Chemokine Receptor 4-Targeted PET/CT with [ 68 Ga]pentixather in Newly Diagnosed Multiple Myeloma: a Comparative Study with [ 68 Ga]pentixafor PET/CT.

Purpose: This study aimed to compare the detection rate of [ ⁶⁸ Ga]pentixather PET/CT and [ ⁶⁸ Ga]pentixafor PET/CT in newly diagnosed multiple myeloma (NDMM) patients, and to explore the value of [ ⁶⁸ Ga]pentixather PET/CT for tumor load assessment.
Methods: Nineteen NDMM Patients were prospectively recruited and underwent both [ ⁶⁸ Ga]pentixather PET/CT and [ ⁶⁸ Ga]pentixafor PET/CT. A positive PET scan was defined as the presence of PET-positive focal bone lesions, paraskeletal disease, extramedullary plasmacytoma, or diffuse bone marrow uptake. Lesion numbers, SUVmax and PET-related tumor burden values were compared. The correlations between PET-related tumor burden and clinical risk stratification were analyzed.
Results: [ ⁶⁸ Ga]pentixather PET/CT showed a tendency of higher positive rate compared with [ ⁶⁸ Ga]pentixafor PET/CT [94.7% (18/19) vs. 78.9% (15/19), p > 0.05]. Among 14 patients with 151 matched focal bone lesions, [ ⁶⁸ Ga]pentixather PET detected more or equal number of lesions in 13 patients, and demonstrated higher uptake value than ⁶⁸  Ga-pentixafor PET [SUVmax, 16.8 (9.0, 23.8) vs. 13.4 (6.5, 20.4), p < 0.001]. For PET related-tumor burden, positive correlations of total bone marrow uptake (TBmU) (r = 0.9540, p < 0.0001) and SUVmean of total bone marrow (r = 0.9632, p < 0.0001) in two PET scans were observed. Higher TBmU [7864.9 (5549.2, 11,616.2) vs. 5383.4(4102.7, 11,041.8), p < 0.001], SUVmean of total bone marrow [1.4 (1.1, 2.2) vs. 1.1 (0.7, 2.1), p < 0.001] were demonstrated on [ ⁶⁸ Ga]pentixather PET than [ ⁶⁸ Ga]pentixafor PET. And the level of TBmU in [ ⁶⁸ Ga]pentixather PET and [ ⁶⁸ Ga]pentixafor PET were both elevated in Durie-Salmon Staging (DSS) III than DSS I (p < 0.01).
Conclusions: [ ⁶⁸ Ga]pentixather PET/CT performed a non-inferior capability for tumor detection compared to [ ⁶⁸ Ga]pentixafor PET/CT in NDMM patients. [ ⁶⁸ Ga]pentixather PET/CT can assess tumor load in MM patients and depict a significantly higher PET-related total tumor burden than [ ⁶⁸ Ga]pentixafor PET/CT.
(© 2024. The Author(s), under exclusive licence to World Molecular Imaging Society.)