Multiparametric imaging of tumor hypoxia and perfusion with (18)F-fluoromisonidazole dynamic PET in head and neck cancer Journal Article
| Authors: | Grkovski, M.; Schöder, H.; Lee, N. Y.; Carlin, S. D.; Beattie, B. J.; Riaz, N.; Leeman, J. E.; O'Donoghue, J. A.; Humm, J. L. |
| Article Title: | Multiparametric imaging of tumor hypoxia and perfusion with (18)F-fluoromisonidazole dynamic PET in head and neck cancer |
| Abstract: | Tumor hypoxia and perfusion are independent prognostic indicators of patient outcome. We developed the methodology for and investigated the utility of multiparametric imaging of tumor hypoxia and perfusion with 18F-fluoromisonidazole (18F-FMISO) dynamic PET (dPET) in head and neck cancer. Methods: One hundred twenty head and neck cancer patients underwent 0-to 30-min 18F-FMISO dPET in a customized immobilization mask, followed by 10-min static acquisitions starting at 93 6 6 and 160 6 13 min after injection. A total of 248 lesions ($2 cm3) were analyzed. Voxelwise pharmacokinetic modeling was conducted using an irreversible 1-plasma 2-tissuecompartment model to calculate surrogate biomarkers of tumor hypoxia (k3), perfusion (K1), and 18F-FMISO distribution volume. The analysis was repeated with truncated dPET datasets. Results: Substantial inter-and intratumor heterogeneity was observed for all investigated metrics. Equilibration between the blood and unbound 18F-FMISO was rapid in all tumors. 18F-FMISO distribution volume deviated from the expected value of unity, causing discrepancy between k3 maps and total 18F-FMISO uptake and reducing the dynamic range of total 18F-FMISO uptake for quantifying the degree of hypoxia. Both positive and negative trends between hypoxia and perfusion were observed in individual lesions. All investigated metrics were reproducible when calculated from a truncated 20-min dataset. Conclusion: 18F-FMISO dPET provides the data necessary to generate parametric maps of tumor hypoxia, perfusion, and radiotracer distribution volume. These data clarify the ambiguity in interpreting 18F-FMISO uptake and improve the characterization of lesions. We show total acquisition times can be reduced to 20 min, facilitating the translation of 18F-FMISO dPET into the clinic. |
| Keywords: | hypoxia; head and neck cancer; dynamic pet; perfusion; 18f-fluoromisonidazole; fmiso |
| Journal Title: | Journal of Nuclear Medicine |
| Volume: | 58 |
| Issue: | 7 |
| ISSN: | 0161-5505 |
| Publisher: | Society of Nuclear Medicine |
| Date Published: | 2017-07-01 |
| Start Page: | 1072 |
| End Page: | 1080 |
| Language: | English |
| DOI: | 10.2967/jnumed.116.188649 |
| PROVIDER: | scopus |
| PMCID: | PMC5493008 |
| PUBMED: | 28183993 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 2 August 2017 -- Source: Scopus |
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