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Influence of the scan time point when assessing hypoxia in F-18-fluoromisonidazole PET : 2 vs. 4 h

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Title: Influence of the scan time point when assessing hypoxia in F-18-fluoromisonidazole PET : 2 vs. 4 h
Authors: Kobayashi, Kentaro Browse this author
Manabe, Osamu Browse this author →KAKEN DB
Hirata, Kenji Browse this author →KAKEN DB
Yamaguchi, Shigeru Browse this author
Kobayashi, Hiroyuki Browse this author
Terasaka, Shunsuke Browse this author →KAKEN DB
Toyonaga, Takuya Browse this author
Furuya, Sho Browse this author
Magota, Keiichi Browse this author →KAKEN DB
Kuge, Yuji Browse this author →KAKEN DB
Kudo, Kohsuke Browse this author →KAKEN DB
Shiga, Tohru Browse this author →KAKEN DB
Tamaki, Nagara Browse this author →KAKEN DB
Keywords: Fluoromisonidazole
Positron emission tomography
Scan timing
This article is part of the Topical Collection on Oncology - Brain
Issue Date: Jul-2020
Publisher: Springer
Journal Title: European Journal of Nuclear Medicine and Molecular Imaging
Volume: 47
Start Page: 1833
End Page: 1842
Publisher DOI: 10.1007/s00259-019-04626-8
Abstract: Purpose F-18-fluoromisonidazole (F-18-FMISO) is the most widely used positron emission tomography (PET) tracer for imaging tumor hypoxia. Previous reports suggested that the time from injection to the scan may affect the assessment of F-18-FMISO uptake. Herein, we directly compared the images at 2 h and 4 h after a single injection of F-18-FMISO. Methods Twenty-three patients with or suspected of having a brain tumor were scanned twice at 2 and 4 h following an intravenous injection of F-18-FMISO. We estimated the mean standardized uptake value (SUV) of the gray matter and white matter and the gray-to-white matter ratio in the background brain tissue from the two scans. We also performed a semi-quantitative analysis using the SUVmax and maximum tumor-to-normal ratio (TNR) for the tumor. Results At 2 h, the SUVmean of gray matter was significantly higher than that of white matter (median 1.23, interquartile range (IQR) 1.10-1.32 vs. 1.04, IQR 0.95-1.16, p < 0.0001), whereas at 4 h, it significantly decreased to approach that of the white matter (1.10, IQR 1.00-1.23 vs. 1.02, IQR 0.93-1.13, p = NS). The gray-to-white matter ratio thus significantly declined from 1.17 (IQR 1.14-1.19) to 1.09 (IQR 1.07-1.10) (p < 0.0001). All 7 patients with glioblastoma showed significant increases in the SUVmax (2.20, IQR 1.67-3.32 at 2 h vs. 2.65, IQR 1.74-4.41 at 4 h, p = 0.016) and the TNR (1.75, IQR 1.40-2.38 at 2 h vs. 2.34, IQR 1.67-3.60 at 4 h, p = 0.016). Conclusion In the assessment of hypoxic tumors, F-18-FMISO PET for hypoxia imaging should be obtained at 4 h rather than 2 h after the injection.
Rights: This is a post-peer-review, pre-copyedit version of an article published in European Journal of Nuclear Medicine and Molecular Imaging. The final authenticated version is available online at:
Type: article (author version)
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 真鍋 治

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