Skip to main content

Positron Emission Tomography Imaging of Blood Flow and Hypoxia in Tumors

  • Chapter
In Vivo Imaging of Cancer Therapy

Abstract

In this section, we summarize positron emission tomography (PET) imaging of tumor perfusion and hypoxia. We first summarize biological considerations, and then discuss the imaging approaches and results to date for PET imaging of tumor perfusion and tumor hypoxia. While we consider the importance of angiogenesis in the context of tumor hypoxia and tumor perfusion, we only briefly highlight recent PET imaging methods designed to specifically image angiogenesis and neovascularity. These topics are considered in more detail in other chapters in this text.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Wahl RL. Anatomolecular imaging with 2-deoxy-2-[18F]fluoro-D-glucose: Bench to outpatient center. Mol Imaging Biol 2003;5:49–56.

    PubMed  Google Scholar 

  2. Herschman HR. Molecular imaging: Looking at problems, seeing solutions. Science 2003;302:605–608.

    PubMed  CAS  Google Scholar 

  3. Chapman JD, Bradley JD, Eary JF, Haubner R, Larson SM, Michalski JM, Okunieff PG, Strauss HW, Ung YC, Welch MJ. Molecular (functional) imaging for radiotherapy applications: An RTOG symposium. Int J Radiat Oncol Biol Phys 2003;55:294–301.

    PubMed  CAS  Google Scholar 

  4. Rajendran J, Muzi M, Peterson LM, Diaz AZ, Spence AM, Schwartz DS, Krohn KA. Analyzing the results of [F-18] FMISO PET hypoxia imaging: What is the best way to quantify hypoxia? J Nucl Med 2002;43:102P.

    Google Scholar 

  5. Peters L, McKay M. Predictive assays: Will they ever have a role in the clinic? Int J Radiat Oncol Biol Phys 2001;49:501–504.

    PubMed  CAS  Google Scholar 

  6. Rowland DJ, Lewis JS, Welch MJ. Molecular imaging: The application of small animal positron emission tomography. J Cell Biochem Suppl 2002;39:110–115.

    PubMed  Google Scholar 

  7. Maclean D, Northrop JP, Padgett HC, Walsh JC. Drugs and probes: The symbiotic relationship between pharmaceutical discovery and imaging science. Mol Imaging Biol 2003;5:304–311.

    PubMed  Google Scholar 

  8. Collier TL, Lecomte R, McCarthy TJ, Meikle S, Ruth TJ, Scopinaro F, Signore A, VanBrocklin H, Van De Wiele C, Waterhouse RN. Assessment of cancer-associated biomarkers by positron emission tomography: Advances and challenges. Dis Markers 2002;18:211–247.

    PubMed  Google Scholar 

  9. Gambhir SS. Molecular imaging of cancer with positron emission tomography. Nat Rev Cancer 2002;2:683–693.

    PubMed  CAS  Google Scholar 

  10. Folkman J. Tumor angiogenesis: Therapeutic implications. N Engl J Med 1971;285:1182–1186.

    PubMed  CAS  Google Scholar 

  11. McDonald DM, Teicher BA, Stetler-Stevenson W, Ng SS, Figg WD, Folkman J, Hanahan D, Auerbach R, O’Reilly M, Herbst R, Cheresh D, Gordon M, Eggermont A, Libutti SK. Report from the Society for Biological Therapy and Vascular Biology Faculty of the NCI Workshop on Angiogenesis Monitoring. J Immunother 2004;27:161–175.

    PubMed  Google Scholar 

  12. Costouros NG, Diehn FE, Libutti SK. Molecular imaging of tumor angiogenesis. J Cell Biochem Suppl 2002;39:72–78.

    PubMed  Google Scholar 

  13. Weber WA, Haubner R, Vabuliene E, Kuhnast B, Wester HJ, Schwaiger M. Tumor angiogenesis targeting using imaging agents. Q J Nucl Med 2001;45:179–182.

    PubMed  CAS  Google Scholar 

  14. Koukourakis MI, Giatromanolaki A, Sivridis E, Fezoulidis I. Cancer vascularization: Implications in radiotherapy? Int J Radiat Oncol Biol Phys 2000;48:545–553.

    PubMed  CAS  Google Scholar 

  15. Folkman J. Role of angiogenesis in tumor growth and metastasis. Semin Oncol 2002;29:15–18.

    PubMed  CAS  Google Scholar 

  16. Jain RK. Haemodynamic and transport barriers to the treatment of solid tumors. Int J Radiat Biol 1991;60:85–100.

    PubMed  CAS  Google Scholar 

  17. Herbst RS, Hidalgo M, Pierson AS, Holden SN, Bergen M, Eckhardt SG. Angiogenesis inhibitors in clinical development for lung cancer. Semin Oncol 2002;29:66–77.

    PubMed  CAS  Google Scholar 

  18. Mankoff DA, Dunnwald LK, Gralow JR, Ellis GK, Schubert EK, Tseng, Lawton TJ, Linden HM, Livingston RB. Changes in blood flow and metabolism in locally advanced breast cancer treated with neoadjuvant chemotherapy. J Nucl Med 2003;44:1806–1814.

    PubMed  Google Scholar 

  19. Mankoff DA, Dunnwald LK, Gralow JR, Ellis GK, Charlop A, Lawton TJ, Schubert EK, Tseng J, Livingston RB. Blood flow and metabolism in locally advanced breast cancer: Relationship to response to therapy. J Nucl Med 2002;43:500–9.

    PubMed  Google Scholar 

  20. Rajendran JG, Krohn KA. Imaging hypoxia and angiogenesis in tumors. Radiol Clin North Am 2005;43:169–187.

    PubMed  Google Scholar 

  21. Anderson H, and Price P. Clinical measurement of blood flow in tumours using positron emission tomography: A review. Nucl Med Commun 2002;23:131–138.

