Interesting ImagesLack of Concordance Between the F-18 Fluoromisonidazole PET and the F-18 FDG PET in Human GlioblastomaDe Clermont, Henri MD*,†; Huchet, Aymeri MD‡; Lamare, Frédéric MD*,†; Rivière, Annalisa MD†; Fernandez, Philippe MD, PhD*,† Author Information From the *Service de Médecine Nucléaire, Hôpital Pellegrin, CHU de Bordeaux, Bordeaux, France; †INCIA, CNRS UMR 5287, Université Bordeaux Segalen, Bordeaux, France; and ‡Service de Radiothérapie, Hôpital Saint-André, CHU de Bordeaux, Bordeaux, France. Received for publication February 7, 2011; revision accepted June 13, 2011. Conflicts of interest and sources of funding: Ligue contre le cancer. Reprints: Fernandez Philippe, MD, PhD, Service de Médecine Nucléaire, Hôpital Pellegrin, Place Amélie Raba-Léon, 33076 Bordeaux Cédex, France. E-mail: [email protected]. Clinical Nuclear Medicine: December 2011 - Volume 36 - Issue 12 - p e194-e195 doi: 10.1097/RLU.0b013e3182335e20 Buy Metrics Abstract A 57-year-old man with an unresectable glioblastoma had both F-18 fluorodeoxyglucose and F-18 fluoromisonidazole positron emission tomography coupled with computerized tomography before radiotherapy. Positron emission tomography images were fused with magnetic resonance imaging through computerized tomography images. Important discrepancies were observed in the spatial distribution of the F-18 fluorodeoxyglucose and the F-18 fluoromisonidazole uptake, reflecting the lack of concordance between glucose metabolism and tumor hypoxia. Although tumor hypoxia, through the HIF-1 pathway, increases the expression of GLUT-1 and hexokinase, other factors can increase glucose metabolism. Although there is often correlation between glucose metabolism and hypoxia, they do not completely agree. Copyright © 2011 Wolters Kluwer Health, Inc. All rights reserved.