Imaging of C-X-C Motif Chemokine Receptor 4 Expression in 690 Patients with Solid or Hematologic Neoplasms Using 68Ga-Pentixafor PET

Andreas K. Buck, Alexander Haug, Niklas Dreher, Alessandro Lambertini, Takahiro Higuchi, Constantin Lapa, Alexander Weich, Martin G. Pomper, Hans Jürgen Wester, Anja Zehndner, Andreas Schirbel, Samuel Samnick, Marcus Hacker, Verena Pichler, Stefanie Hahner, Martin Fassnacht, Hermann Einsele, Sebastian E. Serfling, Rudolf A. Werner

Publications: Contribution to journalArticlePeer Reviewed

Abstract

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 5 690) with a variety of neoplasms underwent a total of 777 PET/CT scans with 68Ga-Pentixa-for, serving as the CXCR4-specific radioligand. A semiquantitative target lesion analysis was conducted (providing SUV max and target-to-blood pool ratio [TBR], defined as SUV max [from target lesion] divided by SUV mean [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 (SUV max. 12) was found in multiple myeloma (n 5 113), followed by adrenocortical carcinoma (n 5 30), mantle cell lymphoma (n 5 20), adrenocortical adenoma (n 5 6), and small cell lung cancer (n 5 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 5 6). When comparing specific activity with semiquantitative parameters, no significant correlation was found for SUV max 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.

Original languageEnglish
Pages (from-to)1687-1692
Number of pages6
JournalJournal of nuclear medicine : official publication, Society of Nuclear Medicine
Volume63
Issue number11
DOIs
Publication statusPublished - 1 Nov 2022

Austrian Fields of Science 2012

  • 302054 Nuclear medicine

Keywords

  • 68Ga-Pentixafor
  • C-X-C motif chemokine receptor 4
  • CXCR4
  • PET
  • Ga-Pentixafor

Cite this