Tumour hypoxia imaging with [18F]FAZA PET in head and neck cancer patients: A pilot study

M. Souvatzoglou, A. L. Grosu, B. Röper, B. J. Krause, R. Beck, G. Reischl, M. Picchio, H. J. Machulla, H. J. Wester, M. Piert

Research output: Contribution to journalArticlepeer-review


Purpose: Hypoxia is an important negative prognostic factor for radiation treatment of head and neck cancer. This study was performed to evaluate the feasibility of use of 18F-labelled fluoroazomycin arabinoside ([ 18F]FAZA) for clinical PET imaging of tumour hypoxia. Methods: Eleven patients (age 59.6 ± 9 years) with untreated advanced head and neck cancer were included. After injection of approximately 300 MBq of [ 18F]FAZA, a dynamic sequence up to 60 min was acquired on an ECAT HR+ PET scanner. In addition, approximately 2 and 4 h p.i., static whole-body PET (n = 5) or PET/CT (n = 6) imaging was performed. PET data were reconstructed iteratively (OSEM) and fused with CT images (either an external CT or the CT of integrated PET/CT). Standardised uptake values (SUVs) and tumour-to-muscle (T/M) ratios were calculated in tumour and normal tissues. Also, the tumour volume displaying a T/M ratio >1.5 was determined. Results: Within the first 60 min of the dynamic sequence, the T/M ratio generally decreased, while generally increasing at later time points. At 2 h p.i., the tumour SUVmax and SUVmean were found to be 2.3 ± 0.5 (range 1.5-3.4) and 1.4 ± 0.3 (range 1.0-2.1), respectively. The mean T/M ratio at 2 h p.i. was 2.0 ± 0.3 (range 1.6-2.4). The tumour volume displaying a T/M ratio above 1.5 was highly variable. At 2 h p.i., [18F]FAZA organ distribution was determined as follows: kidney > gallbladder > liver > tumour > muscle > bone > brain > lung. Conclusion: [18F]FAZA PET imaging appears feasible in head and neck cancer patients, and the achieved image quality is adequate for clinical purposes. Based on our initial results, [18F]FAZA warrants further evaluation as a hypoxia PET tracer for imaging of cancer.

Original languageEnglish
Pages (from-to)1566-1575
Number of pages10
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Issue number10
Publication statusPublished - Oct 2007


  • [F]FAZA
  • Head and neck cancer
  • Hypoxia imaging
  • PET

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology


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