    PubMed  CAS  Google Scholar 

  22. Lee TY, Purdie TG, Stewart E. CT imaging of angiogenesis. Q J Nucl Med 2003;47:171–87.

    PubMed  Google Scholar 

  23. Padhani AR. MRI for assessing antivascular cancer treatments. Br J Radiol 2003;76 (Spec No 1):S60–S80.

    PubMed  Google Scholar 

  24. Cosgrove D. Angiogenesis imaging—ultrasound. Br J Radiol 2003;76 (Spec No 1):S43–S49.

    PubMed  Google Scholar 

  25. Schelbert HR. Cardiac PET: Microcirculation and substrate transport in normal and diseased human myocardium. Ann Nucl Med 1994;8:91–100.

    PubMed  CAS  Google Scholar 

  26. Raichle ME, Martin WR, Herscovitch P, Mintun MA, Markham J. Brain blood flow measured with intravenous H2(15)O. II. Implementation and validation. J Nucl Med 1983;24:790–798.

    PubMed  CAS  Google Scholar 

  27. Koh T, Taniguchi H, Yamagishi H. Oxygen-15 positron-emission tomography for predicting selective delivery of a chemotherapeutic agent to hepatic cancers during angiotensin II-induced hypertension. Cancer Chemother Pharmacol 2003;51:349–358.

    PubMed  CAS  Google Scholar 

  28. Alessio AM, Kinahan PE, Cheng PM, Vesselle H, Karp JS. PET/CT scanner instrumentation, challenges, and solutions. Radiol Clin North Am 2004;42:1017–1032.

    PubMed  Google Scholar 

  29. Mathias CJ, Welch MJ, Perry DJ, McGuire AH, Zhu X, Connett JM, Green MA. Investigation of copper-PTSM as a PET tracer for tumor blood flow. Int J Rad Appl Instrum B 1991;18:807–811.

    PubMed  CAS  Google Scholar 

  30. Schmidt KC, Turkheimer FE. Kinetic modeling in positron emission tomography. Q J Nucl Med 2002;46:70–85.

    PubMed  CAS  Google Scholar 

  31. Wilson CBJH, Lammertsma AA, McKenzie CG, Sikora K, Jones T. Measurements of blood flow and exchanging water space in breast tumors using positron emission tomography: A rapid and noninvasive dynamic method. Cancer Res 1992;52:1592–1597.

    PubMed  CAS  Google Scholar 

  32. Tseng J, Dunnwald LK, Schubert EK, Link JM, Minoshima S, Muzi M, Mankoff DA. 18F-FDG kinetics in locally advanced breast cancer: Correlation with tumor blood flow and changes in response to neoadjuvant chemotherapy. J Nucl Med 2004;45:1829–1837.

    PubMed  CAS  Google Scholar 

  33. Lodge MA, Carson RE, Carrasquillo JA, Whatley M, Libutti SK, Bacharach SL. Parametric images of blood flow in oncology PET studies using [15O]water. J Nucl Med 2000;41:1784–1792.

    PubMed  CAS  Google Scholar 

  34. Mathias CJ, Green MA, Morrison WB, Knapp DW. Evaluation of Cu-PTSM as a tracer of tumor perfusion: Comparison with labeled microspheres in spontaneous canine neoplasms. Nucl Med Biol 1994;21:83–87.

    PubMed  CAS  Google Scholar 

  35. Burke D, Davies MM, Zweit J, Flower MA, Ott RJ, Dworkin MJ, Glover C, McCready VR, Carnochan P, Allen-Mersh TG. Continuous angiotensin II infusion increases tumour: Normal blood flow ratio in colo-rectal liver metastases. Br J Cancer 2001;85:1640–1645.

    PubMed  CAS  Google Scholar 

  36. Shibata T, Yamamoto K, Hayashi N, Yonekura Y, Nagara T, Saji H, Mukai T, Konishi J. Dynamic positron emission tomography with 13N-ammonia in liver tumors. Eur J Nucl Med 1998;14:607–611.

    Google Scholar 

  37. Casciari JJ, Graham MM, Rasey JS. A modeling approach for quantifying tumor hypoxia with [F-18]fluoromisonidazole PET time-activity data. Med Phys 1995;22:1127–1139.

    PubMed  CAS  Google Scholar 

  38. Zasadny KR, Tatsumi M, Wahl RL. FDG metabolism and uptake versus blood flow in women with untreated primary breast cancers. Eur J Nucl Med Mol Imaging 2003;30:274–280.

    PubMed  CAS  Google Scholar 

  39. Wells P, Jones T, Price P. Assessment of inter-and intrapatient variability in C15O2 positron emission tomography measurements of blood flow in patients with intra-abdominal cancers. Clin Cancer Res 2003;9:6350–6356.

    PubMed  Google Scholar 

  40. Flower MA, Zweit J, Hall AD, Burke D, Davies MM, Dworkin MJ, Young HE, Mundy J, Ott RJ, McCready VR, Carnochan P, Allen-Mersh TG. 62Cu-PTSM and PET used for the assessment of angiotensin II-induced blood flow changes in patients with colorectal liver metastases. Eur J Nucl Med 2001;28:99–103.

    PubMed  CAS  Google Scholar 

  41. Leenders KL. PET: Blood flow and oxygen consumption in brain tumors. J Neurooncol 1994;22:269–273.

    PubMed  CAS  Google Scholar 

  42. Mineura K, Shioya H, Kowada M, Ogawa T, Hatazawa J, Uemura K. Blood flow and metabolism of oligodendrogliomas: A positron emission tomography study with kinetic analysis of 18Ffluorodeoxyglucose. J Neurooncol 1999;43:49–57.

