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Eur J Nucl Med Mol Imaging. 2018 Feb;45(2):161-169. doi: 10.1007/s00259-017-3857-3. Epub 2017 Oct 26.

Repeatability of tumour hypoxia imaging using [18F]EF5 PET/CT in head and neck cancer.

Author information

1
Turku PET Centre, University of Turku, P.O. BOX 52, FI-20521, Turku, Finland. anmisi@utu.fi.
2
Department of Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital, P.O. BOX 52, FI-20521, Turku, Finland. anmisi@utu.fi.
3
Department of Oncology and Radiotherapy, Turku University Hospital, P.O. BOX 52, FI-20521, Turku, Finland.
4
Department of Medical Physics, Turku University Hospital, P.O. BOX 52, FI-20521, Turku, Finland.
5
Turku PET Centre, University of Turku, P.O. BOX 52, FI-20521, Turku, Finland.
6
Department of Biostatistics, University of Turku, Turku, Finland.
7
Department of Pathology, Turku University Hospital, P.O. BOX 52, FI-20521, Turku, Finland.

Abstract

PURPOSE:

Hypoxia contributes to radiotherapy resistance and more aggressive behaviour of several types of cancer. This study was designed to evaluate the repeatability of intratumour uptake of the hypoxia tracer [18F]EF5 in paired PET/CT scans.

METHODS:

Ten patients with newly diagnosed head and neck cancer (HNC) received three static PET/CT scans before chemoradiotherapy: two with [18F]EF5 a median of 7 days apart and one with [18F]FDG. Metabolically active primary tumour volumes were defined in [18F]FDG images and transferred to co-registered [18F]EF5 images for repeatability analysis. A tumour-to-muscle uptake ratio (TMR) of 1.5 at 3 h from injection of [18F]EF5 was used as a threshold representing hypoxic tissue.

RESULTS:

In 10 paired [18F]EF5 PET/CT image sets, SUVmean, SUVmax, and TMR showed a good correlation with the intraclass correlation coefficients of 0.81, 0.85, and 0.87, respectively. The relative coefficients of repeatability for these parameters were 15%, 17%, and 10%, respectively. Fractional hypoxic volumes of the tumours in the repeated scans had a high correlation using the Spearman rank correlation test (r = 0.94). In a voxel-by-voxel TMR analysis between the repeated scans, the mean of Pearson correlation coefficients of individual patients was 0.65. The mean (± SD) difference of TMR in the pooled data set was 0.03 ± 0.20.

CONCLUSION:

Pretreatment [18F]EF5 PET/CT within one week shows high repeatability and is feasible for the guiding of hypoxia-targeted treatment interventions in HNC.

KEYWORDS:

18F-EF5; Head and neck cancer; Hypoxia; Pet; Repeatability

PMID:
29075831
PMCID:
PMC5745570
DOI:
10.1007/s00259-017-3857-3
[Indexed for MEDLINE]
Free PMC Article

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