Effects of hyperoxygenation on FDG-uptake in head-and-neck cancer.
OBJECTIVE
Tumor hyperoxygenation results in high response rates to ARCON (accelerated radiotherapy with carbogen and nicotinamide). The effect of hyperoxygenation on tumor metabolism using [(18)F]fluorodeoxyglucose (FDG) positron emission tomography (PET) was investigated.


METHODS
Within one week, FDG-PET was performed without and with hyperoxygenation by carbogen breathing and/or nicotinamide administration in 22 patients, eligible for ARCON for head-and-neck cancer. Maximum standardized uptake values (SUV(max)) in both scans and the relative change were calculated in the primary tumor and in normal muscle.


RESULTS
Alteration of the tumor oxygenation state induced profound, but variable, metabolic changes (median DeltaSUV(max) -4%; range -61% to +30%). Metabolism in normal muscle was not affected. In three patients who did not achieve local tumor control, the SUV(max) after hyperoxygenation differed less than 5% change as compared to baseline, whereas 13 of the 16 patients with local tumor control showed a larger difference (p<0.05).


CONCLUSIONS
Given the heterogeneous response pattern of nicotinamide and carbogen on FDG-uptake in head-and-neck carcinoma, the prognostic significance of semiquantitative FDG-PET before and after hyperoxygenation remains uncertain and requires confirmation in larger clinical studies before introducing the procedure as a predictive tool for oxygenation modifying treatments.
de Geus-Oei
Lioe-Fee
LF
Department of Nuclear Medicine, Radbound University Nijmegen Medical Center, The Netherlands. L.degeus-oei@nucmed.umcn.nl
Kaanders
Johannes H A M
JH
Pop
Luc A M
LA
Corstens
Frans H M
FH
Oyen
Wim J G
WJ
D000368:Aged; D000369:Aged, 80 and over; D002244:Carbon / Q000737:chemistry; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009536:Niacinamide / Q000737:chemistry; D010100:Oxygen / Q000737:chemistry / Q000378:metabolism*; D049268:Positron-Emission Tomography; D011379:Prognosis; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics*; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D009536:Niacinamide; D002244:Carbon; D010100:Oxygen