    PubMed  CAS  Google Scholar 

  43. Bruehlmeier M, Roelcke U, Schubiger PA, Ametamey SM. Assessment of hypoxia and perfusion in human brain tumors using PET with 18F-fluoromisonidazole and 15O-H2O. J Nucl Med 2004;45:1851–1859.

    PubMed  Google Scholar 

  44. Yamaguchi A, Taniguchi H, Kunishima S, Koh T, Yamagishi H. Correlation between angiographically assessed vascularity and blood flow in hepatic metastases in patients with colorectal carcinoma. Cancer 2000;89:1236–1244.

    PubMed  CAS  Google Scholar 

  45. Fukuda K, Taniguchi H, Koh T, Kunishima S, Yamagishi H. Relationships between oxygen and glucose metabolism in human liver tumours: Positron emission tomography using (15)O and (18)Fdeoxyglucose. Nucl Med Commun 2004;25:577–583.

    PubMed  CAS  Google Scholar 

  46. Anderson H, Yap JT, Wells P, Miller MP, Propper D, Price P, Harris AL. Measurement of renal tumour and normal tissue perfusion using positron emission tomography in a phase II clinical trial of razoxane. Br J Cancer 2003;89:262–267.

    PubMed  CAS  Google Scholar 

  47. Ponto LL, Madsen MT, Hichwa RD, Mayr N, Yuh WT, Magnotta VA, Watkins GL, Ehrhardt JC. Assessment of blood flow in solid tumors using PET. Clin Positron Imaging 1998;1:117–121.

    PubMed  Google Scholar 

  48. Lehtio K, Eskola O, Viljanen T, Oikonen V, Gronroos T, Sillanmaki L, Grenman R, Minn H. Imaging perfusion and hypoxia with PET to predict radiotherapy response in head-and-neck cancer. Int J Radiat Oncol Biol Phys 2004;59:971–982.

    PubMed  Google Scholar 

  49. Lehtio K, Oikonen V, Nyman S, Gronroos T, Roivainen A, Eskola O, Minn H. Quantifying tumour hypoxia with fluorine-18 fluoroerythronitroimidazole ([18F]FETNIM) and PET using the tumour to plasma ratio. Eur J Nucl Med Mol Imaging 2003;30:101–108.

    PubMed  Google Scholar 

  50. Lehtio K, Oikonen V, Gronroos T, Eskola O, Kalliokoski K, Bergman J, Solin O, Grenman R, Nuutila P, Minn H. Imaging of blood flow and hypoxia in head and neck cancer: Initial evaluation with [(15)O]H(2)O and [(18)F]fluoroerythronitroimidazole PET. J Nucl Med 2001;42:1643–1652.

    PubMed  CAS  Google Scholar 

  51. Muramoto S, Uematsu H, Sadato N, Tsuchida T, Matsuda T, Hatabu H, Yonekura Y, Itoh H. H(2) (15)0 positron emission tomography validation of semiquantitative prostate blood flow determined by double-echo dynamic MRI: A preliminary study. J Comput Assist Tomogr 2002;26:510–514.

    PubMed  Google Scholar 

  52. Kurdziel KA, Figg WD, Carrasquillo JA, Huebsch S, Whatley M, Sellers D, Libutti SK, Pluda JM, Dahut W, Reed E, Bacharach SL. Using positron emission tomography 2-deoxy-2-[18F]fluoro-Dglucose, 11CO, and 15O-water for monitoring androgen independent prostate cancer. Mol Imaging Biol 2003;5:86–93.

    PubMed  Google Scholar 

  53. Logan TF, Jadali F, Egorin MJ, Mintun M, Sashin D, Gooding WE, Choi Y, Bishop H, Trump DL, Gardner D, Kirkwood J, Vlock D, Johnson C. Decreased tumor blood flow as measured by positron emission tomography in cancer patients treated with interleukin-1 and carboplatin on a phase I trial. Cancer Chemother Pharmacol 2002;50:433–444.

    PubMed  CAS  Google Scholar 

  54. Herbst RS, Mullani NA, Davis DW, Hess KR, McConkey DJ, Charnsangavej C, O’Reilly MS, Kim HW, Baker C, Roach J, Ellis LM, Rashid A, Pluda J, Bucana C, Madden TL, Tran HT, Abbruzzese JL. Development of biologic markers of response and assessment of antiangiogenic activity in a clinical trial of human recombinant endostatin. J Clin Oncol 2002;20 3804–3814.

    PubMed  CAS  Google Scholar 

  55. Hanahan D, Weinberg RA. The hallmarks of cancer. Cell 2000;100:57–70.

    PubMed  CAS  Google Scholar 

  56. Simon LM, Robin ED, Theodore J. Differences in oxygen-dependent regulation of enzymes between tumor and normal cell systems in culture. J Cell Physiol 1981;108:393–400.

    PubMed  CAS  Google Scholar 

  57. Thomlinson RH, Gray LH. The histological structure of some human lung cancers and the possible implications for radiotherapy. Br J Cancer 1955;9:537–549.

    Google Scholar 

  58. Bhujwalla ZM, Artemov D, Aboagye E, Ackerstaff E, Gillies RJ, Natarajan K, Solaiyappan M. The physiological environment in cancer vascularization, invasion and metastasis. Novartis Found Symp 2001;240:23–38; discussion 38–45, 152–153.

    PubMed  CAS  Google Scholar 

  59. Folkman J. Tumor angiogenesis. Adv Cancer Res 1974;19:331–358.

    PubMed  CAS  Google Scholar 

  60. Rajendran JG, O’Sullivan F, Peterson LM, Schwartz DL, Conrad EU, Spence AM, Muzi M, Farwell DG, Krohn K. Hypoxia and glucose metabolism in malignant tumors: Evaluation by FMISO and FDG PET imaging. Clin Cancer Res 2004;10:2245–2252.

