Characterization of hypoxia in malignant pleural mesothelioma with FMISO PET-CT

Roslyn Francis, T. Segard, L. Morandeau, Gary Lee, Michael Millward, A. Segal, Anna Nowak

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

© 2015. Objectives: Malignant pleural mesothelioma (MPM) is a chemotherapy resistant tumor with a poor prognosis. Hypoxia is increasingly recognized as an important factor in tumor aggressiveness and cellular resistance to chemotherapy and radiation treatment. This prospective pilot study was performed with [F-18] fluoromisonidazole (FMISO) PET-CT to characterize hypoxia in patients with MPM. Materials and methods: Twenty prospectively recruited patients with histologically or cytologically confirmed MPM not currently receiving systemic or local treatment underwent both FMISO and fluorodeoxyglucose (FDG) PET-CT scans within 2 weeks. FMISO and FDG PET-CT scans were independently analyzed visually and semi-quantitatively using SUVmax and tumor to background ratio (TBR) in order to assess tumor hypoxia and metabolic activity. Lesion by lesion analysis was performed in sites of measurable pleural masses. Results: Visual analysis demonstrated tumor FMISO activity in 17 of 20 patients, and tumor FDG activity in 19 of 20 patients. Focal areas of bulky tumor were most likely to demonstrate hypoxia. In 19 patients suitable for semi-quantitative analysis the median FDG SUVmax was 6.4 (range 1.9-19.1), median FMISO SUVmax was 2.5 (range 1.4-3.7) and median FMISO TBR was 1.8 (1.1-2.5). There was a positive correlation between intensity of metabolic activity and hypoxia (r = 0.72, p = 0.001). Lesion by lesion analysis demonstrated a positive correlation between tumor thickness and FMISO activity (r = 0.77, p <0.001). Conclusion: This pilot study confirms that MPM is a tumor with significant areas of hypoxia, particularly in dominant tumor masses. The relationship of tumor hypoxia to effectiveness of chemotherapy and/or radiation therapy warrants prospective assessment.
Original languageEnglish
Pages (from-to)55-60
JournalLung Cancer
Volume90
Issue number1
DOIs
Publication statusPublished - 2015

Fingerprint

Neoplasms
Drug Therapy
Malignant Mesothelioma
Hypoxia
Positron Emission Tomography Computed Tomography
fluoromisonidazole
Radiotherapy
Prospective Studies
Radiation
Therapeutics
Tumor Hypoxia

Cite this

@article{1e3576d91f1b4a368e806ae2627f2fb2,
title = "Characterization of hypoxia in malignant pleural mesothelioma with FMISO PET-CT",
abstract = "{\circledC} 2015. Objectives: Malignant pleural mesothelioma (MPM) is a chemotherapy resistant tumor with a poor prognosis. Hypoxia is increasingly recognized as an important factor in tumor aggressiveness and cellular resistance to chemotherapy and radiation treatment. This prospective pilot study was performed with [F-18] fluoromisonidazole (FMISO) PET-CT to characterize hypoxia in patients with MPM. Materials and methods: Twenty prospectively recruited patients with histologically or cytologically confirmed MPM not currently receiving systemic or local treatment underwent both FMISO and fluorodeoxyglucose (FDG) PET-CT scans within 2 weeks. FMISO and FDG PET-CT scans were independently analyzed visually and semi-quantitatively using SUVmax and tumor to background ratio (TBR) in order to assess tumor hypoxia and metabolic activity. Lesion by lesion analysis was performed in sites of measurable pleural masses. Results: Visual analysis demonstrated tumor FMISO activity in 17 of 20 patients, and tumor FDG activity in 19 of 20 patients. Focal areas of bulky tumor were most likely to demonstrate hypoxia. In 19 patients suitable for semi-quantitative analysis the median FDG SUVmax was 6.4 (range 1.9-19.1), median FMISO SUVmax was 2.5 (range 1.4-3.7) and median FMISO TBR was 1.8 (1.1-2.5). There was a positive correlation between intensity of metabolic activity and hypoxia (r = 0.72, p = 0.001). Lesion by lesion analysis demonstrated a positive correlation between tumor thickness and FMISO activity (r = 0.77, p <0.001). Conclusion: This pilot study confirms that MPM is a tumor with significant areas of hypoxia, particularly in dominant tumor masses. The relationship of tumor hypoxia to effectiveness of chemotherapy and/or radiation therapy warrants prospective assessment.",
author = "Roslyn Francis and T. Segard and L. Morandeau and Gary Lee and Michael Millward and A. Segal and Anna Nowak",
year = "2015",
doi = "10.1016/j.lungcan.2015.07.015",
language = "English",
volume = "90",
pages = "55--60",
journal = "Lung Cancer",
issn = "0169-5002",
publisher = "Elsevier",
number = "1",

}

Characterization of hypoxia in malignant pleural mesothelioma with FMISO PET-CT. / Francis, Roslyn; Segard, T.; Morandeau, L.; Lee, Gary; Millward, Michael; Segal, A.; Nowak, Anna.

