title: PET radiopharmaceuticals for imaging of tumor hypoxia: a review of the evidence.
abstract: Hypoxia is a pathological condition arising in living tissues when oxygen supply does not adequately cover the cellular metabolic demand. Detection of this phenomenon in tumors is of the utmost clinical relevance because tumor aggressiveness, metastatic spread, failure to achieve tumor control, increased rate of recurrence, and ultimate poor outcome are all associated with hypoxia. Consequently, in recent decades there has been increasing interest in developing methods for measurement of oxygen levels in tumors. Among the image-based modalities for hypoxia assessment, positron emission tomography (PET) is one of the most extensively investigated based on the various advantages it offers, i.e., broad range of radiopharmaceuticals, good intrinsic resolution, three-dimensional tumor representation, possibility of semiquantification/quantification of the amount of hypoxic tumor burden, overall patient friendliness, and ease of repetition. Compared with the other non-invasive techniques, the biggest advantage of PET imaging is that it offers the highest specificity for detection of hypoxic tissue. Starting with the 2-nitroimidazole family of compounds in the early 1980s, a great number of PET tracers have been developed for the identification of hypoxia in living tissue and solid tumors. This paper provides an overview of the principal PET tracers applied in cancer imaging of hypoxia and discusses in detail their advantages and pitfalls.
authors: Department of Nuclear Medicine, University Hospital S. Orsola-Malpighi Bologna, Italy ; Department of Nuclear Medicine, Humanitas Clinical and Research Center Rozzano, Italy.
authors: Egesta
authors: E
authors: Lopci
authors: Department of Nuclear Medicine, University Hospital S. Orsola-Malpighi Bologna, Italy.
authors: Ilaria
authors: I
authors: Grassi
authors: Department of Nuclear Medicine, Humanitas Clinical and Research Center Rozzano, Italy.
authors: Arturo
authors: A
authors: Chiti
authors: Department of Nuclear Medicine, University Hospital S. Orsola-Malpighi Bologna, Italy.
authors: Cristina
authors: C
authors: Nanni
authors: Department of Medical Physics, University Hospital S. Orsola-Malpighi Bologna, Italy.
authors: Gianfranco
authors: G
authors: Cicoria
authors: Department of Medical Oncology, Humanitas Clinical and Research Center Rozzano, Italy.
authors: Luca
authors: L
authors: Toschi
authors: Department of Nuclear Medicine, University Hospital S. Orsola-Malpighi Bologna, Italy.
authors: Cristina
authors: C
authors: Fonti
authors: Department of Nuclear Medicine, University Hospital S. Orsola-Malpighi Bologna, Italy.
authors: Filippo
authors: F
authors: Lodi
authors: Division of Thoracic Surgery, University Hospital S. Orsola-Malpighi Bologna, Italy.
authors: Sandro
authors: S
authors: Mattioli
authors: Department of Nuclear Medicine, University Hospital S. Orsola-Malpighi Bologna, Italy.
authors: Stefano
authors: S
authors: Fanti
keywords: 18F-FAZA; 18F-FDG; 18F-FMISO; 64Cu-ATSM; Hypoxia; PET; tumor imaging