Abstract
Background[18F]HX4 is a promising new PET tracer developed to identify hypoxic areas in tumor tissue. This study analyzes [18F]HX4 kinetics and assesses the performance of simplified methods for quantification of [18F]HX4 uptake.To this end, eight patients with non-small cell lung cancer received dynamic PET scans at three different time points (0, 120, and 240 min) after injection of 426 ± 72 MBq [18F]HX4, each lasting 30 min. Several compartment models were fitted to time activity curves (TAC) derived from various areas within tumor tissue using image-derived input functions.ResultsBest fits were obtained using the reversible two-tissue compartment model with blood volume parameter (2T4k+VB). Simplified measures correlated well with VT estimates (tumor-to-blood ratio (TBr) R 2 = 0.96, tumor-to-muscle ratio R 2 = 0.94, standardized uptake value R 2 = 0.89).Conclusions[18F]HX4 shows reversible kinetics in tumor tissue: 2T4k+VB. TBr based on static imaging at 2 or 4 h can be used for quantification of [18F]HX4 uptake.Electronic supplementary materialThe online version of this article (doi:10.1186/s40658-016-0167-y) contains supplementary material, which is available to authorized users.
Highlights
Tumor tissue often exhibits insufficient or abnormal vasculature, leading to reduced delivery of oxygen and nutrients to tumor cells
Exclusion criteria were radiotherapy to the thorax prior to Positron emission tomography (PET)/CT imaging, tumor growth in large blood vessels, and postobstructive atelectasis or infiltration that cannot be distinguished from tumor tissue on a PET/CT scan
All patients had been previously treated with at least one course of chemotherapy, but PET/CT imaging was performed before the onset of external beam radiation therapy
Summary
Tumor tissue often exhibits insufficient or abnormal vasculature, leading to reduced delivery of oxygen and nutrients to tumor cells. Decreased pO2 tension (“hypoxia”) can lead to upregulation of hypoxia inducible factor-1 (HIF-1), promoting tumor cell survival as well as tumor growth and metastatic potential [1]. Tumor targeted therapy strategies, such as radiation therapy and many types of chemotherapy, require the presence of oxygen in the cell [2, 3]. Advanced treatment strategies for targeting hypoxic tumor cells [5, 6], such as hypoxia-specific. For correct diagnosis as well as successful application of these advanced treatment strategies, accurate assessment of oxygenation status and the heterogeneous distribution of hypoxia in tumor tissue are required
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