Rasey J S, Koh W J, Evans M L, Peterson L M, Lewellen T K, Graham M M, Krohn K A
Department of Radiation Oncology, University of Washington, Seattle, 98195-6069, USA.
Int J Radiat Oncol Biol Phys. 1996 Sep 1;36(2):417-28. doi: 10.1016/s0360-3016(96)00325-2.
To assess pretreatment hypoxia in a variety of tumors using positron emission tomography (PET) after injection of the hypoxia-binding radiopharmaceutical [18F]fluoromisonidazole ([18F]FMISO).
Tumor fractional hypoxic volume (FHV) was determined in 21 nonsmall cell lung cancer patients, 7 head and neck cancer patients, 4 prostate cancer patients, and 5 patients with other malignancies by quantitative PET imaging after injection of [18F]FMISO (0.1 mCi/kg). The FHV was defined as the proportion of pixels in the imaged tumor volume with a tissue:blood [18F] activity ratio > or = 1.4 at 120-160 min postinjection. A FHV > 0 was taken as evidence for tumor hypoxia.
Hypoxia was observed in 36 of 37 tumors studied with FMISO PET imaging; FHVs ranged from 0 to 94.7%. In nonsmall cell lung cancers (n = 21), the median FHV was 47.6% and the range, 1.3 to 94.7%. There was no correlation between tumor size and FHV. In the seven head and neck carcinomas, the median FHV was 8.8%, with a range from 0.2 to 18.9%. In the group of four prostate cancers, the median and range were 18.2% and 0 to 93.9%, while in a group of five tumors of different types the median FHV was 55.2% (range: 21.4 to 85.8%).
Hypoxia was present in 97% of the tumors studied and the extent of hypoxia varied markedly between tumors in the same site or of the same histology. Hypoxia also was distributed heterogeneously between regions within a single tumor. These results are consistent with O2 electrode measures with other types of human tumors. The intra- and intertumor variability indicate the importance of making oxygenation measures in individual tumors and the necessity to sample as much of the tumor volume as possible.
在注射缺氧结合放射性药物[18F]氟米索硝唑（[18F]FMISO）后，使用正电子发射断层扫描（PET）评估多种肿瘤的治疗前缺氧情况。
通过注射[18F]FMISO（0.1mCi/kg）后的定量PET成像，在21例非小细胞肺癌患者、7例头颈癌患者、4例前列腺癌患者和5例其他恶性肿瘤患者中测定肿瘤乏氧分数体积（FHV）。FHV定义为在注射后120 - 160分钟时，成像肿瘤体积中组织与血液[18F]活性比≥1.4的像素比例。FHV＞0被视为肿瘤缺氧的证据。
在用FMISO PET成像研究的37个肿瘤中，有36个观察到缺氧；FHV范围为0至94.7%。在非小细胞肺癌（n = 21）中，FHV中位数为47.6%，范围为1.3至94.7%。肿瘤大小与FHV之间无相关性。在7例头颈癌中，FHV中位数为8.8%，范围为0.2至18.9%。在4例前列腺癌组中，中位数和范围分别为18.2%和0至93.9%，而在5例不同类型肿瘤组中，FHV中位数为55.2%（范围：21.4至85.8%）。
在所研究的肿瘤中，97%存在缺氧，并且同一部位或相同组织学类型的肿瘤之间缺氧程度差异明显。缺氧在单个肿瘤内的区域之间也呈异质性分布。这些结果与其他类型人类肿瘤的氧电极测量结果一致。肿瘤内和肿瘤间的变异性表明在个体肿瘤中进行氧合测量的重要性以及尽可能多地对肿瘤体积进行取样的必要性。
