PT - JOURNAL ARTICLE AU - Martin H. Cherk AU - Serene S. Foo AU - Aurora M.T. Poon AU - Simon R. Knight AU - Carmel Murone AU - Anthony T. Papenfuss AU - John I. Sachinidis AU - Timothy H.C. Saunder AU - Graeme J. O'Keefe AU - Andrew M. Scott TI - Lack of Correlation of Hypoxic Cell Fraction and Angiogenesis with Glucose Metabolic Rate in Non–Small Cell Lung Cancer Assessed by <sup>18</sup>F-Fluoromisonidazole and <sup>18</sup>F-FDG PET DP - 2006 Dec 01 TA - Journal of Nuclear Medicine PG - 1921--1926 VI - 47 IP - 12 4099 - http://jnm.snmjournals.org/content/47/12/1921.short 4100 - http://jnm.snmjournals.org/content/47/12/1921.full SO - J Nucl Med2006 Dec 01; 47 AB - PET offers a noninvasive means to assess neoplasms, in view of its sensitivity and accuracy in staging tumors and potentially in monitoring treatment response. The aim of this study was to evaluate newly diagnosed non–small cell lung cancer (NSCLC) for the presence of hypoxia, as indicated by the uptake of 18F-fluoromisonidazole (18F-FMISO), and to examine the relationship of hypoxia to the uptake of 18F-FDG, microvessel density, and other molecular markers of hypoxia. Methods: Twenty-one patients with suspected or biopsy-proven NSCLC were enrolled prospectively in this study. All patients had PET studies with 18F-FMISO and 18F-FDG. Seventeen patients subsequently underwent surgery, with analysis performed for tumor markers of angiogenesis and hypoxia. Results: In the 17 patients with resectable NSCLC (13 men, 4 women; age range, 51−77 y), the mean 18F-FMISO uptake in tumor was significantly lower than that of 18F-FDG uptake (P &lt; 0.0001) and showed no correlation with 18F-FDG uptake (r = 0.26). The mean (95% confidence interval [CI]) 18F-FMISO SUVmax (maximum standardized uptake value) was 1.20 [0.95−1.45] compared with the mean [95% CI] 18F-FDG SUVmax of 5.99 [4.62−7.35]. The correlation between 18F-FMISO uptake, 18F-FDG uptake, and tumor markers of hypoxia and angiogenesis was poor. A weakly positive correlation between 18F-FMISO and 18F-FDG uptake and Ki67 was found. Conclusion: The hypoxic cell fraction of primary NSCLC is consistently low, and there is no significant correlation in NSCLC between hypoxia and glucose metabolism in NSCLC assessed by 18F-FDG. These findings have direct implications in understanding the role of angiogenesis and hypoxia in NSCLC biology.