Quantifying regional hypoxia in human tumors with positron emission tomography of [18F]fluoromisonidazole: A pretherapy study of 37 patients

Use of PET and PET/CT for Radiation Therapy Planning: IAEA expert report 2006–2007

“…Uncontrolled local recurrence in the head and neck region can lead to prolonged misery and disfigurement. The results of PET studies of hypoxia imaging in H&N tumours [109][110][111][112] are provocative. A significant correlation between PET hypoxia-tracer uptake and treatment response has been reported.…”

Reproducibility of Intratumor Distribution of 18F-Fluoromisonidazole in Head and Neck Cancer

“…Rajendran et al (18) showed the feasibility of this approach using 18 F-FMISO PET to detect tissue hypoxia (corresponding to pO 2 values of ≤3 mm Hg) in imaging studies and showed that 18 F-FMISO uptake was directly related to tissue hypoxia (19). Different tumor/blood and tumor/muscle threshold ratios have been proposed as quantitative criteria for delineating hypoxic tumor volumes (19)(20)(21)(22)(23). To our knowledge, no standard PET criterion for defining hypoxia has yet been established.…”

In vivo evaluation of [18F]fluoroetanidazole as a new marker for imaging tumour hypoxia with positron emission tomography

“…Of the numerous possibilities available, the use of appropriately labelled 2-nitroimidazoles detectable by PET imaging is particularly attractive. (Jerabek et al, 1986;Koh et al, 1995;Rasey et al, 1996)) is the most widely studied radiotracer for tumour hypoxia. This radiotracer has, however, failed to gain a wider acceptance for routine clinical application in a PET setting because of a number of limitations including: (i) slow accumulation in hypoxic tumours (scanning has been performed up to 5 h p.i.…”

“…In this regard, a number of probes have been developed for imaging hypoxia by positron emission tomography (PET) and single-photon emission tomography in nuclear medicine. These include 18 F-labelled 2-nitroimidazoles such as [ 18 F]FMISO (Koh et al, 1995;Rasey et al, 1996), [ 18 F]EF5 (Ziemer et al, 2003), [ 18 F]FETNIM (Yang et al, 1995), [ 18 F]FAZA (Sorger et al, 2003), and N-(2-([ 18 F]fluoroethyl)-2-(2-nitroimidazol-1-yl)-acetamide ([ 18 F]FETA) (Rasey et al, 1999); copper bis-thiosemi-carbazones such as [ 60 Cu]ATSM (Fujibayashi et al, 1997;Dehdashti et al, 2003); technetium-based probes such as [ 99m Tc]HL-91 (Honess et al, 1998); and iodine-based probes such as [ 123 I]IAZA (Mannan et al, 1991). Due to various limitations, none of these radiotracers have found their way into routine clinical use (Workman and Brown, 1981;Nunn et al, 1995;Rasey et al, 1999;Bentzen et al, 2002).…”