Usefulness of 64Cu-ATSM in head and neck cancer: A preliminary prospective study

Ilaria Grassi, Cristina Nanni, Gianfranco Cicoria, Claudio Blasi, Feisal Bunkheila, Egesta Lopci, Patrick M. Colletti, Domenico Rubello, Stefano Fanti

Research output: Contribution to journalArticlepeer-review


AIMS: 64Cu-diacetyl-bis(N4-methylthiosemicarbazone) ( 64Cu-ATSM) is a hypoxia-avid, positron emitter radiotracer. The primary aim of this study is to assess the efficacy of pretherapy 64Cu-ATSM PET/CT as a prognostic factor of response to therapy. The secondary aims are to investigate if there is a difference between early and late PET/CT scans and if there is a difference between the biologic tumor volume (BTV) in radiotherapy treatment planning calculated between 64Cu-ATSM and 18F-FDG, and to assess if 64Cu-ATSM is a prognostic marker of disease progression. METHODS: Eleven patients with head and neck cancer treated with chemoradiotherapy were enrolled prospectively; both 64Cu-ATSM and 18F-FDG PET/CT scans before and after treatment were obtained. The 64Cu-ATSM scans were performed after 1 hour (early) and 16 hours (late). RESULTS: All patients had stage III or IV squamous cell head and neck cancer; 7 of 11 patients had nodal metastasis, and 22 cancer foci were detected with 64Cu-ATSM. SUVmax was 16.2 ± 7.9, and there was no significant SUVmax difference between early and late imaging. 18F-FDG SUVmax before therapy was 15.6 ± 9.4, whereas 18F-FDG SUVmax after therapy was 1.5 ± 1.2. Sensitivity and specificity values of 64Cu-ATSM calculated with receiver operating characteristic curves were 100% and 50% considering the SUVmax and 100% and 33% considering the volume, respectively. No difference has been found between the BTV contoured with 64Cu-ATSM and 18F-FDG. CONCLUSIONS: The 64Cu-ATSM scans showed high sensitivity but low specificity in predicting neoadjuvant chemoradiotherapy response. No difference was noted between early and late scans. 18F-FDG and 64Cu-ATSM provided similar results about delineation of BTV.

Original languageEnglish
JournalClinical Nuclear Medicine
Issue number1
Publication statusPublished - Jan 2014


  • Biologic tumor volume (BTV)
  • Head and neck cancer
  • Hypoxia
  • Radiotherapy treatment planning

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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