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Pharmacokinetic analysis of [18F]FAZA in non-small cell lung cancer patients

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

[18F]Fluoroazomycin arabinoside (FAZA) is a positron emission tomography (PET) tracer developed to enable identification of hypoxic regions within a tumour. The aims of this study were to determine the optimal kinetic model along with validation of using alternatives to arterial blood sampling for analysing [18F]FAZA studies and to assess the validity of simplified analytical methods.

Methods

Dynamic 70-min [18F]FAZA PET/CT scans were obtained from nine non-small cell lung cancer patients. Continuous arterial blood sampling, together with manual arterial and venous sampling, was performed to derive metabolite-corrected plasma input functions. Volumes of interest (VOIs) were defined for tumour, healthy lung muscle and adipose tissue generating [18F]FAZA time-activity curves (TACs). TACs were analysed using one- and two-tissue compartment models using both metabolite-corrected blood sampler plasma input functions (BSIF) and image-derived plasma input functions (IDIF).

Results

The reversible two-tissue compartment model with blood volume parameter (2T4k+VB) best described kinetics of [18F]FAZA in tumours. Volumes of distribution (VT) obtained using IDIF correlated well with those derived using BSIF (R 2 = 0.82). Venous samples yielded the same radioactivity concentrations as arterial samples for times >50 min post-injection (p.i.). In addition, both plasma to whole blood ratios and parent fractions were essentially the same for venous and arterial samples. Both standardised uptake value (SUV), normalised to lean body mass, and tumour to blood ratio correlated well with VT (R 2 = 0.77 and R 2 = 0.87, respectively, at 50–60 min p.i.), although a bias was observed at low VT.

Conclusion

The 2T4k+VB model provided the best fit to the dynamic [18F]FAZA data. IDIF with venous blood samples can be used as input function. Further data are needed to validate the use of simplified methods.

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Acknowledgements

The authors would like to thank members of the Department of Radiology & Nuclear Medicine for tracer production and data acquisition. This study was performed within the framework of the Center for Translational Molecular Medicine (CTMM), which provided financial support (AIRFORCE project, grant 03O-103).

Conflicts of interest

None.

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Authors and Affiliations

  1. Department of Radiology & Nuclear Medicine, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands

    Eline E. Verwer, Floris H. P. van Velden, Maqsood Yaqub, Robert C. Schuit, Albert D. Windhorst, Pieter Raijmakers, Adriaan A. Lammertsma & Ronald Boellaard

  2. Department of Pulmonary Diseases, VU University Medical Center, Amsterdam, The Netherlands

    Idris Bahce & Egbert F. Smit

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  1. Eline E. Verwer
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  2. Floris H. P. van Velden
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Correspondence to Eline E. Verwer.

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Verwer, E.E., van Velden, F.H.P., Bahce, I. et al. Pharmacokinetic analysis of [18F]FAZA in non-small cell lung cancer patients. Eur J Nucl Med Mol Imaging 40, 1523–1531 (2013). https://doi.org/10.1007/s00259-013-2462-3

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