibor Vag, Julia Slotta-Huspenina, Stefan Habringer, Constantin Lapa, Tobias Pukrop, Dirk Hellwig, Benedikt Wiestler, Andreas K. Buck, Martina Deckert, Hans-Jürgen Wester, Florian Bassermann, Markus Schwaiger, Wolfgang Weber, Björn Menze, Ulrich Keller
Journal of Nuclear Medicine Dec 2020, 61 (12) 1765-1771; DOI: 10.2967/jnumed.120.241703
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Keywords

  • central nervous system lymphoma
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