    PubMed  CAS  Google Scholar 

  61. Scandurro AB, Weldon CW, Figueroa YG, Alam J, Beckman BS. Gene microarray analysis reveals a novel hypoxia signal transduction pathway in human hepatocellular carcinoma cells. Int J Oncol 2001;19:129–135.

    PubMed  CAS  Google Scholar 

  62. Villaret DB, Wang T, Dillon D, Xu J, Sivam D, Cheever MA, Reed SG. Identification of genes overexpressed in head and neck squamous cell carcinoma using a combination of complementary DNA subtraction and microarray analysis. Laryngoscope 2000;110:374–381.

    PubMed  CAS  Google Scholar 

  63. Agani F, Semenza GL. Mersalyl is a novel inducer of vascular endothelial growth factor gene expression and hypoxia-inducible factor 1 activity. Mol Pharmacol 1998;54:49–54.

    Google Scholar 

  64. Bae MK, Kwon YW, Kim MS, Bae SK, Bae MH, Lee YM, Kim YJ, Kim KW. Identification of genes differentially expressed by hypoxia in hepatocellular carcinoma cells. Biochem Biophys Res Commun 1998;243:158–162.

    PubMed  CAS  Google Scholar 

  65. Dachs GU, Tozer GM. Hypoxia modulated gene expression: Angiogenesis, metastasis and therapeutic exploitation. Eur J Cancer 2000;36:1649–1660.

    PubMed  CAS  Google Scholar 

  66. Eisma RJ, Spiro JD, Kreutzer DL. Vascular endothelial growth factor expression in head and neck squamous cell carcinoma. Am J Surg 1997;174:513–517.

    PubMed  CAS  Google Scholar 

  67. Hockel M, Schlenger K, Hockel S, Vaupel P. Hypoxic cervical cancers with low apoptotic index are highly aggressive. Cancer Res 1999;59:4525–4528.

    PubMed  CAS  Google Scholar 

  68. Guillemin K, Krasnoq MA. The hypoxic response: Huffing and HIFing. Cell 1997;89:9–12.

    PubMed  CAS  Google Scholar 

  69. Jiang BH, Semenza GL, Bauer C, Marti HH. Hypoxia-inducible factor 1 levels vary exponentially over a physiologically relevant range of O2 tension. Am J Physiol 1996;271:C1172–C1180.

    PubMed  CAS  Google Scholar 

  70. Clavo AC, Wahl RL. Effects of hypoxia on the uptake of tritiated thymidine, L-leucine, L-methionine and FDG in cultured cancer cells. J Nucl Med 1996;37:502–506.

    PubMed  CAS  Google Scholar 

  71. Burgman P, Odonoghue JA, Humm JL, Ling CC. Hypoxia-induced increase in FDG uptake in MCF7 cells. J Nucl Med 2001;42:170–175.

    PubMed  CAS  Google Scholar 

  72. Hwang DY, Ismail-Beigi F. Glucose uptake and lactate production in cells exposed to CoCl(2) and in cells overexpressing the Glut-1 glucose transporter. Arch Biochem Biophys 2002;399:206–211.

    PubMed  CAS  Google Scholar 

  73. Ivan M, Kondo K, Yang H, Kim W, Valiando J, Ohh M, Salic A, Asara JM, Lane WS, Kaelin WG Jr. HIFalpha targeted for VHL-mediated destruction by proline hydroxylation: Implications for O2 sensing. Science 2001;292:464–468.

    PubMed  CAS  Google Scholar 

  74. Huang LE, Arany Z, Livingston D.M, Bunn HF. Activation of hypoxia-inducible transcription factor depends primarily upon redox-sensitive stabilization of its alpha subunit. J Biol Chem 1996;271:32253–32259.

    PubMed  CAS  Google Scholar 

  75. Guillemin K, Krasnow MA. The hypoxic response: Huffing and HIFing. Cell 1997;89:9–12.

    PubMed  CAS  Google Scholar 

  76. Bos R, Zhong H, Hanrahan CF, Mommers EC, Semenza GL, Pinedo HM, Abeloff MD, Simons JW, van Diest PJ, van der Wall E. Levels of hypoxia-inducible factor-1 alpha during breast carcinogenesis. J Natl Cancer Inst 2001;93:309–314.

    PubMed  CAS  Google Scholar 

  77. Zhong H, De Marzo AM, Laughner E, Lim M, Hilton DA, Zagzag D, Buechler P, Isaacs WB, Semenza GL, Simons JW. Overexpression of hypoxia-inducible factor 1alpha in common human cancers and their metastases. Cancer Res 1999;59:5830–5835.

    PubMed  CAS  Google Scholar 

  78. Marxsen JH, Schmitt O, Metzen E, Jelkmann W, Hellwig-Burgel T. Vascular endothelial growth factor gene expression in the human breast cancer cell line MX-1 is controlled by O2 availability in vitro and in vivo. Ann Anat 2001;183:243–249.

    PubMed  CAS  Google Scholar 

  79. Yaziji H, Gown AM. Immunohistochemical analysis of gynecologic tumors. Int J Gynecol Pathol 2001;20:64–78.

    PubMed  CAS  Google Scholar 

  80. Hall EJ. Radiobiology for the Radiologist. Philadelphia, PA: Lippincott Williams & Wilkins, 2000.

    Google Scholar 

  81. Marples B, Greco O, Joiner MC, Scott SD. Molecular approaches to chemo-radiotherapy. Eur J Cancer 2002;38:231–239.

    PubMed  CAS  Google Scholar 

  82. Overgaard J, Horsman MR. Modification of hypoxia-induced radioresistance in tumors by the use of oxygen and sensitizers. Semin Radiat Oncol 1996;6:10–21.

