4.7 Article

A Comparison of the Imaging Characteristics and Microregional Distribution of 4 Hypoxia PET Tracers

Journal

JOURNAL OF NUCLEAR MEDICINE
Volume 55, Issue 3, Pages 515-521

Publisher

SOC NUCLEAR MEDICINE INC
DOI: 10.2967/jnumed.113.126615

Keywords

autoradiography; animal imaging; PET; hypoxia; immunofluorescence

Funding

  1. NIH Small-Animal Imaging Research Program (SAIRP) grant [R24 CA83084]
  2. NIH Center grant [P30 CA08748]
  3. MSKCC-AstraZeneca partnership
  4. National Institutes of Health [R01 CA138468]
  5. Geoffrey Beene Cancer Research Foundation

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We compared the imaging characteristics and hypoxia selectivity of 4 hypoxia PET radiotracers (F-18-fluoromisonidazole [F-18-FMISO], F-18-flortanidazole [F-18-HX4], F-18-fluoroazomycin arabinoside [F-18-FAZA], and Cu-64-diacetyl-bis(N4-methylsemicarbazone) [Cu-64-ATSM]) in a single murine xenograft tumor model condition using small-animal PET imaging and combined ex vivo autoradiography and fluorescence immunohistochemistry. Methods: Nude mice bearing SQ20b xenograft tumors were administered 1 of 4 hypoxia PET tracers and images acquired 80-90 min after injection. Frozen sections from excised tumors were then evaluated for tracer distribution using digital autoradiography and compared with histologic markers of tumor hypoxia (pimonidazole, carbonic anydrase 9 [CA9]) and vascular perfusion (Hoechst 33342). Results: The highest tumor uptake was observed with Cu-64-ATSM (maximum standardized uptake values [SUVmax], 1.26 +/- 0.13) and the lowest with F-18-FAZA (SUVmax, 0.41 +/- 0.24). F-18-FMISO and F-18-HX4 had similar intermediate tumor uptake (SUVmax, 0.76 +/- 0.38 and 0.65 +/- 0.19, respectively). Digital autoradiographs of hypoxia tracer distribution were compared pixel by pixel with images of immunohistochemistry stains. The fluorinated nitroimidazoles all showed radiotracer uptake increasing with pimonidazole and CA9 staining. Cu-64-ATSM showed the opposite pattern, with highest radiotracer uptake observed in regions with the lowest pimonidazole and CA9 staining. Conclusion: The fluorinated nitroimidazoles showed similar tumor distributions when compared with immunohistochemistry markers of hypoxia. Variations in tumor standardized uptake value and normal tissue distribution may determine the most appropriate clinical setting for each tracer. Cu-64-ATSM showed the highest tumor accumulation and little renal clearance. However, the lack of correlation between Cu-64-ATSM distribution and immunohistochemistry hypoxia markers casts some doubt on the hypoxia selectivity of Cu-64-ATSM.

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