Reproducibility of Intratumor Distribution of {sup 18}F-Fluoromisonidazole in Head and Neck Cancer
- Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)
- Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)
Purpose: Hypoxia is one of the main causes of the failure to achieve local control using radiotherapy. This is due to the increased radioresistance of hypoxic cells. {sup 18}F-fluoromisonidazole ({sup 18}F-FMISO) positron emission tomography (PET) is a noninvasive imaging technique that can assist in the identification of intratumor regions of hypoxia. The aim of this study was to evaluate the reproducibility of {sup 18}F-FMISO intratumor distribution using two pretreatment PET scans. Methods and Materials: We enrolled 20 head and neck cancer patients in this study. Of these, 6 were excluded from the analysis for technical reasons. All patients underwent an {sup 18}F-fluorodeoxyglucose study, followed by two {sup 18}F-FMISO studies 3 days apart. The hypoxic volumes were delineated according to a tumor/blood ratio {>=}1.2. The {sup 18}F-FMISO tracer distributions from the two {sup 18}F-FMISO studies were co-registered on a voxel-by-voxel basis using the computed tomography images from the PET/computed tomography examinations. A correlation between the {sup 18}F-FMISO intensities of the corresponding spatial voxels was derived. Results: A voxel-by-voxel analysis of the {sup 18}F-FMISO distributions in the entire tumor volume showed a strong correlation in 71% of the patients. Restraining the correlation to putatively hypoxic zones reduced the number of patients exhibiting a strong correlation to 46%. Conclusion: Variability in spatial uptake can occur between repeat {sup 18}F-FMISO PET scans in patients with head and neck cancer. Blood data for one patient was not available. Of 13 patients, 6 had well-correlated intratumor distributions of {sup 18}F-FMISO-suggestive of chronic hypoxia. More work is required to identify the underlying causes of changes in intratumor distribution before single-time-point {sup 18}F-FMISO PET images can be used as the basis of hypoxia-targeting intensity-modulated radiotherapy.
- OSTI ID:
- 21039724
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Vol. 70, Issue 1; Other Information: DOI: 10.1016/j.ijrobp.2007.08.036; PII: S0360-3016(07)03899-0; Copyright (c) 2008 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
Similar Records
Noninvasive Assessment of Tumor Microenvironment Using Dynamic Contrast-Enhanced Magnetic Resonance Imaging and {sup 18}F-Fluoromisonidazole Positron Emission Tomography Imaging in Neck Nodal Metastases
Strategy of Using Intratreatment Hypoxia Imaging to Selectively and Safely Guide Radiation Dose De-escalation Concurrent With Chemotherapy for Locoregionally Advanced Human Papillomavirus–Related Oropharyngeal Carcinoma