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Hypoxia Imaging of Uterine Cervix Carcinoma With 18F-FETNIM PET/CT

Vercellino, Laetitia MD*; Groheux, David MD*; Thoury, Anne MD; Delord, Marc MS; Schlageter, Marie-Hélène PharmD§; Delpech, Yann MD; Barré, Emmanuelle PharmD*; Baruch-Hennequin, Valérie MD; Tylski, Perrine PhD*; Homyrda, Laurence§; Walker, Francine MD; Barranger, Emmanuel MD, PhD; Hindié, Elif MD, PhD*

doi: 10.1097/RLU.0b013e3182638e7e
Original Articles

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:

© 2012 Lippincott Williams & Wilkins, Inc.