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Assessment of tumor hypoxia by 62Cu-ATSM PET/CT as a predictor of response in head and neck cancer: a pilot study

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Abstract

Objective

In radiotherapy and chemotherapy tumor hypoxia is recognized as a major obstacle to effective treatment. We undertook a pilot study in patients with locally advanced head and neck cancer to determine whether there is a relationship between tumor uptake of 62Cu-ATSM and response to chemoradiotherapy.

Methods

Seventeen patients were studied using PET/CT with 62Cu-ATSM and 18F-FDG prior to the initiation of radiotherapy and chemotherapy. All patients had locally advanced head and neck cancer (stage III or IV). Tumor uptake in all patients was measured by region of interest analysis using the maximal standardized uptake value (SUVmax). A total dose of 50.4–70.2 Gy (median 70.2 Gy) was delivered in 29–39 fractions (median 39 fractions) to tumor. In patients with (non CR) and without (CR) residual/recurrent tumors at 2-year post irradiation, the statistical significance of the differences in tumor 62Cu-ATSM SUVmax, T/M ratio, 18F-FDG SUVmax and tumor volume were analyzed using Student’s t test and Welch test. The relationship between clinical outcome and 62Cu-ATSM/18F-FDG uptake patterns was analyzed using Kruskal–Wallis test. The correlation between SUVmax of 62Cu-ATSM and 18F-FDG was compared by Spearman’s rank correlation test.

Results

Two of the 17 patients that were enrolled in our study were excluded from the final analysis. Of the 15 remaining patients, 9 patients were free of disease and 6 patients had residual/recurrent tumors. The SUVmax differed significantly (p < 0.05) between patients with or without residual/recurrent tumor on 62Cu-ATSM PET/CT. Six of the 10 patients with tumors SUVmax >5.00 had residual/recurrent tumor, whereas all of the 5 patients with tumors SUVmax <5.00 were free of disease. There was no significant difference in FDG uptake between patients with and without residual/recurrent tumor.

Conclusions

The results of this pilot study suggested that 62Cu-ATSM uptake may be a predictive indicator of tumor response to chemoradiotherapy in patients with locally advanced head and neck cancer.

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Acknowledgments

We thank Dr. Tsuneo Saga, Dr. Toshimitsu Fukumura, and other staff at the Molecular Imaging Center, National Institute of Radiological Sciences, Chiba, Japan. This study was partly funded by a Grant-in-Aid for Scientific Research from the Japan Society for the Promotion of Science (17209041, 21390342) and the 21st Century COE Program (Medical Science).

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Authors and Affiliations

  1. Department of Radiology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan

    Yumiko Minagawa, Kazuya Shizukuishi, Izumi Koike, Choichi Horiuchi, Kei Watanuki, Masaharu Hata, Motoko Omura, Kazumasa Odagiri, Iwai Tohnai, Tomio Inoue & Ukihide Tateishi

  2. Department of Otorhinolaryngology and Head and Neck Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, 236-0004, Japan

    Yumiko Minagawa, Kazuya Shizukuishi, Izumi Koike, Choichi Horiuchi, Kei Watanuki, Masaharu Hata, Motoko Omura, Kazumasa Odagiri, Iwai Tohnai, Tomio Inoue & Ukihide Tateishi

  3. Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, 236-0004, Japan

    Yumiko Minagawa, Kazuya Shizukuishi, Izumi Koike, Choichi Horiuchi, Kei Watanuki, Masaharu Hata, Motoko Omura, Kazumasa Odagiri, Iwai Tohnai, Tomio Inoue & Ukihide Tateishi

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  1. Yumiko Minagawa
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  2. Kazuya Shizukuishi
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  3. Izumi Koike
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  9. Iwai Tohnai
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  10. Tomio Inoue
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  11. Ukihide Tateishi
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Corresponding author

Correspondence to Ukihide Tateishi.

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Minagawa, Y., Shizukuishi, K., Koike, I. et al. Assessment of tumor hypoxia by 62Cu-ATSM PET/CT as a predictor of response in head and neck cancer: a pilot study. Ann Nucl Med 25, 339–345 (2011). https://doi.org/10.1007/s12149-011-0471-5

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  • DOI: https://doi.org/10.1007/s12149-011-0471-5

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