Correlation of hypoxic cell fraction and angiogenesis with glucose metabolic rate in gliomas using F-18-fluoromisonidazole, F-18-FDG PET, and immunohistochemical studies

Cher, LM; Murone, C; Lawrentschuk, N; Ramdave, S; Papenfuss, A; Hannah, A; O&#39;Keefe, GJ; Sachinidis, JI; Berlangieri, SU; Fabinyi, G; Scott, AM

Author(s): Cher, LM; Murone, C; Lawrentschuk, N; Ramdave, S; Papenfuss, A; Hannah, A; O'Keefe, GJ; Sachinidis, JI; Berlangieri, SU; Fabinyi, G; Scott, AM;
Details: Publication Year 2006-03-01,Volume 47,Issue #3,Page 410-418
Journal Title: JOURNAL OF NUCLEAR MEDICINE
Publication Type: Journal Article
Abstract: 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 primary brain tumors for the presence of hypoxia, as indicated by the uptake of F-18-fluoromisonidazole (F-18-FMISO) and to examine the relationship of hypoxia to the uptake of F-18-FDG and molecular markers of hypoxia. Methods: Seventeen patients with suspected primary glioma were enrolled prospectively in this study. Sixteen patients had histology, with 2 having metastatic disease. All patients had PET studies with 18F-FMISO and F-18-FDG and MRI studies. Immunohistochemistry was undertaken with tumor markers of angiogenesis and hyp_ oxia. Patients were monitored for disease progression and statistical analysis of data was performed. Results: Of the 14 patients with histology, 8 died with a median time of 16 mo (range, 2-30 mo) until death. Of those who died, 7 had positive and 1 had negative F-18-FMISO uptake. F-18-FMISO uptake was observed in all high-grade gliomas but not in low-grade gliomas. A significant relationship was found between F-18-FDG or F-18-FMISO uptake and expression of VEGF-R1 and Ki67 expression. Other immunohistochemical markers demonstrated a trend toward increased uptake but none was significant. Conclusion: F-18-FMISO PET provides a noninvasive assessment of hypoxia in glioma and was prognostic for treatment outcomes in the majority of patients. F-18-FMISO PET may have a role not only in directing patients toward targeted hypoxic therapies but also in monitoring response to such therapies.
Publisher: SOC NUCLEAR MEDICINE INC
Keywords: POSITRON-EMISSION-TOMOGRAPHY; ENDOTHELIAL GROWTH-FACTOR; ACUTE ISCHEMIC-STROKE; BRAIN-TUMORS; NECK-CANCER; TISSUE; FLUOROMISONIDAZOLE; RADIOTHERAPY; EXPRESSION; OXYGENATION
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Creation Date: 2006-03-01 12:00:00