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![TUMOUR HYPOXIA
•TUMOUR
METABOLISM
[18F]fluoroazomycin arabinoside (FAZA)
Feasibility of of 18F- FMISO PET imaging to measure hypoxia in patient
With glioblastoma
spenser et al.](https://image.slidesharecdn.com/petctonco1-191211143008/85/PET-CT-in-Oncology-24-320.jpg)
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Similar to PET-CT in Oncology
PET-CT in Oncology
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- 2. SYNTHESIS OF THEPET TRACERS
- 3. SYNTHESIS OF THEPET TRACERS
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- 5. BIOLOGICAL MARKER (PET PROBE) 18F-+ (labelling radiopharmaceitical agent) FDG
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- 7. Biological tumour TARGETS and the UTILITYof the PET PROBES
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- 12. 18-F- FDG (glucosemetabolism) 58-year0old man –staging of NSCLC
- 13. RECIST 1.1 Complete Response(CR): Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to <10 mm. Partial Response (PR): At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters. Progressive Disease (PD): At least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study). In addition to the relative increase of 20%, the sum must also dem- onstrate an absolute increase of at least 5 mm. (Note: the appearance of one or more new lesions is also considered progression).
- 15. Comparison of QualitativePET Response Criteria Hicks criteria Measurability of lesion at baseline 1. 18F-FDG–avid tumor; baseline PET scan is desirable 2. Standardized display with normalization to liver 2. Variably 18F-FDG–avid tumor; 18F-FDG baseline PET scan is required 3. Follow-up PET at least 3 wk after last chemotherapy session or at least 8–12 wk after last radiation therapy session J Nucl Med. 2009 May; 50(Suppl 1): 122S–150S.
- 16. Comparison of QualitativePET Response CriteriaPositron emission tomography is superior to computed tomography scanning for response-assessment after radical radiotherapy or chemoradiotherapy in patients with non-small-cell lung cancer. Mac Manus MP, Hicks RJ, Matthews JP, McKenzie A, Rischin D, Salminen EK, Ball DL J Clin Oncol. 2003 Apr 1; 21(7):1285-92. Complete metabolic response: 18F-FDG–avid lesions revert to background of normal tissues in which they are located Complete response in 18F-FDG–avid tumors: no focal or diffuse increased 18F-FDG uptake over background in location consistent with tumor, regardless of CT abnormality; new lung nodules in lymphoma patient without history of lung involvement (regardless of 18F-FDG avidity) are not considered lymphoma; increased focal or multifocal marrow uptake is not considered tumor unless biopsy is done Partial metabolic response: “significant reduction in SUV in tumors” Noncomplete response: diffuse or focal uptake exceeding mediastinal blood pool if >2 cm in size; in nodes < 2 cm diameter, uptake of 18F-FDG greater than background is positive; lesions > 1.5 cm in size in liver or spleen with uptake equal to or greater than spleen are considered tumor SMD: “no visible change in metabolic activity of tumors” Partial remission: Progressive metabolic disease: “increase in intensity or extent of tumor metabolic activity or new sites” Progressive disease:
- 19. FDG-PET ( treatmentmonitoring) B-cell lymphoma (pre versus post treatment)
- 20. (2-18F-fluoroethyl)-L-tyrosine (18F-FET) [amino acidmetabolism) Tumour versus Inflammation Eddie W.F. et al PET study using F-18 FET and F-18 FDG for the evaluation of patients with suspected brain tumour. Journal of Clinical Neuroscience .volume 17, Issue 1, January 2010, Pages 43-4 18F-FDG
- 21. 3'-deoxy-3'-18F-fluorothymidine (FLT) –tumour proliferation
- 22. FLT • Andreas Ket al. Imaging Proliferation in Lung Tumors with PET:18F-FLT Versus 18F-FDG. Journal of Nuclear Medicine 2003. Vol. 44 No. 9 1426-1431
- 23. TUMOUR HYPOXIA MORE AGGRESSIVETUMOUR TYPES A/W METASTASIS & CHEMOTHERAPY RESISTANCE - POOR PROGNOSIS QUANTIFICATION OF TUMOUR HYPOXIA - STUDIES UNDERWAY •TUMOUR METABOISM A
- 24. TUMOUR HYPOXIA •TUMOUR METABOLISM [18F]fluoroazomycin arabinoside(FAZA) Feasibility of of 18F- FMISO PET imaging to measure hypoxia in patient With glioblastoma spenser et al.
- 25. TUMOUR RECEPTOR OVEREXPRESSION•TUMOUR METABOLISM NETSSRT 1- 5 18F- FDG 68Ga- DOTA NOC meningioma SSRT -2 68Ga- DOTA NOC
- 26. TUMOUR RECEPTOR OVEREXPRESSION•TUMOUR METABOLISM 123I- MIBG 68-Ga –DOTA TOC
- 27. Targeted therapy (PET PROBE) Angiogenesis ανβЗintegrin VEGF mAbs ANGIOGENESIS – VEGF factor 90 Ytr + Radiolabelled anti CD 20 ( monoclonal antibody) In NHL treatment.
- 28. MOLECULARSURROGATE MARKER PET TRACERSPET PROBE SURROGATE MARKER USE 18 F 18 F- FDG GLUCOSE METABOLISM Lymphoma Head & Neck ca NSCLC, melanoma, colon ca 18-F-FET AMINO ACID METABOLISM CANCER (BRAIN- glioma) 18 F- FLT TISSUE PROLIFERATION CANCER (BRAIN) 18-F- FMISO/FAZA TISSUE HYPOXIA CANCER (GIST/SARCOMA) 18-F- FCL STEROL PROLIFERATION CANCER (Prostate) 68 Ga 68-Ga- Octreotate TUMOUR RECEPTOR OVEREXPRESSION CANCER (NET)
- 29. SUV – = traceractivity / injected dose normalized to body weight. • SUV was a significant and independent predictor of local control and disease-free survival . Tatsuo Torizuka et al AJR 2009; 192:W156-W160
- 30. COMMON ONCOLOGY INDICATION NET GLIOMA SARCOMA HEAD &NECK TUMOUR GIT TUMOUR NSCLC LYMPHOMA
- 31. INDICATIONS • LOCALISATION • PRETREATMENTSTAGING • TREATMENT MONITORING • NEGATIVE ON CT OR NUCLEAR IMAGING • PREDICTION OF RECURRENCES • PROGNOSTIC FACTOR
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- 34. HEAD & NECKTUMOUR
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