在边缘区淋巴瘤 (MZL) 患者中，[18F]FDG PET/CT 提供的诊断准确性不一致。 C-X-C 基序趋化因子受体 4 (CXCR4) 在 MZL 中过度表达，因此可能成为新的治疗诊断靶点。我们的目的是评估 CXCR4 靶向 [68Ga]Ga-PentixaFor 与 [18F]FDG PET/CT 相比在 MZL 中的诊断性能。 32 名未经治疗的 MZL 患者（淋巴结，n = 17；结外，n = 13；脾脏） ，n = 2) 在中位 2 天内接受了 [68Ga]Ga-PentixaFor 和 [18F]FDG PET/CT。我们通过测量最大/峰值标准化摄取值（SUVmax/peak）并计算目标与背景比率（TBR，定义为基于病变的 SUVpeak 除以血池中的 SUVmean），对淋巴瘤总体积进行了视觉和定量分析。 。对所有目标病灶 (TL) 进行两种放射性示踪剂的视觉比较，并对两次扫描中明显的一致 TL 进行定量分析。最后，还进行了 MZL 亚型分析。在基于患者的水平上，[68Ga]Ga-PentixaFor 确定了 32 名 (100%) 受试者的 MZL 表现（相对于 [18F]FDG，25/32 [78.1%]）。在 256 个已识别的 TL 中，127/256 (49.6%) 的表现仅在 CXCR4 定向成像中明显，而只有 7/256 (2.7%) 在 [18F]FDG 上被识别，但被 [68Ga]Ga-PentixaFor 遗漏。在剩余的 122/256 (47.7%) 一致 TL 中，与 [18F]FDG 相比，[68Ga]Ga-PentixaFor 始终提供更高的指标：SUVmax，10.3（范围，2.53-37.2）与 5.72（2.32-37.0）； SUVpeak，6.23 (1.58-25.7) vs. 3.87 (1.54-27.7)； P < 0.01，分别。 [68Ga]Ga-PentixaFor 上的一致 TL TBR（中位数，3.85；范围，1.05-16.0）也相对于 [18F]FDG（中位数，2.08；范围，0.81-28.8；P < 0.01）高约 1.8 倍。然而，这些关于图像对比度的发现是由淋巴结 MZL 驱动的（P < 0.01），并且错过了结外 MZL 的显着性（P = 0.06）。在新诊断的 MZL 患者中，[68Ga]Ga-PentixaFor 识别出更多的疾病部位。与 [18F]FDG 相比，无论 MZL 亚型如何。 [68Ga]Ga-PentixaFor PET/CT 上的定量 PET 参数（包括 TBR）也较高，表明使用趋化因子受体靶向成像可改善诊断读数。© 2023。作者。

In patients with marginal zone lymphoma (MZL), [18F]FDG PET/CT provided inconsistent diagnostic accuracy. C-X-C motif chemokine receptor 4 (CXCR4) is overexpressed in MZL and thus, may emerge as novel theranostic target. We aimed to evaluate the diagnostic performance of CXCR4-targeting [68Ga]Ga-PentixaFor when compared to [18F]FDG PET/CT in MZL.Thirty-two untreated MZL patients (nodal, n = 17; extranodal, n = 13; splenic, n = 2) received [68Ga]Ga-PentixaFor and [18F]FDG PET/CT within median 2 days. We performed a visual and quantitative analysis of the total lymphoma volume by measuring maximum/peak standardized uptake values (SUVmax/peak), and calculating target-to-background ratios (TBR, defined as lesion-based SUVpeak divided by SUVmean from blood pool). Visual comparisons for both radiotracers were carried out for all target lesions (TL), and quantitative analysis of concordant TL evident on both scans. Last, MZL subtype analyses were also conducted.On a patient-based level, [68Ga]Ga-PentixaFor identified MZL manifestations in 32 (100%) subjects (vs. [18F]FDG, 25/32 [78.1%]). Of the 256 identified TL, 127/256 (49.6%) manifestations were evident only on CXCR4-directed imaging, while only 7/256 (2.7%) were identified on [18F]FDG but missed by [68Ga]Ga-PentixaFor. In the remaining 122/256 (47.7%) concordant TL, [68Ga]Ga-PentixaFor consistently provided increased metrics when compared to [18F]FDG: SUVmax, 10.3 (range, 2.53-37.2) vs. 5.72 (2.32-37.0); SUVpeak, 6.23 (1.58-25.7) vs. 3.87 (1.54-27.7); P < 0.01, respectively. Concordant TL TBR on [68Ga]Ga-PentixaFor (median, 3.85; range, 1.05-16.0) was also approximately 1.8-fold higher relative to [18F]FDG (median, 2.08; range, 0.81-28.8; P < 0.01). Those findings on image contrast, however, were driven by nodal MZL (P < 0.01), and just missed significance for extranodal MZL (P = 0.06).In newly diagnosed MZL patients, [68Ga]Ga-PentixaFor identified more sites of disease when compared to [18F]FDG, irrespective of MZL subtype. Quantitative PET parameters including TBR were also higher on [68Ga]Ga-PentixaFor PET/CT, suggesting improved diagnostic read-out using chemokine receptor-targeted imaging.© 2023. The Author(s).