Lack of Correlation of Hypoxic Cell Fraction and Angiogenesis with Glucose Metabolic Rate in Non–Small Cell Lung Cancer Assessed by 18F-Fluoromisonidazole and 18F-FDG PET

Journal of Nuclear Medicine

Anthony T. Papenfuss¹  Carmel Murone¹  Simon R. Knight¹  Aurora M.T. Poon¹  Serene S. Foo¹  Timothy H.C. Saunder¹  John I. Sachinidis¹  Martin H. Cherk¹  Andrew M. Scott¹  Graeme J. O'Keefe¹ 

关键词: PET;    tumor hypoxia;    non–small cell lung cancer;    immunohistochemistry;    vascular endothelial growth factor;   

DOI  :  

学科分类：医学（综合）

来源: Society of Nuclear Medicine

【 摘 要 】

PET offers a noninvasive means to assess neoplasms, in view of its sensitivity and accuracy in staging tumors and potentially in monitoring treatment response. The aim of this study was to evaluate newly diagnosed non–small cell lung cancer (NSCLC) for the presence of hypoxia, as indicated by the uptake of 18F-fluoromisonidazole (18F-FMISO), and to examine the relationship of hypoxia to the uptake of 18F-FDG, microvessel density, and other molecular markers of hypoxia. Methods: Twenty-one patients with suspected or biopsy-proven NSCLC were enrolled prospectively in this study. All patients had PET studies with 18F-FMISO and 18F-FDG. Seventeen patients subsequently underwent surgery, with analysis performed for tumor markers of angiogenesis and hypoxia. Results: In the 17 patients with resectable NSCLC (13 men, 4 women; age range, 51−77 y), the mean 18F-FMISO uptake in tumor was significantly lower than that of 18F-FDG uptake (P < 0.0001) and showed no correlation with 18F-FDG uptake (r = 0.26). The mean (95% confidence interval [CI]) 18F-FMISO SUVmax (maximum standardized uptake value) was 1.20 [0.95−1.45] compared with the mean [95% CI] 18F-FDG SUVmax of 5.99 [4.62−7.35]. The correlation between 18F-FMISO uptake, 18F-FDG uptake, and tumor markers of hypoxia and angiogenesis was poor. A weakly positive correlation between 18F-FMISO and 18F-FDG uptake and Ki67 was found. Conclusion: The hypoxic cell fraction of primary NSCLC is consistently low, and there is no significant correlation in NSCLC between hypoxia and glucose metabolism in NSCLC assessed by 18F-FDG. These findings have direct implications in understanding the role of angiogenesis and hypoxia in NSCLC biology.

【 授权许可】

Unknown