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| Radiotracer | Reference | Trial and aim | Results |
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18F-MISO | Rischin et al. 2006 [16] | TROG randomized trial (45 patients)
To determine the association between tumour hypoxia, treatment regimen, and locoregional failure in advanced HNC |
18F-MISO-detected hypoxia is associated with high locoregional failure in patients not receiving tirapazamine. |
| Kikuchi et al. 2011 [17] | Clinical study (17 patients)
To evaluate the role of 18F-MISO as a predictor of treatment outcome in HNC | Local control after radiotherapy was significantly lower in patients with high uptake than in those with low tracer uptake. Pretreatment scan with 18F-MISO may predict treatment outcome. |
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18F-FAZA | Souvatzoglou et al. 2007 [18] | Phase I trial (11 patients)
Feasibility of 18F-FAZA for hypoxia imaging in HNC patients | Feasible for clinical use and offers adequate image quality for hypoxia assessment. |
| Postema et al. 2009 [19] | Phase I trial (9 HNC patients out of 50 overall cancer patients)
To demonstrate the safety and biodistribution pattern of 18F-FAZA in patients with HNC, lung cancer, gliomas, and lymphomas | Clear uptake of 18F-FAZA was observed in 6 out of 9 HNC patients; good imaging properties; good tumour-to-blood ratio. Promising agent for hypoxia imaging in HNC. |
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18F-EF3 | Mahy et al. 2008 [20] | Phase I trial (10 patients)
To assess the pharmacokinetics, biodistribution, and metabolism (324 MBq versus 1,134 MBq) | Uptake and retention in tumour was observed; no difference between the radioactivity groups; no side effects; safe and feasible. |
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18F-EF5 | Komar et al. 2008 [21] | Phase I trial (15 patients)
To determine the optimal PET protocol for 18F-EF5 as a hypoxia imaging agent | Initial 18F-EF5 uptake is governed by blood flow; later phase uptake is hypoxia specific (optimal detection time is 3 h after injection); warranting more study. |
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18F-HX4 | Chen et al. 2012 [22] | Phase I trial (12 patients)
To evaluate the feasibility of HX4 compared with 18F-MISO | HX4 possibly has higher sensitivity and specificity and shorter injection-acquisition time (1.5 h) than 18F-MISO |
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Cu-ATSM | Minagawa et al. 2011 [23] | Phase I/II trial (17 patients)
To evaluate the relationship between 62Cu-ATSM tumour uptake and chemoradiotherapy |
62Cu-ATSM SUVmax greatly differed between patients with and without residual disease. 62Cu-ATSM could be a predictor of tumour response to treatment. |
| Grassi et al. 2014 [24] | Preliminary prospective study (11 patients)
To assess the efficacy of pretreatment 64Cu-ATSM as a prognostic factor and its role as a marker of disease progression |
64Cu-ATSM showed high sensitivity but low specificity in predicting response to chemoradiotherapy. There were no differences between early and late scans. |
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