    PubMed  Google Scholar 

  83. Fowler JF. Eighth annual Juan del Regato lecture. Chemical modifiers of radiosensitivity—theory and reality: a review. Int J Radiat Oncol Biol Phys 1985;11:665–674.

    PubMed  CAS  Google Scholar 

  84. Frommhold H, Guttenberger R, Henke M. The impact of blood hemoglobin content on the outcome of radiotherapy. The Freiburg experience. Strahlenther Onkol 1998;174(Suppl 4):31–34.

    PubMed  Google Scholar 

  85. Evans SM, Koch CJ. Prognostic significance of tumor oxygenation in humans. Cancer Lett 2003;195:1–16.

    PubMed  CAS  Google Scholar 

  86. Koong AC, Denk NC, Hudson KM, Schindler C, Swiersz L, Koch C, Evans S, Ibrahim H. Le QT, Terris DJ, Giaccia AJ. Candidate genes for the hypoxic tumor phenotype. Cancer Res 2000;60:883–887.

    PubMed  CAS  Google Scholar 

  87. Blancher C, Moore JW, Talks KL, Houlbrook S, Harris AL. Relationship of hypoxia-inducible factor (HIF)-1alpha and HIF-2alpha expression to vascular endothelial growth factor induction and hypoxia survival in human breast cancer cell lines. Cancer Res 2000;60:7106–7113.

    PubMed  CAS  Google Scholar 

  88. Sutherland RM. Tumor hypoxia and gene expression—implications for malignant progression and therapy. Acta Oncol 1998;37:567–574.

    PubMed  CAS  Google Scholar 

  89. Amellem O, Pettersen EO. Cell inactivation and cell cycle inhibition as induced by extreme hypoxia: The possible role of cell cycle arrest as a protection against hypoxia-induced lethal damage. Cell Prolif 1991;24:127–141.

    PubMed  CAS  Google Scholar 

  90. Moulder JE, Rockwell S. Tumor hypoxia: Its impact on cancer therapy. Cancer Metastasis Rev 1987;5:313–341.

    PubMed  CAS  Google Scholar 

  91. Brown MJ. The hypoxic cell: A target for selective cancer therapy—Eighteenth Bruce F. Cain memorial award lecture. Cancer Res 1999;59:5863–70.

    PubMed  CAS  Google Scholar 

  92. Hockel M, Schlenger K, Knoop C, Vaupel P. Oxygenation of carcinoma of the uterine cervix: Evaluation by computerized oxygen tension measurements. Cancer Res 1991;51:6098–6102.

    PubMed  CAS  Google Scholar 

  93. Koh WJ, Bergman KS, Rasey JS, Peterson LM, Evans ML, Graham MM, Grierson JR, Lindsley KL, Lewellen TK, Krohn KA, et al. Evaluation of oxygenation status during fractionated radiotherapy in human nonsmall cell lung cancers using [F-18]fluoromisonidazole positron emission tomography. Int J Radiat Oncol Biol Phys 1995;33:391–398.

    PubMed  CAS  Google Scholar 

  94. Rajendran JG, Wilson D, Conrad EU, Peterson LM, Bruckner JD, Rasey JS, Chin LK, Hofstrand PD, Grierson JR, Eary JF, Krohn KA. F-18 FMISO and F-18 FDG PET imaging in soft tissue sarcomas: Correlation of hypoxia, metabolism and VEGF expression. Eur J Nuc Med 2003;30:695–704.

    CAS  Google Scholar 

  95. Rajendran JGNP, Peterson LM, Schwartz DL, Scharnhrost J, Conrad EU, Grierson JR, Krohn KA. F-18 FMISO PET tumor hypoxia imaging: Investigating the tumor volume-hypoxia connection. J Nucl Med 2003;44:1340, 1376P.

    Google Scholar 

  96. Adam M, Gabalski EC, Bloch DA, Ochlert JW, Brown JM, Elsaid AA, Pinto HA, Terris DJ. Tissue oxygen distribution in head and neck cancer patients. Head Neck 1999;21:146–153.

    PubMed  CAS  Google Scholar 

  97. Blancher C, Harris AL. The molecular basis of the hypoxia response pathway: Tumour hypoxia as a therapy target. Cancer Metastasis Rev 1998;17:187–194.

    PubMed  CAS  Google Scholar 

  98. Brown JM. Exploiting the hypoxic cancer cell: Mechanisms and therapeutic strategies. Mol Med Today 2000;6:157–162.

    PubMed  CAS  Google Scholar 

  99. Rajendran JGMJ, Schwartz DL, Kinahan PE, Cheng P, Hummel SM, Lewellen B, Philips M, Krohn KA. Imaging with F-18 FMISO-PET permits hypoxia directed radiotherapy dose escalation for head and neck cancer. J Nucl Med 2003;44:415, 127P.

    Google Scholar 

  100. Chao KS, Bosch WR, Mutic S, Lewis JS, Dehdashti F, Mintun MA, Dempsey JF, Perez CA, Purdy JA, Welch MJ. A novel approach to overcome hypoxic tumor resistance: Cu-ATSM-guided intensitymodulated radiation therapy. Int J Radiat Oncol Biol Phys 2001;49:1171–1182.

    PubMed  CAS  Google Scholar 

  101. Lee DJ, Moini M, Giuliano J, Westra WH. Hypoxic sensitizer and cytotoxin for head and neck cancer. Ann Acad Med Singapore 1996;25:397–404.

