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Assessment of hypoxic subvolumes in laryngeal cancer with F-18-fluoroazomycinarabinoside (F-18-FAZA)-PET/CT scanning and immunohistochemistry

Bruine de Bruin, L., Bollineni, V. R., Wachters, J. E., Schuuring, E., van Hemel, B. M., van der Wal, J. E., Slagter-Menkema, L., de Bock, G. H., Steenbakkers, R. J. H. M., Langendijk, J. A., Pruim, J., van der Laan, B. F. A. M. & Halmos, G. B., Oct-2015, In : Radiotherapy and Oncology. 117, 1, p. 106-112 7 p.

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  • Assessment of hypoxic subvolumes in laryngeal cancer with F-18-fluoroazomycinarabinoside (F-18-FAZA)

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Background and purpose: F-18-fluoroazomycinarabinoside (F-18-FAZA) is a promising hypoxia radiopharmaceutical agent with outstanding biokinetic parameters. We aimed to determine the accuracy of F-18-FAZA-PET/CT scan in detecting hypoxic regions within the tumor using immunohistochemical markers in a pilot study.

Patients and methods: Eleven patients with primary or recurrent laryngeal squamous cell carcinoma were indicated for total laryngectomy (TLE). Patients underwent F-18-FAZA-PET/CT scan before TLE. Hypoxic regions inside the laryngeal tumor were determined. After TLE, regions with high uptake on F-18-FAZA-PET scan were selected for immunohistochemical examination for exogenous (pimonidazole) and endogenous (HIFI alpha, CA-IX and GLUT-1) hypoxia markers. To assess the accuracy of F-18-FAZA-PET scanning, radiopharmacon accumulation was related with immunohistochemical expression of hypoxia markers.

Results: Inter- and intratumoral heterogeneity of tumor hypoxia was observed on F-18-FAZA-PET scan. Nine of the eleven tumors were hypoxic with F-18-FAZA-PET. Hypoxia could also be detected with pimonidazole, HIFI alpha, CA-IX and GLUT-1 expression in some tumors. No clear association was observed between F-18-FAZA uptake and hypoxia markers.

Conclusions: This pilot study could not prove the accuracy of F-18-FAZA-PET in determining hypoxic sub-volumes in laryngeal cancer. Further study is required to investigate the benefit of F-18-FAZA-PET imaging in radiotherapy planning. (C) 2015 Elsevier Ireland Ltd. All rights reserved.

Original languageEnglish
Pages (from-to)106-112
Number of pages7
JournalRadiotherapy and Oncology
Volume117
Issue number1
Publication statusPublished - Oct-2015

    Keywords

  • F-18-FAZA-PET, Hypoxia markers, Laryngeal cancer, Tumor hypoxia, SQUAMOUS-CELL CARCINOMA, POSITRON-EMISSION-TOMOGRAPHY, TUMOR HYPOXIA, NECK-CANCER, CA-IX, HEAD, RADIOTHERAPY, PET, PIMONIDAZOLE, EXPRESSION

ID: 22824046