Pharmacokinetic Analysis of Hypoxia 18F-Fluoromisonidazole Dynamic PET in Head and Neck Cancer

Journal of Nuclear Medicine

Heiko Schöder¹  John L. Humm¹  Jens-Christoph Georgi¹  Wenli Wang¹  Jose Guillem¹  Nancy Y. Lee¹  Manoj Narayanan¹ 

关键词: hypoxia;    head and neck cancer;    PET;    ¹⁸F-FMISO;    pharmacokinetics;   

DOI  :  10.2967/jnumed.109.067009

学科分类：医学（综合）

来源: Society of Nuclear Medicine

【 摘 要 】

This study used pharmacokinetic analysis of 18F-labeled fluoromisonidazole (18F-FMISO) dynamic PET to assist the identification of regional tumor hypoxia and to investigate the relationship among a potential tumor hypoxia index (Ki), tumor-to-blood ratio (T/B) in the late-time image, plasma-to-tissue transport rate (k1), and local vascular volume fraction (β) for head and neck cancer patients. Methods: Newly diagnosed patients underwent a dynamic 18F-FMISO PET scan before chemotherapy or radiotherapy. The data were acquired in 3 consecutive PET/CT dynamic scan segments, registered with each other and analyzed using pharmacokinetics software. The (Ki, k1, β) kinetic parameter images were derived for each patient. Results: Nine patients' data were analyzed. Representative images of 18F-FDG PET (of the tumor), CT (of the anatomy), and late-time 18F-FMISO PET (of the T/B) and parametric images of Ki (potentially representing tumor hypoxia) are shown. The patient image data could be classified into 3 types: with good concordance between the parametric hypoxia map Ki and high T/B, with concordant findings between the parametric hypoxia map and low T/B, and with ambiguity between parametric hypoxia map and T/B. Correlation coefficients are computed between each pair of T/B, Ki, k1, and β. Data are also presented for other potential hypoxia surrogate measures, for example, k3 and k1/k2. Conclusion: There is a positive correlation of 0.86 between the average T/B and average hypoxia index Ki of the region of interest. However, because of the statistical photon counting noise in PET and the amplification of noise in kinetic analysis, the direct correlation between the T/B and hypoxia of the individual pixel is not obvious. For a tumor region of interest, there is a slight negative correlation between k1 and Ki, moderate positive correlation between β and Ki, but no correlation between β and k1.

【 授权许可】

Unknown