PURPOSE: This study was designed to evaluate 68Ga-pentixafor, which targets C-X-C chemokine receptor 4 (CXCR4), in the noninvasive diagnosis of thymomas. PATIENTS AND METHODS: With institutional review board approval and signed informed consent, 32 patients with thymic masses were enrolled in this study, and all patients underwent 68Ga-pentixafor PET/CT scans. RESULTS: Among the 28 patients included in the analysis, 13 patients were diagnosed with thymomas, 9 patients with cysts, and 6 patients with other anterior mediastinal masses. 68Ga-pentixafor identified all patients with thymomas (13/13, 100%), and the mean SUVmax in all 13 thymomas lesions was 13.96±8.20, which was significantly higher than that in patients with cysts (1.54±0.88) and other anterior mediastinal masses (2.59±1.68), respectively (P<
0.001). CONCLUSIONS: The preliminary study indicates the diagnostic utility of 68Ga-pentixafor in thymomas and the differential diagnostic ability of 68Ga-pentixafor in thymomas, thymic cysts and other benign anterior mediastinal masses.