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Tumour hypoxia imaging with [18F]FAZA PET in head and neck cancer patients: a pilot study

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Abstract

Purpose

Hypoxia is an important negative prognostic factor for radiation treatment of head and neck cancer. This study was performed to evaluate the feasibility of use of 18F-labelled fluoroazomycin arabinoside ([18F]FAZA) for clinical PET imaging of tumour hypoxia.

Methods

Eleven patients (age 59.6 ± 9 years) with untreated advanced head and neck cancer were included. After injection of approximately 300 MBq of [18F]FAZA, a dynamic sequence up to 60 min was acquired on an ECAT HR+ PET scanner. In addition, approximately 2 and 4 h p.i., static whole-body PET (n = 5) or PET/CT (n = 6) imaging was performed. PET data were reconstructed iteratively (OSEM) and fused with CT images (either an external CT or the CT of integrated PET/CT). Standardised uptake values (SUVs) and tumour-to-muscle (T/M) ratios were calculated in tumour and normal tissues. Also, the tumour volume displaying a T/M ratio >1.5 was determined.

Results

Within the first 60 min of the dynamic sequence, the T/M ratio generally decreased, while generally increasing at later time points. At 2 h p.i., the tumour SUVmax and SUVmean were found to be 2.3 ± 0.5 (range 1.5–3.4) and 1.4 ± 0.3 (range 1.0–2.1), respectively. The mean T/M ratio at 2 h p.i. was 2.0 ± 0.3 (range 1.6–2.4). The tumour volume displaying a T/M ratio above 1.5 was highly variable. At 2 h p.i., [18F]FAZA organ distribution was determined as follows: kidney > gallbladder > liver > tumour > muscle > bone > brain > lung.

Conclusion

[18F]FAZA PET imaging appears feasible in head and neck cancer patients, and the achieved image quality is adequate for clinical purposes. Based on our initial results, [18F]FAZA warrants further evaluation as a hypoxia PET tracer for imaging of cancer.

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Acknowledgements

We would like to thank B. Dzewas for her outstanding technical support. The study was funded by the Deutsche Forschungsgemeinschaft grant Pi 242/3-1 and MA 1096/5-1.

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Author notes

  1. M. Piert

    Present address: Division of Nuclear Medicine, Department of Radiology, University of Michigan Health System, University Hospital B1G505C, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109-0028, USA

Authors and Affiliations

  1. Department of Nuclear Medicine, Technische Universität München, Ismaningerstr. 22, 81675, Munich, Germany

    M. Souvatzoglou, B. J. Krause, R. Beck, H.-J. Wester & M. Piert

  2. Radiooncology Department, Technische Universität München, Munich, Germany

    A. L. Grosu & B. Röper

  3. Radiopharmacy, PET Center, University of Tübingen, Tübingen, Germany

    G. Reischl & H.-J. Machulla

  4. Scientific Institute San Raffaele, IBFM-CNR, University Milano-Bicocca, Milan, Italy

    M. Picchio

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  1. M. Souvatzoglou
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Souvatzoglou, M., Grosu, A.L., Röper, B. et al. Tumour hypoxia imaging with [18F]FAZA PET in head and neck cancer patients: a pilot study. Eur J Nucl Med Mol Imaging 34, 1566–1575 (2007). https://doi.org/10.1007/s00259-007-0424-3

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  • DOI: https://doi.org/10.1007/s00259-007-0424-3

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