Evaluation of [18F]-FMISO for Non Operated Glioblastoma

Hypoxia is recognized to be an independent predictor of clinical outcome in oncology. PET using \[18F\]-FMISO has been described to be useful for the non invasive assessment of hypoxia in cancer. The use of this radiotracer for brain tumours is very limited and there is no standard to acquire and quantify \[18F\]-FMISO uptake. So there is a need for a methodological evaluation of this PET tracer The purpose of this research is to define optimal parameters for acquisition and data exploitation to quantify \[18F\]-FMISO uptake and so predict clinical outcome in glioblastomas. Low sensitivity to radiation of glioblastoma is partly caused by hypoxia. Hypoxia in tumours is not predicted by tumour size. Detecting and monitoring tissue oxygenation are of great interest to modify therapeutic strategies, including local dose escalation for radiotherapy or select chemotherapeutic agents with better impact in glioblastomas. PET with appropriate radiotracers, especially \[18F\]-FMISO, enables non-invasive assessment of hypoxia. \[18F\]-FMISO only accumulates in viable hypoxic cells. So, it has been demonstrated that PET using 18F-FMISO is suitable to localize and quantify hypoxia. But there isn't any optimal acquisition protocol or standardized images quantification treatment. Thus, the interpretation of \[18F\]-FMISO PET images and the predictive value of \[18F\]-FMISO SUV (Standardized Uptake Value) remain unclear explaining the need of methodological approaches.