TY - JOUR T1 - Improved primary staging of marginal zone lymphoma by addition of CXCR4-directed PET/CT JF - Journal of Nuclear Medicine JO - J Nucl Med DO - 10.2967/jnumed.120.257279 SP - jnumed.120.257279 AU - Johannes Duell AU - Franziska Krummenast AU - Andreas Schirbel AU - Philipp Klassen AU - Samuel Samnick AU - Hilka Rauert-Wunderlich AU - Leo Rasche AU - Andreas K. Buck AU - Hans-Jürgen Wester AU - Andreas Rosenwald AU - Hermann Einsele AU - Max S Topp AU - Constantin Lapa AU - Malte Kircher Y1 - 2021/02/01 UR - http://jnm.snmjournals.org/content/early/2021/02/12/jnumed.120.257279.abstract N2 - Positron emission tomography/computed tomography (PET/CT) with 18F-fluorodesoxyglucose (FDG) is an integral component in the primary staging of most lymphomas. However, its utility is limited in marginal zone lymphoma (MZL) due to inconsistent FDG avidity. One diagnostic alternative could be the targeting of CXC-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: 22 newly diagnosed MZL patients were staged conventionally and with 68Ga-Pentixafor PET/CT. Lesions exclusively identified by 68Ga-Pentixafor PET/CT were biopsied as standard of reference and compared to imaging results. The impact of CXCR4-directed imaging on staging results and treatment protocol was assessed. Results: 68Ga-Pentixafor 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 21/24 PET-guided biopsy samples. Inclusion of 68Ga-Pentixafor PET/CT in primary staging significantly impacted staging results in almost half, and treatment protocols in one third of patients (upstaging, n = 7; downstaging, n = 3; treatment change, n = 8; P < 0.03). Conclusion: 68Ga-Pentixafor PET/CT is a suitable tool in primary staging of MZL and holds the potential to improve existing diagnostic algorithms. ER -