    PubMed  CAS  Google Scholar 

  102. Sartorelli AC, Hodnick WF. Mitomycin C: A prototype bioreductive agent. Oncol Res 1994;6:501–508.

    PubMed  CAS  Google Scholar 

  103. Denny WA, Wilson WR. Tirapazamine: A bioreductive anticancer drug that exploits tumour hypoxia. Expert Opin Investig Drugs 2000;9:2889–2901.

    PubMed  CAS  Google Scholar 

  104. von Pawel J, von Roemeling R, Gatzemeier U, Boyer M, Elisson LO, Clark P, Talbot D, Rey A, Butler TW, Hirsh V, Olver I, Bergman B, Ayoub J, Richardson G, Dunlop D, Arcenas A, Vescio R, Viallet J, Treat J. Tirapazamine plus cisplatin versus cisplatin in advanced non-small-cell lung cancer: A report of the international CATAPULT I study group. Cisplatin and Tirapazamine in Subjects with Advanced Previously Untreated Non-Small-Cell Lung Tumors. J Clin Oncol 2000;18:1351–1359.

    Google Scholar 

  105. Rischin D, Peters L, Hicks R, Hughes P, Fisher R, Hart R, Sexton M, D’Costa I, von Roemeling R. Phase I trial of concurrent tirapazamine, cisplatin, and radiotherapy in patients with advanced head and neck cancer. J Clin Oncol 2001;19:535–542.

    PubMed  CAS  Google Scholar 

  106. Vordermark D, Brown JM. Endogenous markers of tumor hypoxia predictors of clinical radiation resistance? Strahlenther Onkol 2003;179:801–811.

    PubMed  Google Scholar 

  107. Hockel M, Schlenger K, Knoop C, Vaupel P. Oxygenation of carcinomas of the uterine cervix: Evaluation by computerized O2 tension measurments. Cancer Res 1991;51:6098–6102.

    PubMed  CAS  Google Scholar 

  108. Brizel DM, Sibley GS, Prosnitz LR, Scher RL, Dewhirst MW. Tumor hypoxia adversely affects the prognosis of carcinoma of the head and neck. Int J Radat Oncol Biol Phys 1997;38:285–289.

    CAS  Google Scholar 

  109. Lartigau E, Lusinchi A, Weeger P, Wibault P, Luboinski B, Eschwege F, Guichard M. Variations in tumour oxygen tension (pO2) during accelerated radiotherapy of head and neck carcinoma. Eur J Cancer 1998;34:856–861.

    PubMed  CAS  Google Scholar 

  110. Ng PRJ, Peterson LM, Schwartz DL, Scharnhrost J, Krohn KA. Can F-18 fluoromisonidazole PET imaging predict treatment response in head and neck cancer? J Nucl Med 2003;44:416, 128P.

    Google Scholar 

  111. Muzi M, Spence AM, Rajendran JG, Grierson JR, Krohn KA. Glioma patients assessed with FMISO and FDG: Two tracers provide different information. J Nucl Med 2003;44:878, 243P.

    Google Scholar 

  112. Valk P, Mathis C, Prados M, Gilbert J, Budinger T. Hypoxia in human gliomas: Demonstration by PET with flouorine-18-fluoromisonidazole. J Nucl Med 1992;33:2133–2137.

    PubMed  CAS  Google Scholar 

  113. Rajendran J, Peterson L, Schwartz DS, Muzi M, Scharnhorst JD, Eary JF, Krohn KA. [F-18] FMISO PET hypoxia imaging in head and neck cancer: Heterogeneity in hypoxia—primary tumor vs lymph nodal metastases. J Nucl Med 2002;43:73P.

    Google Scholar 

  114. Stone HB, Brown JM, Phillips TL, Sutherland RM. Oxygen in human tumors: Correlations between methods of measurement and response to therapy. Summary of a workshop held November 19–20, 1992, at the National Cancer Institute, Bethesda, Maryland. Radiat Res 1993;136:422–434.

    PubMed  CAS  Google Scholar 

  115. Hockel M, Vaupel, P. Tumor hypoxia: Definitions and current clinical, biologic, and molecular aspects. J Natl Cancer Inst 2001;93:266–276.

    PubMed  CAS  Google Scholar 

  116. Rasey JS, Casciari JJ, Hofstrand PD, Muzi M, Graham MM, Chin LK. Determining hypoxic fraction in a rat glioma by uptake of radiolabeled fluoromisonidazole. Radiat Res 2000;153:84–92.

    PubMed  CAS  Google Scholar 

  117. Vaupel P, Kelleher DK, Hockel M. Oxygen status of malignant tumors: Pathogenesis of hypoxia and significance for tumor therapy. Semin Oncol 2001;28:29–35.

    PubMed  CAS  Google Scholar 

  118. Nozue M, Lee I, Yuan F, et al.Interlaboratory variation in oxygen tension measurement by Eppendorf “histograph” and comparision withhypoxic marker. J Surg Oncol 1997;66:30–38.

    PubMed  CAS  Google Scholar 

  119. Lartigau E, Le Ridant AM, Lambin P, Weeger P, Martin L, Sigal R, Lusinchi A, Luboinski B, Eschwege F, Guichard M. Oxygenation of head and neck tumors. Cancer 1993;71:2319–2325.

    PubMed  CAS  Google Scholar 

  120. Brizel DM, Rosner GL, Harrelson J, Prosnitz LR, Dewhirst MW. Pretreatment oxygenation profiles of human soft tissue sarcomas. Int J Radiation Oncol Biol Phys 1994;30:635–642.

    CAS  Google Scholar 

  121. Prekeges JL, Rasey JS, Grunbaum Z, Krohn KH. Reduction of fluoromisonidazole, a new imaging agent for hypoxia. Biochem Pharmacol 1991;42:2387–2395.

