PET a tool for assessing the in vivo tumour cell and its microenvironment?
BACKGROUND
Positron emission tomography (PET) has started to develop beyond its roots in glucose imaging, expanding to study other parameters of the tumour and its microenvironment.


METHODS
A review of imaging literature over the past 5 years has shown that functional imaging with PET is starting to exploit our increasing knowledge of genomics and the phenotypic expression of cells and how they interact with their microenvironment.


RESULTS
For most of those working in this field, there is agreement that therapeutic outcomes for patients can only be obtained by the assessment and continued reassessment not only of the tumour microenvironment, but also how it is changed by treatment.


RESULTS
Although PET offers a tool by which the tumour and its microenvironment can be assessed in vivo without the need for multiple interventions, the cost of PET is high and there is a cumulative radiation burden with repeated studies. As the quantity and quality of PET scans increase, we are able to assess tumour cell turn over, metabolism, hypoxia, angiogenesis and a variety of other factors that might affect tumour survival and response to treatment.


CONCLUSIONS
As it is impossible to do everything for every patient, we need to know what are the critical factors in the tumour cell microenvironment in each patient and need to have the tools to assess that factor.
Department of Nuclear Medicine and PET, Addenbrooke’s Hospital, Hills Road, Cambridge, UK. john.buscombe@addenbrookes.nhs.uk
John R
JR
Buscombe
Bernadette
B
Wong
D017209:Apoptosis; D006801:Humans; D000860:Hypoxia; D009369:Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism*; D018358:Neuroendocrine Tumors / Q000000981:diagnostic imaging / Q000378:metabolism; D049268:Positron-Emission Tomography / Q000379:methods*; D014057:Tomography, X-Ray Computed