Neue Radiopharmaka beim Lymphom-Imaging

Zusammenfassung

Die FDG PET hat in der Bildgebung von aggressiven Lymphomen einen festen Stellenwert, insbesondere im initialen Staging und in der Beurteilung des Therapieansprechens. Die FLT PET, ein Surrogatparameter der Proliferation, hat im Beurteilen des Therapieansprechens bei DLBCL jedoch eine signifikant bessere Genauigkeit gegenüber der FDG PET, auch was das PFS, die Rezidivwahrscheinlichkeit und das Überleben betrifft. Indolente Lymphome sind häufig FDG-negativ, exprimieren jedoch in der überwiegenden Mehrzahl CXCR4, an das [⁶⁸Ga]-Pentixafor bindet. Die [⁶⁸Ga]-Pentixafor-PET hat hier vielversprechende Ergebnisse gezeigt. Bei verschiedenen indolenten NHL, insbesondere bei MALT-Lymphomen, Marginalzonenlymphomen, Mantelzelllymphomen sowie dem Morbus Waldenström hat die [⁶⁸Ga]-Pentixafor-PET Sensitivitäten nahe an 100 % gezeigt und könnte sich zum neuen Standard entwickeln. Auch in der Bildgebung von ZNS-Lymphomen konnte die hohe diagnostische Genauigkeit der [⁶⁸Ga]-Pentixafor-PET gezeigt werden.

Abstract

FDG PET is well established in the imaging of aggressive lymphomas, particularly in initial staging and in the assessment of treatment response. However, FLT PET, a surrogate parameter of proliferation, has shown significantly better accuracy than FDG PET in assessing treatment response in DLBCL, including PFS, recurrence probability, and survival. Indolent lymphomas are often FDG negative but overwhelmingly express CXCR4, which is targeted by [68Ga]-pentixafor. [68Ga]-pentixafor PET has shown promising results in this regard. In various indolent NHL, particularly MALT lymphomas, marginal zone lymphomas, mantle cell lymphomas, as well as Waldenström's disease, [68Ga]-pentixafor PET has shown sensitivities close to 100 % and may become the new standard. The high diagnostic accuracy of [68Ga]-Pentixafor PET has also been demonstrated in the imaging of CNS lymphomas.

Schlüsselwörter

PET - Lymphom - PET/CT

Key words

PET - lymphoma - PET/CT

Publication History

Article published online:
07 March 2022

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