PT - JOURNAL ARTICLE AU - Cristiane Metran-Nascente AU - Ivan Yeung AU - Douglass C. Vines AU - Ur Metser AU - Neesha C. Dhani AU - David Green AU - Michael Milosevic AU - David Jaffray AU - David W. Hedley TI - Measurement of Tumor Hypoxia in Patients with Advanced Pancreatic Cancer Based on <sup>18</sup>F-Fluoroazomyin Arabinoside Uptake AID - 10.2967/jnumed.115.167650 DP - 2016 Mar 01 TA - Journal of Nuclear Medicine PG - 361--366 VI - 57 IP - 3 4099 - http://jnm.snmjournals.org/content/57/3/361.short 4100 - http://jnm.snmjournals.org/content/57/3/361.full SO - J Nucl Med2016 Mar 01; 57 AB - Pancreatic cancers are thought to be unusually hypoxic, which might sensitize them to drugs that are activated under hypoxic conditions. In order to develop this idea in the clinic, a minimally invasive technique for measuring the oxygenation status of pancreatic cancers is needed. Methods: We tested the potential for minimally invasive imaging of hypoxia in pancreatic cancer patients, using the 2-nitroimidazole PET tracer 18F-fluoroazomycin arabinoside (or 18F-1-α-d-[5-fluoro-5-deoxyarabinofuranosyl]-2-nitroimidazole [18F-FAZA]). Dynamic and static scans were obtained in 21 patients with either locally advanced or metastatic disease. The hypoxic fraction was determined in the 2-h static scans as the percentage of voxels with SUVs more than 3 SDs from the mean values obtained for skeletal muscle. Results: Hypoxia was detected in 15 of 20 evaluable patients, with the hypoxic fraction ranging from less than 5% to greater than 50%. Compartmental analysis of the dynamic scans allowed us to approximate the tumor perfusion as mL/min/g of tissue, a value that is independent of the extent of hypoxia derived from tracer uptake in the 2-h static scan. There was no significant correlation between tumor perfusion and hypoxia; nor did we see an association between tumor volume and hypoxia. Conclusion: Although pancreatic cancers can be highly hypoxic, a substantial proportion appears to be well oxygenated. Therefore, we suggest that a minimally invasive technique such as the one described in this study be used for patient stratification in future clinical trials of hypoxia-targeting agents.