In: Lung Cancer, Vol. 90, No. 1, 2015, p. 55-60.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Characterization of hypoxia in malignant pleural mesothelioma with FMISO PET-CT

AU - Francis, Roslyn

AU - Segard, T.

AU - Morandeau, L.

AU - Lee, Gary

AU - Millward, Michael

AU - Segal, A.

AU - Nowak, Anna

PY - 2015

Y1 - 2015

N2 - © 2015. Objectives: Malignant pleural mesothelioma (MPM) is a chemotherapy resistant tumor with a poor prognosis. Hypoxia is increasingly recognized as an important factor in tumor aggressiveness and cellular resistance to chemotherapy and radiation treatment. This prospective pilot study was performed with [F-18] fluoromisonidazole (FMISO) PET-CT to characterize hypoxia in patients with MPM. Materials and methods: Twenty prospectively recruited patients with histologically or cytologically confirmed MPM not currently receiving systemic or local treatment underwent both FMISO and fluorodeoxyglucose (FDG) PET-CT scans within 2 weeks. FMISO and FDG PET-CT scans were independently analyzed visually and semi-quantitatively using SUVmax and tumor to background ratio (TBR) in order to assess tumor hypoxia and metabolic activity. Lesion by lesion analysis was performed in sites of measurable pleural masses. Results: Visual analysis demonstrated tumor FMISO activity in 17 of 20 patients, and tumor FDG activity in 19 of 20 patients. Focal areas of bulky tumor were most likely to demonstrate hypoxia. In 19 patients suitable for semi-quantitative analysis the median FDG SUVmax was 6.4 (range 1.9-19.1), median FMISO SUVmax was 2.5 (range 1.4-3.7) and median FMISO TBR was 1.8 (1.1-2.5). There was a positive correlation between intensity of metabolic activity and hypoxia (r = 0.72, p = 0.001). Lesion by lesion analysis demonstrated a positive correlation between tumor thickness and FMISO activity (r = 0.77, p <0.001). Conclusion: This pilot study confirms that MPM is a tumor with significant areas of hypoxia, particularly in dominant tumor masses. The relationship of tumor hypoxia to effectiveness of chemotherapy and/or radiation therapy warrants prospective assessment.

AB - © 2015. Objectives: Malignant pleural mesothelioma (MPM) is a chemotherapy resistant tumor with a poor prognosis. Hypoxia is increasingly recognized as an important factor in tumor aggressiveness and cellular resistance to chemotherapy and radiation treatment. This prospective pilot study was performed with [F-18] fluoromisonidazole (FMISO) PET-CT to characterize hypoxia in patients with MPM. Materials and methods: Twenty prospectively recruited patients with histologically or cytologically confirmed MPM not currently receiving systemic or local treatment underwent both FMISO and fluorodeoxyglucose (FDG) PET-CT scans within 2 weeks. FMISO and FDG PET-CT scans were independently analyzed visually and semi-quantitatively using SUVmax and tumor to background ratio (TBR) in order to assess tumor hypoxia and metabolic activity. Lesion by lesion analysis was performed in sites of measurable pleural masses. Results: Visual analysis demonstrated tumor FMISO activity in 17 of 20 patients, and tumor FDG activity in 19 of 20 patients. Focal areas of bulky tumor were most likely to demonstrate hypoxia. In 19 patients suitable for semi-quantitative analysis the median FDG SUVmax was 6.4 (range 1.9-19.1), median FMISO SUVmax was 2.5 (range 1.4-3.7) and median FMISO TBR was 1.8 (1.1-2.5). There was a positive correlation between intensity of metabolic activity and hypoxia (r = 0.72, p = 0.001). Lesion by lesion analysis demonstrated a positive correlation between tumor thickness and FMISO activity (r = 0.77, p <0.001). Conclusion: This pilot study confirms that MPM is a tumor with significant areas of hypoxia, particularly in dominant tumor masses. The relationship of tumor hypoxia to effectiveness of chemotherapy and/or radiation therapy warrants prospective assessment.

U2 - 10.1016/j.lungcan.2015.07.015

DO - 10.1016/j.lungcan.2015.07.015

M3 - Article

VL - 90

SP - 55

EP - 60

JO - Lung Cancer

JF - Lung Cancer

SN - 0169-5002

IS - 1

ER -