CXCR4-targeted PET/CT Imaging in Hematological Malignancies

Hematological malignancies continue to pose significant clinical challenges due to their high incidence, heterogeneous biology, and substantial mortality. Although 18F-FDG PET/CT remains the most commonly used molecular imaging modality, its limited specificity can result in false-positive or false-negative findings, especially in indolent or low-metabolism subtypes, thereby hampering accurate diagnosis, staging, and therapeutic evaluation. C-X-C chemokine receptor type 4 (CXCR4) is frequently overexpressed in a broad spectrum of hematologic malignancies and correlates with aggressive disease and unfavorable outcomes. CXCR4-targeted molecular imaging using \^68Ga-pentixafor PET/CT has shown promise for improved disease characterization. This prospective study aims to systematically compare 68Ga-pentixafor PET/CT with 18F-FDG PET/CT in terms of diagnostic performance, staging accuracy, risk stratification, and prognostic relevance in patients with hematological malignancies. Furthermore, the study will incorporate artificial intelligence-based image analysis to enhance lesion detection, automate quantitative assessments, and support personalized clinical decision-making.

Sex

All

Minimum age

18 Years

Maximum age

90 Years

Inclusion Criteria:

1. Volunteer to participate and sign an informed consent form;
2. 18 ≤ Age ≤ 90 years;
3. Patients with highly suspected, or newly diagnosed, or relapsed hematological malignancies;
4. Willing and able to follow schedule visits, treatment plans and laboratory tests.

Exclusion Criteria:

1. pregnancy or breastfeeding;
2. Allergic to CXCR4-targeted tracers or excipients;
3. Fasting blood glucose level exceeded 11.0 mmol/L prior to injection of 18F-FDG;
4. Those who cannot complete PET/CT scan, including inability to keep supine, claustrophobia, radiation phobia, etc.;
5. Researchers think it is inappropriate to participate in this clinical trial for patients with poor compliance or other unsuitable factors.

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• BACKGROUNDDuell J, Krummenast F, Schirbel A, Klassen P, Samnick S, Rauert-Wunderlich H, Rasche L, Buck AK, Wester HJ, Rosenwald A, Einsele H, Topp MS, Lapa C, Kircher M. Improved Primary Staging of Marginal-Zone Lymphoma by Addition of CXCR4-Directed PET/CT. J Nucl Med. 2021 Oct;62(10):1415-1421. doi: 10.2967/jnumed.120.257279. Epub 2021 Feb 12. PMID 33579803
• DERIVEDChen J, Tang S, Liu L, Tian Y, Wang Y, Xiao Z, Xing D, Zhou F, Li C, He Y. [68Ga]Ga-Pentixafor PET/CT for Durie-Salmon PLUS staging and risk stratification in newly diagnosed multiple myeloma. Eur J Nucl Med Mol Imaging. 2026 Jun;53(7):4572-4586. doi: 10.1007/s00259-026-07813-6. Epub 2026 Feb 28. PMID 41760826