Abstract
Tumour oxygenation is an important determinant of radiotherapy outcome as it could modulate cellular radiation sensitivity. Advanced PET imaging able to characterise this microenvironmental aspect in vivo might be used to devise counteracting therapies as it could provide information on the severity and the spatial distribution of the hypoxic regions. This study reviews the advantages and limitations of PET for imaging and quantifying tumour hypoxia and proposes a novel approach to obtain absolute levels of hypoxia from PET images through the use of EPR oximetry. This would offer a significant advantage over proposals based on empirical conversions of the intensities in the PET images to relative radiosensitivities. Thus, tumour hypoxia must be taken into account at the stage of treatment planning for photons and particle therapy by accounting for its extent and severity through the use of PET imaging combined with absolute EPR measurements.
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References
Vaupel P, Kallinowski F, Okunieff P (1989) Blood flow, oxygen and nutrient supply, and metabolic microenvironment of human tumors: a review. Cancer Res 49:6449–6465
Gray LH, Conger AD, Ebert M et al (1953) The concentration of oxygen dissolved in tissues at the time of irradiation as a factor in radiotherapy. Br J Radiol 26:638–648
Hockel M, Knoop C, Schlenger K et al (1993) Intratumoral pO2 predicts survival in advanced cancer of the uterine cervix. Radiother Oncol 26:45–50
Hockel M, Schlenger K, Aral B et al (1996) Association between tumor hypoxia and malignant progression in advanced cancer of the uterine cervix. Cancer Res 56:4509–4515
Brizel DM, Sibley GS, Prosnitz LR et al (1997) Tumor hypoxia adversely affects the prognosis of carcinoma of the head and neck. Int J Radiat Oncol Biol Phys 38:285–289
Rasey JS, Grunbaum Z, Magee S et al (1987) Characterization of radiolabeled fluoromisonidazole as a probe for hypoxic cells. Radiat Res 111:292–304
Lee ST, Scott AM (2007) Hypoxia positron emission tomography imaging with 18f-fluoromisonidazole. Semin Nucl Med 37:451–461
Piert M, Machulla HJ, Picchio M et al (2005) Hypoxia-specific tumor imaging with 18F-fluoroazomycin arabinoside. J Nucl Med 46:106–113
Krohn KA, Link JM, Mason RP (2008) Molecular imaging of hypoxia. J Nucl Med 49(Suppl 2):129S–148S
Lewis JS, McCarthy DW, McCarthy TJ et al (1999) Evaluation of 64Cu-ATSM in vitro and in vivo in a hypoxic tumor model. J Nucl Med 40:177–183
Grosu AL, Souvatzoglou M, Roper B et al (2007) Hypoxia imaging with FAZA-PET and theoretical considerations with regard to dose painting for individualization of radiotherapy in patients with head and neck cancer. Int J Radiat Oncol Biol Phys 69:541–551
Alber M, Paulsen F, Eschmann SM et al (2003) On biologically conformal boost dose optimization. Phys Med Biol 48:N31–N35
Flynn RT, Bowen SR, Bentzen SM et al (2008) Intensity-modulated x-ray (IMXT) versus proton (IMPT) therapy for theragnostic hypoxia-based dose painting. Phys Med Biol 53:4153–4167
Thorwarth D, Eschmann SM, Paulsen F et al (2007) Hypoxia dose painting by numbers: a planning study. Int J Radiat Oncol Biol Phys 68:291–300
Roels S, Slagmolen P, Nuyts J et al (2008) Biological image-guided radiotherapy in rectal cancer: is there a role for FMISO or FLT, next to FDG? Acta Oncol 47:1237–1248
Dasu A, Toma-Dasu I (2013) Dose painting by numbers – do the practical limitations of the technique decrease or increase the probability of controlling tumours? IFMBE Proc 39:1731–1734
Toma-Dasu I, Uhrdin J, Antonovic L et al (2012) Dose prescription and treatment planning based on FMISO-PET hypoxia. Acta Oncol 51:222–230
Toma-Dasu I, Dasu A (2013) Biologically-optimised IMRT based on molecular imaging of tumour hypoxia – the impact of the tracer used. IFMBE Proc 39:1742–1745
Toma-Dasu I, Uhrdin J, Dasu A et al (2009) Therapy optimization based on non-linear uptake of PET tracers versus "linear dose painting". IFMBE Proc 25(1):221–224
Tran LB, Bol A, Labar D et al (2012) Hypoxia imaging with the nitroimidazole 18F-FAZA PET tracer: a comparison with OxyLite, EPR oximetry and 19F-MRI relaxometry. Radiother Oncol 105:29–35
Acknowledgments
Financial support from the Cancer Research Funds of Radiumhemmet, Stockholm and the LiU Cancer research network at Linköping University and the County Council of Östergötland (Sweden) is gratefully acknowledged.
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Toma-Dasu, I., Dasu, A. (2014). Quantitative Hypoxia Imaging for Treatment Planning of Radiotherapy. In: Swartz, H.M., Harrison, D.K., Bruley, D.F. (eds) Oxygen Transport to Tissue XXXVI. Advances in Experimental Medicine and Biology, vol 812. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-0620-8_19
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DOI: https://doi.org/10.1007/978-1-4939-0620-8_19
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