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European Journal of Nuclear Medicine and Molecular Imaging

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01-10-2011 | Original Article

Investigation on tumor hypoxia in resectable primary prostate cancer as demonstrated by ¹⁸F-FAZA PET/CT utilizing multimodality fusion techniques

Authors: Rita Garcia-Parra, David Wood, Rajal B. Shah, Javed Siddiqui, Hero Hussain, Hyunjin Park, Timothy Desmond, Charles Meyer, Morand Piert

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 10/2011

Abstract

Purpose

As hypoxia is believed to play an important role in the development and progression of prostate cancer, we evaluated whether ¹⁸F-labeled fluoroazomycin arabinoside (¹⁸F-FAZA) would be useful to identify tumor hypoxia in resectable prostate cancer.

Methods

Positron emission tomography (PET)/CT was performed on 14 patients with untreated localized primary prostate cancer 3 h post-injection of approximately 390 MBq of ¹⁸F-FAZA using forced diuresis to decrease radioactivity in the urinary bladder. Anatomical trans-pelvic coil and pre- and post-contrast 1.5 T MRI with endorectal coil were performed on the same day. Patients underwent radical prostatectomy and ex vivo 3 T MRI of the prostatectomy specimen within 14 days following in vivo imaging. Imaging results were verified by whole mount histopathology plus tissue microarray (TMA) immunohistochemical (IHC) analysis for carbonic anhydrase IX (CAIX) and hypoxia-inducible factor 1α (HIF-1α). Registration of in vivo imaging with histology was achieved using mutual information software and performing ex vivo MRI of the prostatectomy specimen and whole mount sectioning with block face photography as intermediate steps.

Results

Whole mount histology identified 43 tumor nodules, 19 of them larger than 1 ml as determined on coregistered volumes featuring ¹⁸F-FAZA, MRI, and histological 3-D image information. None of these lesions was found to be positive for CAIX or visualized by ¹⁸F-FAZA PET/CT while IHC for HIF-1α showed variable staining of tumor tissues. Accordingly, no correlation was found between ¹⁸F-FAZA uptake and Gleason scores.

Conclusion

Our data based on ¹⁸F-FAZA PET/CT and CAIX IHC do not support the presence of clinically relevant hypoxia in localized primary prostate cancer including high-grade disease. Activation of HIF-1α may be independent of tissue hypoxia in primary prostate cancer.

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Title: Investigation on tumor hypoxia in resectable primary prostate cancer as demonstrated by 18F-FAZA PET/CT utilizing multimodality fusion techniques
Authors: Rita Garcia-Parra
David Wood
Rajal B. Shah
Javed Siddiqui
Hero Hussain
Hyunjin Park
Timothy Desmond
Charles Meyer
Morand Piert
Publication date: 01-10-2011
Publisher: Springer-Verlag
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 10/2011
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-011-1876-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Investigation on tumor hypoxia in resectable primary prostate cancer as demonstrated by ¹⁸F-FAZA PET/CT utilizing multimodality fusion techniques

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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