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An Imaging Comparison of ⁶⁴Cu-ATSM and ⁶⁰Cu-ATSM in Cancer of the Uterine Cervix

¹ Division of Radiological Sciences, Mallinckrodt Institute of Radiology, St. Louis, Missouri; ² Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, Missouri; ³ Division of Nuclear Medicine, Mallinckrodt Institute of Radiology, St. Louis, Missouri; and ⁴ Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri

View larger version (10K): [in this window] [in a new window]   FIGURE 1.  Activity ratios of hot cylinders to background, with cylinders of 8-, 12-, 16-, and 25-mm diameter for 64Cu and 60Cu (without and with cascade coincidence subtraction [CS]). Ratios of hot cylinder to uniform area in A are averages within cylinder and in B are peak values. Values were normalized to expected ratio of 9.87 to be equal to 1.

View larger version (12K): [in this window] [in a new window]   FIGURE 2.  Correlation of 60Cu-ATSM uptake (without and with cascade subtraction [CS]) and 64Cu-ATSM uptake in 10 patients with cervical cancer. Results are expressed as T/M ratios. Good correlation between uptakes of these 2 radiotracers was found. This analysis was performed to demonstrate that similar T/M ratios can be obtained with both nuclides and that applying 60Cu cascade coincidence correction improves comparability of measured T/M ratios. Linear regressions were determined by setting y-intercept to zero and slope derived from least-square minimization.

View larger version (37K): [in this window] [in a new window]   FIGURE 3.  (A) Transaxial CT (top left) and 18F-FDG PET (top right) images of pelvis show intense 18F-FDG uptake within known cervical tumor at site of cervical mass seen on CT. Transaxial 30- to 60-min summed images of 60Cu-ATSM PET (bottom left) and 64Cu-ATSM PET (bottom right) of pelvis at same level demonstrate mildly increased uptake within known primary cervical tumor. There are similar patterns of 60Cu-ATSM and 64Cu-ATSM uptake within tumor. (B) Transaxial coregistered 18F-FDG PET/CT (top left) and 18F-FDG PET (top right) images of pelvis show intense 18F-FDG uptake within known cervical tumor at site of cervical mass seen on CT. Transaxial 30- to 60-min summed images of 60Cu-ATSM PET (bottom left) and 64Cu-ATSM PET (bottom right) of pelvis at same level demonstrate markedly increased uptake within known primary cervical tumor. There are similar patterns of 60Cu-ATSM and 64Cu-ATSM uptake within tumor.