CXCR4-Directed PET/CT in Patients with Newly Diagnosed Neuroendocrine Carcinomas
Alexander Weich,
Rudolf A. Werner,
Andreas K. Buck,
Philipp E. Hartrampf,
Sebastian E. Serfling,
Michael Scheurlen,
Hans-Jürgen Wester,
Alexander Meining,
Stefan Kircher,
Takahiro Higuchi,
Martin G. Pomper,
Steven P. Rowe,
Constantin Lapa,
Malte Kircher
Affiliations
Alexander Weich
Department of Internal Medicine I, Gastroenterology, University Hospital Würzburg, 97080 Würzburg, Germany
Rudolf A. Werner
European Neuroendocrine Tumor Society (ENETS) Center of Excellence, NET Zentrum, University Hospital Würzburg, 97080 Würzburg, Germany
Andreas K. Buck
European Neuroendocrine Tumor Society (ENETS) Center of Excellence, NET Zentrum, University Hospital Würzburg, 97080 Würzburg, Germany
Philipp E. Hartrampf
Department of Nuclear Medicine, University Hospital Würzburg, 97080 Würzburg, Germany
Sebastian E. Serfling
Department of Nuclear Medicine, University Hospital Würzburg, 97080 Würzburg, Germany
Michael Scheurlen
Department of Internal Medicine I, Gastroenterology, University Hospital Würzburg, 97080 Würzburg, Germany
Hans-Jürgen Wester
Pharmaceutical Radiochemistry, Technische Universität München, 80333 München, Germany
Alexander Meining
Department of Internal Medicine I, Gastroenterology, University Hospital Würzburg, 97080 Würzburg, Germany
Stefan Kircher
Institute of Pathology, University of Würzburg, 97080 Würzburg, Germany
Takahiro Higuchi
Department of Nuclear Medicine, University Hospital Würzburg, 97080 Würzburg, Germany
Martin G. Pomper
The Russell H. Morgan Department of Radiology and Radiological Science, Division of Nuclear Medicine and Molecular Imaging, Johns Hopkins University School of Medicine, Baltimore, MD 21218, USA
Steven P. Rowe
The Russell H. Morgan Department of Radiology and Radiological Science, Division of Nuclear Medicine and Molecular Imaging, Johns Hopkins University School of Medicine, Baltimore, MD 21218, USA
Constantin Lapa
European Neuroendocrine Tumor Society (ENETS) Center of Excellence, NET Zentrum, University Hospital Würzburg, 97080 Würzburg, Germany
Malte Kircher
European Neuroendocrine Tumor Society (ENETS) Center of Excellence, NET Zentrum, University Hospital Würzburg, 97080 Würzburg, Germany
We aimed to elucidate the diagnostic potential of the C-X-C motif chemokine receptor 4 (CXCR4)-directed positron emission tomography (PET) tracer 68Ga-Pentixafor in patients with poorly differentiated neuroendocrine carcinomas (NEC), relative to the established reference standard 18F-FDG PET/computed tomography (CT). In our database, we retrospectively identified 11 treatment-naïve patients with histologically proven NEC, who underwent 18F-FDG and CXCR4-directed PET/CT for staging and therapy planning. The images were analyzed on a per-patient and per-lesion basis and compared to immunohistochemical staining (IHC) of CXCR4 from PET-guided biopsies. 68Ga-Pentixafor visualized tumor lesions in 10/11 subjects, while18F-FDG revealed sites of disease in all 11 patients. Although weak to moderate CXCR4 expression could be corroborated by IHC in 10/11 cases, 18F-FDG PET/CT detected significantly more tumor lesions (102 vs. 42; total lesions, n = 107; p 18F-FDG uptake as compared to 68Ga-Pentixafor (maximum and mean standardized uptake values (SUV) and tumor-to-background ratios (TBR) of cancerous lesions, SUVmax: 12.8 ± 9.8 vs. 5.2 ± 3.7; SUVmean: 7.4 ± 5.4 vs. 3.1 ± 3.2, p p 18F-FDG PET/CT.
