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

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16 Citations (Scopus)


We aimed to elucidate the diagnostic potential of the C-X-C motif chemokine receptor 4 (CXCR4)-directed positron emission tomography (PET) tracer68Ga-Pentixafor in patients with poorly differentiated neuroendocrine carcinomas (NEC), relative to the established reference standard18F-FDG PET/computed tomography (CT). In our database, we retrospectively identified 11 treatment-naïve patients with histologically proven NEC, who underwent18F-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 < 0.001). Semi-quantitative analysis revealed markedly higher18F-FDG uptake as compared to68Ga-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 < 0.001; and, TBR 7.2 ± 7.9 vs. 3.4 ± 3.0, p < 0.001). Non-invasive imaging of CXCR4 expression in NEC is inferior to the reference standard18F-FDG PET/CT.

Original languageEnglish
Article number605
Issue number4
Publication statusPublished - Apr 2021
Externally publishedYes


  • CXCR4
  • F-FDG
  • Ga-Pentixafor
  • NEC
  • NET

ASJC Scopus subject areas

  • Clinical Biochemistry


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