[⁶⁸Ga]Ga-Pentixafor for PET Imaging of Vascular Expression of CXCR-4 as a Marker of Arterial Inflammation in HIV-Infected Patients: A Comparison with ¹⁸F[FDG] PET Imaging

People living with human immunodeficiency virus (PLHIV) have excess risk of atherosclerotic cardiovascular disease (ASCVD). Arterial inflammation is the hallmark of atherogenesis and its complications. In this study we aimed to perform a head-to-head comparison of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography ([¹⁸F]FDG PET/CT) and Gallium-68 pentixafor positron emission tomography/computed tomography [⁶⁸Ga]Ga-pentixafor PET/CT for quantification of arterial inflammation in PLHIV. We prospectively recruited human immunodeficiency virus (HIV)-infected patients to undergo [¹⁸F]FDG PET/CT and [⁶⁸Ga]Ga-pentixafor PET/CT within two weeks of each other. We quantified the levels of arterial tracer uptake on both scans using maximum standardized uptake value (SUVmax) and target–background ratio. We used Bland and Altman plots to measure the level of agreement between tracer quantification parameters obtained on both scans. A total of 12 patients were included with a mean age of 44.67 ± 7.62 years. The mean duration of HIV infection and mean CD+ T-cell count of the study population were 71.08 ± 37 months and 522.17 ± 260.33 cells/µL, respectively. We found a high level of agreement in the quantification variables obtained using [¹⁸F]FDG PET and [⁶⁸Ga]Ga-pentixafor PET. There is a good level of agreement in the arterial tracer quantification variables obtained using [¹⁸F]FDG PET/CT and [⁶⁸Ga]Ga-pentixafor PET/CT in PLHIV. This suggests that [⁶⁸Ga]Ga-pentixafor may be applied in the place of [¹⁸F]FDG PET/CT for the quantification of arterial inflammation.