TY - JOUR T1 - Whole-Body PET/CT Evaluation of Tumor Perfusion Using Generator-Based <sup>62</sup>Cu-Ethylglyoxal <em>Bis</em>(Thiosemicarbazonato)Copper(II): Validation by Direct Comparison to <sup>15</sup>O-Water in Metastatic Renal Cell Carcinoma JF - Journal of Nuclear Medicine JO - J Nucl Med SP - 56 LP - 62 DO - 10.2967/jnumed.114.148106 VL - 56 IS - 1 AU - James W. Fletcher AU - Theodore F. Logan AU - Jacob A. Eitel AU - Carla J. Mathias AU - Yen Ng AU - Jeffrey L. Lacy AU - Gary D. Hutchins AU - Mark A. Green Y1 - 2015/01/01 UR - http://jnm.snmjournals.org/content/56/1/56.abstract N2 - This study was undertaken to demonstrate the feasibility of whole-body 62Cu-ethylglyoxal bis(thiosemicarbazonato)copper(II) (62Cu-ETS) PET/CT tumor perfusion imaging in patients with metastatic renal carcinoma and to validate 62Cu-ETS as a quantitative marker of tumor perfusion by direct comparison with 15O-water perfusion imaging. Methods: PET/CT imaging of 10 subjects with stage IV renal cell cancer was performed after intravenous administration of 15O-water (10-min dynamic list-mode study) with the heart and at least 1 tumor in the PET field of view, followed 10 min later by intravenous 62Cu-ETS (6-min list-mode study). Whole-body 62Cu imaging was then performed from 6 to 20 min at 2–3 min/bed position. Blood flow (K1) was quantified with both agents for normal and malignant tissues in the 21.7-cm dynamic field of view. The required arterial input functions were derived from the left atrium and, in the case of 62Cu-ETS, corrected for partial decomposition of the agent by blood with data from an in vitro analysis using a sample of each patient’s blood. This imaging protocol was repeated at an interval of 3–4 wk after initiation of a standard clinical treatment course of the antiangiogenic agent sunitinib. Results: All subjects received the scheduled 62Cu-ETS doses for the dynamic and subsequent whole-body PET/CT scans, but technical issues resulted in no baseline 15O-water data for 2 subjects. Direct comparisons of the perfusion estimates for normal tissues and tumor metastases were made in 18 paired baseline and treatment studies (10 subjects; 8 baseline studies, 10 repeated studies during treatment). There was an excellent correlation between the blood flow estimates made with 62Cu-ETS and 15O-water for normal tissues (muscle, thyroid, myocardium) and malignant lesions (pulmonary nodules, bone lesions); the regression line was y = 0.85x + 0.15, R2 = 0.83, for the 88 regions analyzed. Conclusion: 62Cu-ETS provided high-quality whole-body PET/CT images, and 62Cu-ETS measures of blood flow were highly and linearly correlated with 15O-water–derived K1 values (mL−1⋅min−1⋅g). This tracer is suitable for use as a PET tracer of tumor perfusion in patients with metastatic renal cell carcinoma. ER -