RT Journal Article
SR Electronic
T1 Improved Primary Staging of Marginal-Zone Lymphoma by Addition of CXCR4-Directed PET/CT
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 1415
OP 1421
DO 10.2967/jnumed.120.257279
VO 62
IS 10
A1 Johannes Duell
A1 Franziska Krummenast
A1 Andreas Schirbel
A1 Philipp Klassen
A1 Samuel Samnick
A1 Hilka Rauert-Wunderlich
A1 Leo Rasche
A1 Andreas K. Buck
A1 Hans-Jürgen Wester
A1 Andreas Rosenwald
A1 Herrmann Einsele
A1 Max S. Topp
A1 Constantin Lapa
A1 Malte Kircher
YR 2021
UL http://jnm.snmjournals.org/content/62/10/1415.abstract
AB PET/CT with 18F-FDG is an integral component in the primary staging of most lymphomas. However, its utility is limited in marginal-zone lymphoma (MZL) because of inconsistent 18F-FDG avidity. One diagnostic alternative could be the targeting of C-X-C motif chemokine receptor 4 (CXCR4), shown to be expressed by MZL cells. This study investigated the value of adding CXCR4-directed 68Ga-pentixafor PET/CT to conventional staging. Methods: Twenty-two newly diagnosed MZL patients were staged conventionally and with CXCR4 PET/CT. Lesions identified exclusively by CXCR4 PET/CT were biopsied as the standard of reference and compared with imaging results. The impact of CXCR4-directed imaging on staging results and treatment protocol was assessed. Results: CXCR4 PET/CT correctly identified all patients with viable MZL and was superior to conventional staging (P < 0.001). CXCR4-directed imaging results were validated by confirmation of MZL in 16 of 18 PET-guided biopsy samples. Inclusion of CXCR4 PET/CT in primary staging significantly impacted staging results in almost half of patients and treatment protocols in a third (upstaging, n = 7; downstaging, n = 3; treatment change, n = 8; P < 0.03). Conclusion: CXCR4 PET/CT is a suitable tool in primary staging of MZL and holds the potential to improve existing diagnostic algorithms.