Diagnostic value of [68Ga]Ga-Pentixafor versus [18F]FDG PET/CTs in non-small cell lung cancer: a head-to-head comparative study

Abstract

Objective In this study, we aimed to compare the diagnostic value of [68Ga]Ga-Pentixafor and [18F]FDG PET/CT in the evaluation of non-small cell lung cancer (NSCLC) patients. Methods Patients with pathology-proven NSCLC were prospectively included. Patients underwent [18F]FDG and [68Ga]Ga-Pentixafor PET/CT within 1 week. All suspicious lesions were interpreted as benign or malignant, and the corresponding PET/CT semi-quantitative parameters were recorded. A two-sided P-value <0.05 was considered significant. Results Twelve consecutive NSCLC patients (mean age: 60 ± 7) were included. All patients underwent both [18F]FDG and [68Ga]Ga-Pentixafor PET/CT scans with a median interval of 2 days. Overall, 73 abnormal lesions were detected, from which 58 (79%) were concordant between [18F]FDG and [68Ga]Ga-Pentixafor PET/CT. All primary tumors were clearly detectable in both scans visually. Also, [68Ga]Ga-Pentixafor PET/CT demonstrated rather comparable results with [18F]FDG PET/CT scan in detecting metastatic lesions. However, malignant lesions demonstrated significantly higher SUVmax and SUVmean in [18F]FDG PET/CT (P-values <0.05). Regarding the advantages, [68Ga]Ga-Pentixafor depicted two brain metastases that were missed by [18F]FDG PET/CT. Also, a highly suspicious lesion for recurrence on [18F]FDG PET/CT scan was correctly classified as benign by subsequent [68Ga]Ga-Pentixafor PET/CT. Conclusion [68Ga]Ga-Pentixafor PET/CT was concordant with [18F]FDG PET/CT in detecting primary NSCLC tumors and could visualize the majority of metastatic lesions. Moreover, this modality was found to be potentially helpful in excluding tumoural lesions when the [18F]FDG PET/CT was equivocal, as well as in detecting brain metastasis where [18F]FDG PET/CT suffers from poor sensitivity. However, the count statistics were significantly lower.