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Evaluation of tumor hypoxia prior to radiotherapy in intermediate-risk prostate cancer using [18]F-fluoromisonidazole PET/CT: a pilot study

Abstract : Purpose: Hypoxia is a major factor in prostate cancer aggressiveness and radioresistance. Predicting which patients might be bad candidates for radiotherapy may help better personalize treatment decisions in intermediate-risk prostate cancer patients. We assessed spatial distribution of [18]F-Misonidazole (FMISO) PET/CT uptake in the prostate prior to radiotherapy treatment. Materials and Methods: Intermediate-risk prostate cancer patients about to receive high-dose (>74 Gy) radiotherapy to the prostate without hormonal treatment were prospectively recruited between 9/2012 and 10/2014. Prior to radiotherapy, all patients underwent a FMISO PET/CT as well as a MRI and [18]F-choline-PET. [18]F-choline and FMISO-positive volumes were semi-automatically determined using the fuzzy locally adaptive Bayesian (FLAB) method. In FMISO-positive patients, a dynamic analysis of early tumor uptake was performed. Group differences were assessed using the Wilcoxon signed rank test. Parameters were correlated using Spearman rank correlation. Results: Of 27 patients (median age 76) recruited to the study, 7 and 9 patients were considered positive at 2.5h and 3.5h FMISO PET/CT respectively. Median SUV[max] and SUV[max] tumor to muscle (T/M) ratio were respectively 3.4 and 3.6 at 2.5h, and 3.2 and 4.4 at 3.5h. The median FMISO-positive volume was 1.1 ml. Conclusions: This is the first study regarding hypoxia imaging using FMISO in prostate cancer showing that a small FMISO-positive volume was detected in one third of intermediate-risk prostate cancer patients.
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Submitted on : Tuesday, June 26, 2018 - 9:52:32 AM
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Stéphane Supiot, Caroline Rousseau, Mélanie Dore, Catherine Cheze-Le-Rest, Christine Kandel-Aznar, et al.. Evaluation of tumor hypoxia prior to radiotherapy in intermediate-risk prostate cancer using [18]F-fluoromisonidazole PET/CT: a pilot study. Oncotarget, Impact journals, 2018, 9 (11), pp.10005 - 10015. ⟨10.18632/oncotarget.24234⟩. ⟨inserm-01823478⟩



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