A Review of Hypoxia Imaging Using 18F-Fluoromisonidazole Positron Emission Tomography

Kenji Hirata; Shiro Watanabe; Yoshimasa Kitagawa; Kohsuke Kudo

doi:10.1007/978-1-0716-3633-6_9

A Review of Hypoxia Imaging Using 18F-Fluoromisonidazole Positron Emission Tomography

Methods Mol Biol. 2024:2755:133-140. doi: 10.1007/978-1-0716-3633-6_9.

Authors

Kenji Hirata^{1

2

3}, Shiro Watanabe^{4

5

6}, Yoshimasa Kitagawa⁷, Kohsuke Kudo^{4

5

8}

Affiliations

¹ Department of Diagnostic Imaging, Graduate School of Medicine, Hokkaido University, Sapporo, Japan. khirata@med.hokudai.ac.jp.
² Department of Nuclear Medicine, Hokkaido University Hospital, Sapporo, Japan. khirata@med.hokudai.ac.jp.
³ Global Center for Biomedical Science and Engineering, Faculty of Medicine, Hokkaido University, Sapporo, Japan. khirata@med.hokudai.ac.jp.
⁴ Department of Diagnostic Imaging, Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
⁵ Department of Nuclear Medicine, Hokkaido University Hospital, Sapporo, Japan.
⁶ Global Center for Biomedical Science and Engineering, Faculty of Medicine, Hokkaido University, Sapporo, Japan.
⁷ Oral Diagnosis and Medicine, Department of Oral Pathobiological Science, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Hokkaido, Japan.
⁸ Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan.

PMID: 38319574
DOI: 10.1007/978-1-0716-3633-6_9

Abstract

Tumor hypoxia is an essential factor related to malignancy, prognosis, and resistance to treatment. Positron emission tomography (PET) is a modality that visualizes the distribution of radiopharmaceuticals administered into the body. PET imaging with [¹⁸F]fluoromisonidazole ([¹⁸F]FMISO) identifies hypoxic tissues. Unlike [¹⁸F]fluorodeoxyglucose ([¹⁸F]FDG)-PET, fasting is not necessary for [¹⁸F]FMISO-PET, but the waiting time from injection to image acquisition needs to be relatively long (e.g., 2-4 h). [¹⁸F]FMISO-PET images can be displayed on an ordinary commercial viewer on a personal computer (PC). While visual assessment is fundamental, various quantitative indices such as tumor-to-muscle ratio have also been proposed. Several novel hypoxia tracers have been invented to compensate for the limitations of [¹⁸F]FMISO.

Keywords: Hypoxia radiotracer; PET; Positron emission tomography; [14C]misonidazole; [18F]FMISO; [18F]FMISO-PET; [18F]fluorodeoxyglucose; [18F]fluoromisonidazole.

MeSH terms

Fasting
Fluorodeoxyglucose F18
Humans
Hypoxia / diagnostic imaging
Misonidazole*
Positron-Emission Tomography*

Substances

Fluorodeoxyglucose F18
fluoromisonidazole
Misonidazole