title: Hypoxia imaging in gliomas with 18F-fluoromisonidazole PET: toward clinical translation.
abstract: There is significant interest in the development of improved image-guided therapy for neuro-oncology applications. Glioblastomas (GBM) in particular present a considerable challenge because of their pervasive nature, propensity for recurrence, and resistance to conventional therapies. MRI is routinely used as a guide for planning treatment strategies. However, this imaging modality is not able to provide images that clearly delineate tumor boundaries and affords only indirect information about key tumor pathophysiology. With the emergence of PET imaging with new oncology radiotracers, mapping of tumor infiltration and other important molecular events such as hypoxia is now feasible within the clinical setting. In particular, the importance of imaging hypoxia levels within the tumoral microenvironment is gathering interest, as hypoxia is known to play a central role in glioma pathogenesis and resistance to treatment. One of the hypoxia radiotracers known for its clinical utility is (18)F-fluoromisodazole ((18)F-FMISO). In this review, we highlight the typical causes of treatment failure in gliomas that may be linked to hypoxia and outline current methods for the detection of hypoxia. We also provide an overview of the growing body of studies focusing on the clinical translation of (18)F-FMISO PET imaging, strengthening the argument for the use of (18)F-FMISO hypoxia imaging to help optimize and guide treatment strategies for patients with glioblastoma.
authors.affiliation: CSIRO Preventative Health Flagship, CSIRO Computational Informatics, The Australian e-Health Research Centre, Herston, Queensland, Australia; CSIRO Computational Informatics, The Australian e-Health Research Centre, Herston, Queensland, Australia; School of Medicine, University of Queensland, St Lucia, Brisbane, Queensland, Australia.
authors.forename: Christopher
authors.initials: C
authors.lastname: Bell
authors.affiliation: CSIRO Preventative Health Flagship, CSIRO Computational Informatics, The Australian e-Health Research Centre, Herston, Queensland, Australia; CSIRO Computational Informatics, The Australian e-Health Research Centre, Herston, Queensland, Australia.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Dowson
authors.affiliation: Department of Radiation Oncology, Royal Brisbane and Women's Hospital, Herston, Brisbane, Queensland, Australia.
authors.forename: Mike
authors.initials: M
authors.lastname: Fay
authors.affiliation: Specialised PET Services Queensland, Royal Brisbane and Women's Hospital, Herston, Brisbane, Queensland, Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Thomas
authors.affiliation: Australian Institute for Bioengineering and Nanotechnology, The University of Queensland, St Lucia, Brisbane, Queensland, Australia.
authors.forename: Simon
authors.initials: S
authors.lastname: Puttick
authors.affiliation: Centre for Medical Diagnostic Technologies in Queensland, University of Queensland, St Lucia, Brisbane, Queensland, Australia.
authors.forename: Yaniv
authors.initials: Y
authors.lastname: Gal
authors.affiliation: CSIRO Preventative Health Flagship, CSIRO Computational Informatics, The Australian e-Health Research Centre, Herston, Queensland, Australia; CSIRO Computational Informatics, The Australian e-Health Research Centre, Herston, Queensland, Australia; School of Medicine, University of Queensland, St Lucia, Brisbane, Queensland, Australia. Electronic address: Stephen.Rose@csiro.au.
authors.forename: Stephen
authors.initials: S
authors.lastname: Rose
mesh_terms: D000818:Animals; D015687:Cell Hypoxia; D005910:Glioma / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D008920:Misonidazole / Q000031:analogs & derivatives*; D049268:Positron-Emission Tomography / Q000379:methods*; D057170:Translational Research, Biomedical / Q000379:methods*; D017211:Treatment Failure
chemical_list: C031843:fluoromisonidazole; D008920:Misonidazole