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Abstract
Introduction. Polarographic oxygen-sensitive electrodes have demonstrated prognostic significance of hypoxia. However, its routine application is limited. 18F-FMISO PET scans are a noninvasive approach, able to measure spatial and temporal changes in hypoxia. The aim of this study was to examine the association between measures of hypoxia defined by functional imaging and Eppendorf pO2 electrodes. Materials and methods. A total of 18 patients were included, nine squamous cell carcinoma of the head and neck and nine soft tissue tumors. The tumor volume was defined by CT, MRI, 18FDG-PET or by clinical examination. The oxygenation status of the tumors was assessed using 18F-FMISO PET imaging followed by Eppendorf pO2 electrode measurements. Data were compared in a ‘virtual voxel’, resulting in individual histograms from each tumor. Results. The percentages of pO2 ≤ 5 mmHg ranged from 9 to 94% (median 43%) for all 18 tumors. For 18F-FMISO PET the T/M ratio ranged from 0.70 to 2.38 (median 1.13). Analyzing the virtual voxel histograms tumors could be categorized in three groups: Well oxygenated tumors with no hypoxia and concordance between the 18F-FMISO data and the Eppendorf measurements, hypoxic tumors likewise with concordance between the two assays and inconclusive tumors with no concordance between the assays. Conclusion. This study analyzed the relationship between 18F-FMISO PET and Eppendorf pO2 electrode measurements by use of a virtual voxel model. There was a spectrum of hypoxia among tumors that can be detected by both assays. However no correlation was observed, and in general tumors were more hypoxic based on Eppendorf pO2 measurements as compared to 18F-FMISO PET.
Acknowledgements
Supported by the Danish Cancer Society, CIRRO – The Lundbeck Foundation Center for Interventional Research in Radiation Oncology and The Danish Council for Strategic Research.
Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.