Lack of correlation of hypoxic cell fraction and angiogenesis with glucose metabolic rate in non-small cell lung cancer assessed by F-18-fluoromisonidazole and F-18-FDG PET

Cherk, MH; Foo, SS; Poon, AMT; Knight, SR; Murone, C; Papenfuss, AT; Sachinidis, JI; Saunder, THC; O&#39;Keefe, GJ; Scott, AM

Author(s): Cherk, MH; Foo, SS; Poon, AMT; Knight, SR; Murone, C; Papenfuss, AT; Sachinidis, JI; Saunder, THC; O'Keefe, GJ; Scott, AM;
Details: Publication Year 2006-12-01,Volume 47,Issue #12,Page 1921-1926
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 non-small cell lung cancer (NSCLC) for the presence of hypoxia, as indicated by the uptake of F-18-fluoromisoniclazole (F-18-FMISO), and to examine the relationship of hypoxia to the uptake of F-18-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 F-18-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 [Cl]) 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 F-18-FMISO uptake, F-18-FDG uptake, and tumor markers of hypoxia and angiogenesis was poor. A weakly positive correlation between F-18-FMISO and F-18-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 F-18-FDG. These findings have direct implications in understanding the role of angiogenesis and hypoxia in NSCLC biology.
Publisher: SOC NUCLEAR MEDICINE INC
Keywords: POSITRON-EMISSION-TOMOGRAPHY; TUMOR HYPOXIA; OXYGENATION STATUS; GENE-EXPRESSION; ISCHEMIC-STROKE; NECK-CANCER; FLUOROMISONIDAZOLE; CHEMOTHERAPY; RADIOTHERAPY; TISSUE
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Creation Date: 2006-12-01 12:00:00