    PubMed  CAS  Google Scholar 

  122. Chapman JD, Engelhardt EL, Stobbe CC, Schneider RF, Hanks GE. Measuring hypoxia and predicting tumor radioresistance with nuclear medicine assays. Radiother Oncol 1998;46:229–237.

    PubMed  CAS  Google Scholar 

  123. Grierson JR, Link JM, Mathis CA, Rasey JS, Krohn KA. Radiosynthesis of of fluorine-18 fluoromisonidazole. J Nucl Med 1989;30:343–350.

    PubMed  CAS  Google Scholar 

  124. Rasey JS, Koh WJ, Evans ML, Peterson LM, Lewellen TK, Graham MM, Krohn KA. Quantifying regional hypoxia in human tumors with positron emission tomography of [18F]fluoromisonidazole: A pretherapy study of 37 patients. Int J Radiat Oncol Biol Phys 1996;36:417–428.

    PubMed  CAS  Google Scholar 

  125. Rajendran JG, Mankoff DA, O’Sullivan F, Peterson LM, Schwartz DL, Conrad EU, Spence AM, Muzi M, Farwell DG, Krohn KA. Hypoxia and glucose metabolism in malignant tumors: Evaluation by [(18)f]fluoromisonidazole and [(18)f]fluorodeoxyglucose positron emission tomography imaging. Clin Cancer Res 2004;10:2245–2252.

    PubMed  CAS  Google Scholar 

  126. Liu RS, Chu LS, Yen SH, Chang CP, Chou KL, Wu LC, Chang CW, Lui MT, Chen KY, Yeh SH. Detection of anaerobic odontogenic infections by fluorine-18 fluoromisonidazole. Eur J Nucl Med 1996;23:1384–1387.

    PubMed  CAS  Google Scholar 

  127. Bentzen L, Keiding S, Horsman MR, Falborg L, Hansen SB, Overgaard J. Feasibility of detecting hypoxia in experimental mouse tumours with 18F-fluorinated tracers and positron emission tomography—a study evaluating [18F]fluoro-2-deoxy-D-glucose. Acta Oncol 2000;39:629–637.

    PubMed  CAS  Google Scholar 

  128. Read SJ, Hirano T, Abbott DF, Sachinidis JI, Tochon-Danguy HJ, Chan JG, Egan GF, Scott AM, Bladin CF, McKay WJ, Donnan GA. Identifying hypoxic tissue after acute ischemic stroke using PET and 18F-fluoromisonidazole. Neurology 1998;51:1617–1621.

    PubMed  CAS  Google Scholar 

  129. Yeh SH, Liu RS, Wu LC, Yang DJ, Yen SH, Chang CW, Yu TW, Chou KL, Chen KY. Fluorine-18 fluoromisonidazole tumour to muscle retention ratio for the detection of hypoxia in nasopharyngeal carcinoma. Eur J Nucl Med 1996;23:1378–1383.

    PubMed  CAS  Google Scholar 

  130. Dubois L, Landuyt W, Haustermans K, Dupont P, Bormans G, Vermaelen P, Flamen P, Verbeken E, Mortelmans L. Evaluation of hypoxia in an experimental rat tumour model by [(18)F]fluoromisonid azole PET and immunohistochemistry. Br J Cancer 2004;91:1947–1954.

    PubMed  CAS  Google Scholar 

  131. Graham MM, Peterson LM, Link JM, Evans ML, Rasey JS, Koh WJ, Caldwell JH, Krohn KA. Fluorine-18-fluoromisonidazole radiation dosimetry in imaging studies. J Nucl Med 1997;38:1631–1636.

    PubMed  CAS  Google Scholar 

  132. Rasey JS, Koh WJ, Grierson JR, Grunbaum Z, Krohn KA. Radiolabelled fluoromisonidazole as an imaging agent for tumor hypoxia. Int J Radiat Oncol Biol Phys 1989;17:985–991.

    PubMed  CAS  Google Scholar 

  133. Martin GV, Caldwell JH, Graham MM, Grierson JR, Kroll K, Cowan MJ, Lewellen TK, Rasey JS, Casciari JJ, Krohn KA. Noninvasive detection of hypoxic myocardium using fluorine-18-fluoromisonidazole and positron emission tomography. J Nucl Med 1992;33:2202–2208.

    PubMed  CAS  Google Scholar 

  134. Koh WJ, Rasey JS, Evans ML, Grierson JR, Lewellen TK, Graham MM, Krohn KA, Griffin TW. Imaging of hypoxia in human tumors with [F-18]fluoromisonidazole. Int J Radiat Oncol Biol Phys 1992;22:199–212.

    PubMed  CAS  Google Scholar 

  135. Chapman JD, Schneider RF, Urbain JL, Hanks GE. Single-photon emission computed tomography and positron-emission tomography assays for tissue oxygenation. Semin Radiat Oncol 2001;11:47–57.

    PubMed  CAS  Google Scholar 

  136. Nunn A, Linder K, Strauss HW. Nitroimidazoles and imaging hypoxia. Eur J Nucl Med 1995;22:265–280.

    PubMed  CAS  Google Scholar 

  137. Biskupiak JE, Krohn KA. Second generation hypoxia imaging agents [editorial; comment]. J Nucl Med 1993;34:411–413.

    PubMed  CAS  Google Scholar 

  138. Kachur AV, Dolbier WR Jr, Evans SM, Shiue CY, Shiue GG, Skov KA, Baird IR, James BR, Li AR, Roche A, Koch CJ. Synthesis of new hypoxia markers EF1 and [18F]-EF1. Appl Radiat Isot 1999;51:643–650.

    PubMed  CAS  Google Scholar 

  139. Tewson TJ. Synthesis of [18F]fluoroetanidazole: A potential new tracer for imaging hypoxia. Nucl Med Biol 1997;24:755–760.

