title: Correlation of (18)F-fluoromisonidazole PET findings with HIF-1α and p53 expressions in head and neck cancer: comparison with (18)F-FDG PET.
abstract: OBJECTIVE
  We evaluated tumor hypoxia using F-fluoromisonidazole (F-FMISO) PET in relation to the expression of hypoxia-inducible factor-1α (HIF-1α) and p53 in patients with head and neck cancer and compared the results with those obtained using 2-deoxy-2-F-fluoro-D-glucose (F-FDG) PET.
  
  
  METHODS
  A total of 28 tumors (23 primary tumors and five metastatic lymph nodes) from 24 patients with newly diagnosed head and neck cancer were examined with F-FMISO PET and F-FDG PET. The F-FMISO PET images were scaled to the venous blood concentration of F-FMISO activity to produce tumor-to-blood (T/B) values. Hypoxia was defined as a region with a T/B ratio greater than or equal to 1.2. The maximum T/B (T/Bmax) and hypoxic volumes were calculated by region-of-interest analysis. For F-FDG PET, the maximum standardized uptake value (SUVmax) and hypermetabolic volume were calculated by region-of-interest analysis. The expressions of HIF-1α and p53 using immunohistochemistry were estimated in tumor tissue samples.
  
  
  RESULTS
  A weak correlation was observed between hypoxic volume and T/Bmax (r=0.53, P=0.003) on using F-FMISO PET and between hypermetabolic volume and SUVmax (r=0.38, P=0.046) on using F-FDG PET. The hypoxic volume using F-FMISO PET and hypermetabolic volume using F-FDG PET also showed a weak correlation (r=0.44, P=0.020). The values of F-FMISO hypoxic volume showed a weak correlation with HIF-1α (r=0.40, P=0.037) and p53 (r=0.47, P=0.012) obtained on immunohistochemical examination.
  
  
  CONCLUSIONS
  This study demonstrates a weak correlation between hypoxic volume measured by F-FMISO PET and expressions of HIF-1α and p53 in head and neck cancer.
authors.affiliation: Departments of aRadiology bMedical Physics cDiagnostic Pathology dOral and Maxillofacial Surgery eOtolaryngology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Norikane
authors.forename: Yuka
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Yukito
authors.initials: Y
authors.lastname: Maeda
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Kudomi
authors.forename: Toru
authors.initials: T
authors.lastname: Matsunaga
authors.forename: Reiji
authors.initials: R
authors.lastname: Haba
authors.forename: Akinori
authors.initials: A
authors.lastname: Iwasaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hoshikawa
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Nishiyama
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001692:Biological Transport; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism; D015972:Gene Expression Regulation, Neoplastic; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism; D006801:Humans; D051795:Hypoxia-Inducible Factor 1, alpha Subunit / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D008920:Misonidazole / Q000031:analogs & derivatives* / Q000378:metabolism; D049268:Positron-Emission Tomography; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism*
chemical_list: C497442:HIF1A protein, human; D051795:Hypoxia-Inducible Factor 1, alpha Subunit; D016159:Tumor Suppressor Protein p53; C031843:fluoromisonidazole; D019788:Fluorodeoxyglucose F18; D008920:Misonidazole