Format

Send to

Choose Destination
Lung Cancer. 2015 Oct;90(1):55-60. doi: 10.1016/j.lungcan.2015.07.015. Epub 2015 Jul 30.

Characterization of hypoxia in malignant pleural mesothelioma with FMISO PET-CT.

Author information

1
School of Medicine and Pharmacology, University of Western Australia, Crawley 6009 & Department of Nuclear Medicine/WA PET Service, Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia. Electronic address: roslyn.francis@uwa.edu.au.
2
Department of Nuclear Medicine/WA PET Service, Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia.
3
RAPID labs, Medical Technology and Physics, Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia.
4
School of Medicine and Pharmacology, University of Western Australia, Crawley 6009 & Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia.
5
School of Medicine and Pharmacology, University of Western Australia, Crawley 6009 & Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia.
6
PathWest, Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia.

Abstract

OBJECTIVES:

Malignant pleural mesothelioma (MPM) is a chemotherapy resistant tumor with a poor prognosis. Hypoxia is increasingly recognized as an important factor in tumor aggressiveness and cellular resistance to chemotherapy and radiation treatment. This prospective pilot study was performed with [F-18] fluoromisonidazole (FMISO) PET-CT to characterize hypoxia in patients with MPM.

MATERIALS AND METHODS:

Twenty prospectively recruited patients with histologically or cytologically confirmed MPM not currently receiving systemic or local treatment underwent both FMISO and fluorodeoxyglucose (FDG) PET-CT scans within 2 weeks. FMISO and FDG PET-CT scans were independently analyzed visually and semi-quantitatively using SUVmax and tumor to background ratio (TBR) in order to assess tumor hypoxia and metabolic activity. Lesion by lesion analysis was performed in sites of measurable pleural masses.

RESULTS:

Visual analysis demonstrated tumor FMISO activity in 17 of 20 patients, and tumor FDG activity in 19 of 20 patients. Focal areas of bulky tumor were most likely to demonstrate hypoxia. In 19 patients suitable for semi-quantitative analysis the median FDG SUVmax was 6.4 (range 1.9-19.1), median FMISO SUVmax was 2.5 (range 1.4-3.7) and median FMISO TBR was 1.8 (1.1-2.5). There was a positive correlation between intensity of metabolic activity and hypoxia (r=0.72, p=0.001). Lesion by lesion analysis demonstrated a positive correlation between tumor thickness and FMISO activity (r=0.77, p<0.001).

CONCLUSION:

This pilot study confirms that MPM is a tumor with significant areas of hypoxia, particularly in dominant tumor masses. The relationship of tumor hypoxia to effectiveness of chemotherapy and/or radiation therapy warrants prospective assessment.

KEYWORDS:

Hypoxia; Mesothelioma; PET

PMID:
26259878
DOI:
10.1016/j.lungcan.2015.07.015
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center