    PubMed  CAS  Google Scholar 

  140. Wiebe LI, Stypinski D. Pharmacokinetics of SPECT radiopharmaceuticals for imaging hypoxic tissues. Q J Nucl Med 1996;40:270–284.

    PubMed  CAS  Google Scholar 

  141. Siim BG, Laux WT, Rutland MD, Palmer BN, Wilson WR. Scintigraphic imaging of the hypoxia marker (99m)technetium-labeled 2,2′-(1,4-diaminobutane)bis(2-methyl-3-butanone) dioxime (99mTc-labeled HL-91; prognox): Noninvasive detection of tumor response to the antivascular agent 5,6-dimethylxanthenone-4-acetic acid. Cancer Res 2000;60:4582–4588.

    PubMed  CAS  Google Scholar 

  142. Rumsey WL, Kuczynski B, Patel B, Bauer A, Narra R.K, Eaton SM, Nunn AD, Strauss HW. SPECT imaging of ischemic myocardium using a technetium-99m-nitroimidazole ligand. J Nucl Med 1995;36:1445–1450.

    PubMed  CAS  Google Scholar 

  143. Stypinski D, Wiebe LI, McEwan AJ, Schmidt RP, Tam YK, Mercer JR. Clinical pharmacokinetics of 123I-IAZA in healthy volunteers. Nucl Med Commun 1999;20:559–667.

    PubMed  CAS  Google Scholar 

  144. Shelton ME, Green MA, Mathias CJ, Welch MJ, Bergmann SR. Assessment of regional myocardial and renal blood flow with copper-PTSM and positron emission tomography. Circulation 1990;82:990–997.

    PubMed  CAS  Google Scholar 

  145. Lewis JS, McCarthy DW, McCarthy TJ, Fujibayashi Y, Welch MJ. Evaluation of Cu-64-ATSM in vitro and in vivo in a hypoxic model. J Nucl Med 1999;40:177–183.

    PubMed  CAS  Google Scholar 

  146. Dehdashti F, Mintun MA, Lewis JS, Bradley J, Govindan R, Laforest R, Welch MJ, Siegel BA. In vivo assessment of tumor hypoxia in lung cancer with 60Cu-ATSM. Eur J Nucl Med Mol Imaging 2003;30:844–850.

    PubMed  CAS  Google Scholar 

  147. Fujibayashi Y, Taniuchi H, Yonekura Y, Ohtani H, Konishi J, Yokoyama A. Copper-62-ATSM: A new hypoxia imaging agent with high membrane permeability and low redox potential. J Nucl Med 1997;38:1155–1160.

    PubMed  CAS  Google Scholar 

  148. Ballinger JR. Imaging hypoxia in tumors. Semin Nucl Med 2001;31:321–329.

    PubMed  CAS  Google Scholar 

  149. Gabalski EC, Adam M, Pinto H, Brown JM, Bloch DA, Terris DJ. Pretreatment and midtreatment measurement of oxygen tension levels in head and neck cancers. Laryngoscope 1998;108:1856–1860.

    PubMed  CAS  Google Scholar 

  150. Klabbers BM, Lammertsma AA, Slotman BJ. The value of positron emission tomography for monitoring response to radiotherapy in head and neck cancer. Mol Imaging Biol 2003;5:257–270.

    PubMed  Google Scholar 

  151. Alber M, Paulsen F, Eschmann SM, Machulla HJ. On biologically conformal boost dose optimization. Phys Med Biol 2003;48:N31–N35.

    PubMed  CAS  Google Scholar 

  152. Buatti J, Yao M, Dornfeld K, Skwarchuk M, Hoffman HT, Funk GF, Smith RB, Graham SM, Menda Y, Graham MM. Efficacy of IMRT in head and neck cancer as monitored by post-RT PET scans. Int J Radiat Oncol Biol Phys 2003;57:S305.

    Google Scholar 

  153. Ling CC, Humm J, Larson S, Amols H, Fuks Z, Leibel S, Koutcher JA. Towards multidimensional radiotherapy (MD-CRT): Biological imaging and biological conformality. Int J Radiat Oncol Biol Phys 2000;47:551–60.

    PubMed  CAS  Google Scholar 

  154. Peters LJ. Targeting hypoxia in head and neck cancer. Acta Oncol 2001;40:937–940.

    PubMed  CAS  Google Scholar 

  155. Solomon B, McArthur G, Cullinane C, Zalcberg J, Hicks R. Applications of positron emission tomography in the development of molecular targeted cancer therapeutics. BioDrugs 2003;17:339–354.

    PubMed  CAS  Google Scholar 

  156. Klimas MT. Positron emission tomography and drug discovery: Contributions to the understanding of pharmacokinetics, mechanism of action and disease state characterization. Mol Imaging Biol 2002;4:311–337.

    PubMed  Google Scholar 

  157. Hammond LA, Denis L, Salman U, Jerabek P, Thomas CR Jr, Kuhn JG. Positron emission tomography (PET): Expanding the horizons of oncology drug development. Invest New Drugs 2003;21:309–340.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2007 Humana Press Inc., Totowa, NJ

About this chapter

Cite this chapter

Rajendran, J.G., Mankoff, D.A. (2007). Positron Emission Tomography Imaging of Blood Flow and Hypoxia in Tumors. In: Shields, A.F., Price, P. (eds) In Vivo Imaging of Cancer Therapy. Cancer Drug Discovery and Development. Humana Press. https://doi.org/10.1007/978-1-59745-341-7_4

Download citation

  • DOI: https://doi.org/10.1007/978-1-59745-341-7_4

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-633-7

  • Online ISBN: 978-1-59745-341-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics