PT - JOURNAL ARTICLE AU - Buck, Andreas K. AU - Haug, Alexander AU - Dreher, Niklas AU - Lambertini, Alessandro AU - Higuchi, Takahiro AU - Lapa, Constantin AU - Weich, Alexander AU - Pomper, Martin G. AU - Wester, Hans-Jürgen AU - Zehndner, Anja AU - Schirbel, Andreas AU - Samnick, Samuel AU - Hacker, Marcus AU - Pichler, Verena AU - Hahner, Stefanie AU - Fassnacht, Martin AU - Einsele, Hermann AU - Serfling, Sebastian E. AU - Werner, Rudolf A. TI - Imaging of C-X-C Motif Chemokine Receptor 4 Expression in 690 Patients with Solid or Hematologic Neoplasms Using <sup>68</sup>Ga-Pentixafor PET AID - 10.2967/jnumed.121.263693 DP - 2022 Nov 01 TA - Journal of Nuclear Medicine PG - 1687--1692 VI - 63 IP - 11 4099 - http://jnm.snmjournals.org/content/63/11/1687.short 4100 - http://jnm.snmjournals.org/content/63/11/1687.full SO - J Nucl Med2022 Nov 01; 63 AB - In recent years, molecular imaging addressing the C-X-C motif chemokine receptor 4 (CXCR4) has increasingly been used in various clinical settings. Here, we aimed to assess radiopharmaceutical uptake and image contrast to determine the most relevant clinical applications for CXCR4-directed imaging. We also investigated the impact of specific activity on scan contrast. Methods: Patients (n = 690) with a variety of neoplasms underwent a total of 777 PET/CT scans with 68Ga-Pentixafor, serving as the CXCR4-specific radioligand. A semiquantitative target lesion analysis was conducted (providing SUVmax and target-to-blood pool ratio [TBR], defined as SUVmax [from target lesion] divided by SUVmean [from blood pool]). The applied specific activity (in MBq/μg) was compared with semiquantitative assessments. Results: Of the 777 scans, 242 did not show discernible uptake in disease sites, leaving 535 PET scans (68.9%) for further analysis. Very high tracer uptake (SUVmax &gt; 12) was found in multiple myeloma (n = 113), followed by adrenocortical carcinoma (n = 30), mantle cell lymphoma (n = 20), adrenocortical adenoma (n = 6), and small cell lung cancer (n = 12). Providing information on image contrast, comparable results for TBR were recorded, with TBR (&gt;8) in multiple myeloma, mantle cell lymphoma, and acute lymphoblastoid leukemia (n = 6). When comparing specific activity with semiquantitative parameters, no significant correlation was found for SUVmax or TBR (P ≥ 0.612). Conclusion: In this large cohort, 68Ga-Pentixafor demonstrated high image contrast in a variety of neoplasms, particularly for hematologic malignancies, small cell lung cancer, and adrenocortical neoplasms. The present analysis may provide a roadmap for detecting patients who may benefit from CXCR4-targeted therapies.