Hypoxia and glucose metabolism in malignant tumors:: Evaluation by [18F]fluoromisonidazole and [18F]fluorodeoxyglucose positron emission tomography imaging
Hypoxia and glucose metabolism in malignant tumors:: Evaluation by [18F]fluoromisonidazole and [18F]fluorodeoxyglucose positron emission tomography imaging
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DOI：
10.1158/1078-0432.ccr-0688-3
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发表时间：
2004-04-01
影响因子：
11.5
通讯作者：
Krohn, KA
中科院分区：
文献类型：
--
作者：
Rajendran, JG;Mankoff, DA;Krohn, KA
目的：本研究的目的是用正电子发射断层扫描(PET)比较四种不同类型肿瘤的葡萄糖代谢和缺氧情况。F-18标记的氟代脱氧葡萄糖(FDG)评估能量代谢，而F-18标记的氟异硝唑(FMISO)的摄取与组织缺氧成正比。虽然急性缺氧会加速糖酵解，但在慢性缺氧中细胞代谢会减慢，这促使我们寻找FMISO和FDG摄取之间的不一致。实验设计：49名患者(26例头颈部癌，11例软组织肉瘤，7例乳腺癌，5例多形性胶质母细胞瘤)作为研究方案的一部分，包括FMISO和FDG PET扫描。用最大标准摄取值来描述FDG摄取，用低氧体积和最大组织/血液比来定量低氧。在每个相应肿瘤平面的联合配准图像上进行逐个像素的放射性示踪剂摄取的相关性。结果：在所有四组患者中都检测到缺氧。FMISO与FDG摄取的平均相关系数头颈癌为0.62，乳腺癌为0.47，多形性胶质母细胞瘤为0.38，软组织肉瘤为0.32。肿瘤的最大标准摄取值与缺氧量之间的相关性很小(Spearman r=0.24)，不同肿瘤类型之间的相关性非常显著(P<；0.005)。结论：缺氧是影响糖代谢的一般因素，但一些缺氧性肿瘤可以有适度的糖代谢，而一些高代谢肿瘤则不缺氧，显示出示踪剂摄取不一致，可能是肿瘤类型的特异性。
Purpose: The aim of this study is to compare glucose metabolism and hypoxia in four different tumor types using positron emission tomography (PET). F-18-labeled fluorodeoxyglucose (FDG) evaluates energy metabolism, whereas the uptake of F-18-labeled fluoromisonidazole (FMISO) is proportional to tissue hypoxia. Although acute hypoxia results in accelerated glycolysis, cellular metabolism is slowed in chronic hypoxia, prompting us to look for discordance between FMISO and FDG uptake.Experimental Design: Forty-nine patients (26 with head and neck cancer, 11 with soft tissue sarcoma, 7 with breast cancer, and 5 with glioblastoma multiforme) who had both FMISO and FDG PET scans as part of research protocols through February 2003 were included in this study. The maximum standardized uptake value was used to depict FDG uptake, and hypoxic volume and maximum tissue: blood ratio were used to quantify hypoxia. Pixel-by-pixel correlation of radiotracer uptake was performed on coregistered images for each corresponding tumor plane.Results: Hypoxia was detected in all four patient groups. The mean correlation coefficients between FMISO and FDG uptake were 0.62 for head and neck cancer, 0.47 for breast cancer, 0.38 for glioblastoma multiforme, and 0.32 for soft tissue sarcoma. The correlation between the overall tumor maximum standardized uptake value for FDG and hypoxic volume was small (Spearman r = 0.24), with highly significant differences among the different tumor types (P < 0.005).Conclusions: Hypoxia is a general factor affecting glucose metabolism; however, some hypoxic tumors can have modest glucose metabolism, whereas some highly metabolic tumors are not hypoxic, showing discordance in tracer uptake that can be tumor type specific.