Tumor hypoxia imaging with [F-18] fluoromisonidazole positron emission tomography in head and neck cancer

Joseph G. Rajendran, David L. Schwartz, Janet O'Sullivan, Lanell M. Peterson, Patrick Ng, Jeffrey Scharnhorst, John R. Grierson, Kenneth A. Krohn

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280 Scopus citations

Abstract

Purpose: Advanced head and neck cancer shows hypoxia that results in biological changes to make the tumor cells more aggressive and less responsive to treatment resulting in poor survival. [F-18] fluoromisonidazole (FMISO) positron emission tomography (PET) has the ability to noninvasively quantify regional hypoxia. We investigated the prognostic effect of pretherapy FMISO-PET on survival in head and neck cancer. Experimental Design: Seventy-three patients with head and neck cancer had pretherapy FMISO-PET and 53 also had fluorodeoxyglucose (FDG) PET under a research protocol from April 1994 to April 2004. Results: Significant hypoxia was identified in 58 patients (79%). The mean FMISO tumor/bloodmax (T/Bmax) was 1.6 and the mean hypoxic volume (HV) was 40.2 mL. There were 28 deaths in the follow-up period. Mean FDG standard uptake value (SUV)max was 10.8. The median time for follow-up was 72 weeks. In a univariate analysis, T/Bmax (P = 0.002), HV (P = 0.04), and the presence of nodes (P = 0.01) were strong independent predictors. In a multivariate analysis, including FDG SUV max, no variable was predictive at P < 0.05. When FDG SUV max was removed from the model (resulting in n = 73 with 28 events), nodal status and T/Bmax (or HV) were both highly predictive (P = 0.02,0.006 for node and T/Bmax, respectively; P = 0.02 and 0.001 for node and HV, respectively). Conclusions: Pretherapy FMISO uptake shows a strong trend to be an independent prognostic measure in head and neck cancer.

Original languageEnglish (US)
Pages (from-to)5435-5441
Number of pages7
JournalClinical Cancer Research
Volume12
Issue number18
DOIs
StatePublished - Sep 15 2006

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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    Rajendran, J. G., Schwartz, D. L., O'Sullivan, J., Peterson, L. M., Ng, P., Scharnhorst, J., Grierson, J. R., & Krohn, K. A. (2006). Tumor hypoxia imaging with [F-18] fluoromisonidazole positron emission tomography in head and neck cancer. Clinical Cancer Research, 12(18), 5435-5441. https://doi.org/10.1158/1078-0432.CCR-05-1773