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Peer-reviewedCC BY 4.0Cancers

Head-to-Head Comparison Between [18F]FDG and [68Ga]Ga-Pentixafor PET/CT in Multiple Myeloma: A Systematic Review and Meta-Analysis

  • Domenico Albano1,2
  • Slavko Tasevski3
  • Marco Rapa4
  • Cristina Nanni5
  • Giorgio Treglia6,7,8
8 affiliations
  1. 1Nuclear Medicine, University of Brescia, 25121 Brescia, Italy
  2. 2Nuclear Medicine Department, ASST Spedali Civili di Brescia, 25123 Brescia, Italy
  3. 3Nuclear Medicine, University Institute for Positron Emission Tomography, 1000 Skopje, North Macedonia
  4. 4Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, 40138 Bologna, Italy
  5. 5Nuclear Medicine Unit, Istituto di Ricovero e Cure a Carattere Scientifico (IRCCS), Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
  6. 6Faculty of Biology and Medicine, University of Lausanne, 1015 Lausanne, Switzerland
  7. 7Division of Nuclear Medicine, Ente Ospedaliero Cantonale, 6500 Bellinzona, Switzerland
  8. 8Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6900 Lugano, Switzerland
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Abstract

Background/objective: Multiple myeloma (MM) is a hematological malignancy characterized by the proliferation of clonal plasma cells. While [18F]FDG PET/CT is widely established for assessing disease extent, bone involvement, and treatment response in MM, novel molecular imaging targets like CXCR4 (e.g., using [68Ga]Ga-Pentixafor) have emerged to offer potentially superior sensitivity and theranostic applications. The aim of this manuscript is to systematically review and compare the diagnostic performance, expressed as detection rates, of CXCR4-targeted PET/CT versus [18F]FDG PET/CT in patients with MM. Methods: A systematic literature search was conducted across major databases (PubMed/MEDLINE, Embase, and the Cochrane Library) for head-to-head comparative studies evaluating both [18F]FDG and [68Ga]Ga-Pentixafor PET/CT in MM patients. Risk of bias and study quality were assessed using the QUADAS-2 tool. Results: Eleven studies were collected, amounting to a total of 347 patients. A patient-based analysis showed that [68Ga]Ga-Pentixafor had a higher detection rate than [18F]FDG PET/CT (86.3%, 95% CI: 80.3–92.3% vs 60.9%, 95% CI: 42.5–79.4%). In a descriptive analysis, mean lesion SUVmax values reported across individual studies were generally higher with [68Ga]Ga-Pentixafor PET/CT than with [18F]FDG PET/CT. Conclusions: [68Ga]Ga-Pentixafor PET/CT may serve as a robust alternative or complementary imaging modality to [18F]FDG PET/CT in MM. It could also be helpful for selection in CXCR4-directed theranostic pathways, but more high-quality studies are warranted.

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Cite

BibTeXRIS
BibTeX
@article{albano2026headtohead,
  title = {{Head-to-Head Comparison Between [18F]FDG and [68Ga]Ga-Pentixafor PET/CT in Multiple Myeloma: A Systematic Review and Meta-Analysis}},
  author = {Domenico Albano and Slavko Tasevski and Marco Rapa and Cristina Nanni and Giorgio Treglia},
  journal = {Cancers},
  year = {2026},
  month = oct,
  doi = {10.3390/cancers18203305},
  url = {https://www.mdpi.com/2072-6694/18/20/3305},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Head-to-Head Comparison Between [18F]FDG and [68Ga]Ga-Pentixafor PET/CT in Multiple Myeloma: A Systematic Review and Meta-Analysis
AU  - Domenico Albano
AU  - Slavko Tasevski
AU  - Marco Rapa
AU  - Cristina Nanni
AU  - Giorgio Treglia
PY  - 2026
DA  - 2026/10/01
JO  - Cancers
DO  - 10.3390/cancers18203305
UR  - https://www.mdpi.com/2072-6694/18/20/3305
AB  - Background/objective: Multiple myeloma (MM) is a hematological malignancy characterized by the proliferation of clonal plasma cells. While [18F]FDG PET/CT is widely established for assessing disease extent, bone involvement, and treatment response in MM, novel molecular imaging targets like CXCR4 (e.g., using [68Ga]Ga-Pentixafor) have emerged to offer potentially superior sensitivity and theranostic applications. The aim of this manuscript is to systematically review and compare the diagnostic performance, expressed as detection rates, of CXCR4-targeted PET/CT versus [18F]FDG PET/CT in patients with MM. Methods: A systematic literature search was conducted across major databases (PubMed/MEDLINE, Embase, and the Cochrane Library) for head-to-head comparative studies evaluating both [18F]FDG and [68Ga]Ga-Pentixafor PET/CT in MM patients. Risk of bias and study quality were assessed using the QUADAS-2 tool. Results: Eleven studies were collected, amounting to a total of 347 patients. A patient-based analysis showed that [68Ga]Ga-Pentixafor had a higher detection rate than [18F]FDG PET/CT (86.3%, 95% CI: 80.3–92.3% vs 60.9%, 95% CI: 42.5–79.4%). In a descriptive analysis, mean lesion SUVmax values reported across individual studies were generally higher with [68Ga]Ga-Pentixafor PET/CT than with [18F]FDG PET/CT. Conclusions: [68Ga]Ga-Pentixafor PET/CT may serve as a robust alternative or complementary imaging modality to [18F]FDG PET/CT in MM. It could also be helpful for selection in CXCR4-directed theranostic pathways, but more high-quality studies are warranted.
SN  - 2072-6694
ER  -