Hypoxia imaging with [18F]HX4 PET in NSCLC patients: Defining optimal imaging parameters☆

C.M. Zegers, W. van Elmpt, R. Wierts, B. Reymen, H. Sharifi, M.C. Ollers, F. Hoebers, E.G. Troost, R. Wanders, A. van Baardwijk, B. Brans, J. Eriksson, B. Windhorst, F.M. Mottaghy, D. De Ruysscher, P. Lambin

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background and purpose

[18F]HX4 is a promising hypoxia PET-tracer. Uptake, spatio-temporal stability and optimal acquisition parameters for [18F]HX4 PET imaging were evaluated in non-small cell lung cancer (NSCLC) patients.

Materials and methods

[18F]HX4 PET/CT images of 15 NSCLC patients were acquired 2 h and 4 h after injection (p.i.). Maximum standardized-uptake-value (SUVmax), tumor-to-blood-ratio (TBRmax), hypoxic fraction (HF) and contrast-to-noise-ratio (CNR) were determined for all lesions. To evaluate spatio-temporal stability, DICE-similarity and Pearson correlation coefficients were calculated. Optimal acquisition-duration was assessed by comparing 30, 20, 10 and 5 min acquisitions.

Results

Considerable uptake (TBR >1.4) was observed in 18/25 target lesions. TBRmax increased significantly from 2 h (1.6 ± 0.3) to 4 h p.i. (2.0 ± 0.6). Uptake patterns at 2 h and 4 h p.i. showed a strong correlation (R = 0.77 ± 0.10) with a DICE similarity coefficient of 0.69 ± 0.08 for the 30% highest uptake volume. Reducing acquisition-time resulted in significant changes in SUVmax and CNR. TBRmax and HF were only affected for scan-times of 5 min.

Conclusions

The majority of NSCLC lesions showed considerable [18F]HX4 uptake. The heterogeneous uptake pattern was stable between 2 h and 4 h p.i. [18F]HX4 PET imaging at 4 h p.i. is superior to 2 h p.i. to reach highest contrast. Acquisition time may be reduced to 10 min without significant effects on TBRmax and HF.

Original languageEnglish
Pages (from-to)58-64
Number of pages7
JournalRadiotherapy and Oncology
Volume109
Issue number1
DOIs
Publication statusPublished - Oct 2013

Keywords

  • NSCLC
  • Imaging
  • Hypoxia
  • PET
  • HX4
  • POSITRON-EMISSION-TOMOGRAPHY
  • CELL LUNG-CANCER
  • NECK-CANCER
  • F-18-FLUOROMISONIDAZOLE PET
  • F-18 FLUOROMISONIDAZOLE
  • HEAD
  • RADIOTHERAPY
  • CARCINOMA
  • F-18-FLUOROERYTHRONITROIMIDAZOLE
  • REPRODUCIBILITY

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