RT Journal Article SR Electronic T1 Measurement of Tumor Hypoxia in Patients with Advanced Pancreatic Cancer Based on 18F-Fluoroazomyin Arabinoside Uptake JF Journal of Nuclear Medicine JO J Nucl Med FD Society of Nuclear Medicine SP 361 OP 366 DO 10.2967/jnumed.115.167650 VO 57 IS 3 A1 Cristiane Metran-Nascente A1 Ivan Yeung A1 Douglass C. Vines A1 Ur Metser A1 Neesha C. Dhani A1 David Green A1 Michael Milosevic A1 David Jaffray A1 David W. Hedley YR 2016 UL http://jnm.snmjournals.org/content/57/3/361.abstract 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.