Peeters S G, Zegers C M, Yaromina A, Van Elmpt W, Dubois L, Lambin P
Department of Radiation Oncology (MaastRO), GROW, School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands -
Q J Nucl Med Mol Imaging. 2015 Mar;59(1):39-57. Epub 2014 Dec 17.
Hypoxia is a common characteristic of solid tumors and is associated with poor prognosis. Positron emission tomography (PET) can visualize tumor hypoxia in a non-invasive, 3-dimensional manner and can be used to acquire information longitudinally. Multiple 2-nitroimidazole based PET tracers are developed, validated and quantified in the search for the ideal hypoxia tracer and several tracers have shown to reliably represent tumor hypoxia. Furthermore, multiple studies describe the prognostic value of hypoxia PET imaging and the ability to monitor hypoxia during treatment. These applications can be of great potential and their role in treatment planning and modification needs to be further assessed with respect to personalized chemoradiation therapy. In this review we focus on the tracers that were positively validated in preclinical and clinical studies and report accurate quantification and visualization of hypoxia. The characteristics of these tracers are summarized for both preclinical and clinical studies. Furthermore, the clinical applications of hypoxia PET imaging are addressed with a focus on the ability to reliably monitor tumor hypoxia during treatment and the prognostic potential. Also the feasibility studies for hypoxia guided intensity modulated radiation therapy and the patient stratification for hypoxia targeted drugs are assessed.
缺氧是实体瘤的常见特征，与预后不良相关。正电子发射断层扫描（PET）能够以非侵入性的三维方式显示肿瘤缺氧情况，且可用于纵向获取信息。在寻找理想的缺氧示踪剂过程中，多种基于2-硝基咪唑的PET示踪剂得到开发、验证和定量，有几种示踪剂已被证明能可靠地反映肿瘤缺氧情况。此外，多项研究描述了缺氧PET成像的预后价值以及在治疗期间监测缺氧的能力。这些应用可能具有巨大潜力，其在个性化放化疗治疗计划和调整中的作用需要进一步评估。在本综述中，我们重点关注在临床前和临床研究中得到阳性验证的示踪剂，并报告缺氧情况的准确量化和可视化。总结了这些示踪剂在临床前和临床研究中的特征。此外，还探讨了缺氧PET成像的临床应用，重点关注在治疗期间可靠监测肿瘤缺氧的能力和预后潜力。同时评估了缺氧引导的调强放射治疗的可行性研究以及缺氧靶向药物的患者分层情况。
