68Ga-pentixafor PET/CT shows better diagnostic performance than 18F-FDG PET/CT in chronic lymphocytic leukemia/small lymphocytic lymphoma: a case report and review of literature

Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) is an indolent B-cell lymphoma for which current imaging modalities offer limited diagnostic value. This article reports a comparison of the imaging features of 18 F-FDG and 68 Ga-pentixafor in this disease and reviews the relevant literature. A 60-year-old woman presented with a 6-month history of fever and scattered systemic lymphadenopathy. The patient underwent both 18 F-FDG and 68 Ga-pentixafor PET/CT imaging within a 2-day period. 68 Ga-pentixafor PET/CT identified significantly increased metabolic activity in enlarged lymph nodes, the spleen, and bone marrow. Immunohistochemical staining demonstrated a phenotypic profile positive for CD5, CD20, and CD23; showed focal positivity for cyclin D1; and was negative for CD10, BCL-6, and SOX11, findings consistent with the diagnosis of CLL/SLL. Compared with 18 F-FDG, 68 Ga-pentixafor PET/CT detected more lesions with significantly higher tracer uptake. This case suggests that, for patients with CLL/SLL, 68 Ga-pentixafor PET/CT demonstrates significantly superior performance in evaluating the tumor burden and delineating the disease extent compared with 18 F-FDG PET/CT.