Purpose: Our aims were to assess the feasibility of imaging hypoxia in cervical carcinoma with 18F-fluoroerythronitroimidazole (18F-FETNIM) and to compare 18F-FETNIM uptake with metabolic uptake of 18F-FDG.
Patients and Methods: We included 16 patients with cervical carcinoma. After imaging with FDG, 18F-FETNIM PET/CT was performed and tumor-to-muscle (T/M) ratio uptake was assessed. 18F- FETNIM uptake was correlated to FDG uptake and osteopontin (OPN), a marker of hypoxia, and patients’ outcomes.
Results: All tumors were detected by 18F-FDG PET. 18F-FETNIM T/M ratios ranged from 1.3 to 5.4. There was no significant correlation between 18F-FETNIM and 18F-FDG uptake. High 18F-FETNIM uptake (T/M > 3.2) was associated with reduced progression-free survival (log-rank = 0.002) and overall survival (log-rank = 0.02). Osteopontin ranged from 39 to 662 μg/L (median, 102.5 μg/L). Patients with OPN greater than 144 μg/L had reduced progression-free survival compared with those with OPN less than 144 μg/L (log-rank = 0.03). We found no significant correlation between 18F-FETNIM uptake and OPN blood levels.
Conclusions: Our preliminary results showed that a high uptake of 18F-FETNIM was associated with a worse progression-free and overall survival.
From the Departments of *Nuclear Medicine and †Gynaecology Obstetrics Lariboisière, Hospital Saint Louis APHP; ‡Department of Biostatistics/Bioinformactics, Universitary Institute of Hematology Paris VII; Departments of §Cellular Biology and ∥Oncology-Radiotherapy, Saint Louis Hospital APHP Paris; and ¶Department of pathology Bichat Hospital APHP Paris, France.
Received for publication March 2, 2012 and revision accepted April 23, 2012.
Conflicts of interest and sources of funding: none declared.
Professor Jean-luc Moretti, the main investigator of this study, passed away on December 21, 2010. This work is dedicated to him.
Reprints: Laetitia Vercellino, MD, Hôpital Saint Louis 1 avenue Claude Vellefaux 75010 Paris, France. E-mail: firstname.lastname@example.org.