Imaging of C-X-C Motif Chemokine Receptor 4 Expression in 690 Patients with Solid or Hematologic Neoplasms Using 68Ga-Pentixafor PET
Imaging of C-X-C Motif Chemokine Receptor 4 Expression in 690 Patients with Solid or Hematologic Neoplasms Using 68Ga-Pentixafor PET
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DOI：
10.2967/jnumed.121.263693
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发表时间：
2022-11-01
影响因子：
9.3
通讯作者：
Werner, Rudolf A.
中科院分区：
文献类型：
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作者：
Buck, Andreas K.;Haug, Alexander;Werner, Rudolf A.
近年来，针对C-X-C基序趋化因子受体4（CXCR 4）的分子成像已越来越多地用于各种临床环境。在这里，我们旨在评估放射性药物摄取和图像对比度，以确定CXCR 4导向成像的最相关临床应用。我们还研究了比活度对扫描对比度的影响。研究方法：患有各种肿瘤的患者（n = 690）共接受了777次Ga-68-Pentixafor PET/CT扫描，作为CXCR 4特异性放射性配体。进行了半定量靶病变分析（提供SUVmax和靶-血池比[TBR]，定义为SUVmax [来自靶病变]除以SUVmean [来自血池]）。将应用的比活度（MBq/mg）与半定量评估进行比较。结果：在777次扫描中，242次在疾病部位未显示可辨别的摄取，留下535次PET扫描（68.9%）进行进一步分析。多发性骨髓瘤113例，肾上腺皮质癌30例，套细胞淋巴瘤20例，肾上腺皮质腺瘤6例，小细胞肺癌12例。提供图像对比度的信息，记录了TBR的可比结果，多发性骨髓瘤、套细胞淋巴瘤和急性淋巴母细胞样白血病（n = 6）的TBR（>8）。当比较比活度与半定量参数时，未发现SUVmax或TBR的显著相关性（P >= 0.612）。结论：在这个大型队列中，Ga-68-喷替沙福在各种肿瘤中表现出高图像对比度，特别是血液恶性肿瘤、小细胞肺癌和肾上腺皮质肿瘤。目前的分析可能为检测可能受益于CXCR 4靶向治疗的患者提供路线图。
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 Ga-68-Pentixafor, serving as the CXCR4-specific radioligand. A semiquantitative target lesion analysis was conducted (providing SUVmax and targetto-blood pool ratio [TBR], defined as SUVmax [from target lesion] divided by SUVmean [from blood pool]). The applied specific activity (in MBq/mg) 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 > 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 (>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, Ga-68-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.