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DOI:10.2214/AJR.07.2876
AJR 2008; 190:427-432
© American Roentgen Ray Society

Technical Innovation

PET of Hypoxia and Perfusion with 62Cu-ATSM and 62Cu-PTSM Using a 62Zn/62Cu Generator

Terence Z. Wong1, Jeffrey L. Lacy2, Neil A. Petry1, Thomas C. Hawk1, Thomas A. Sporn3, Mark W. Dewhirst4 and Gordana Vlahovic5

1 Department of Radiology, Nuclear Medicine Division, Duke University Medical Center, Box 3949, Durham, NC 27710.
2 Proportional Technologies, Inc., Houston, TX.
3 Department of Pathology, Duke University Medical Center, Durham, NC.
4 Department of Radiation Oncology, Duke University Medical Center, Durham, NC.
5 Department of Medicine, Duke University Medical Center, Durham, NC.

OBJECTIVE. Copper-diacetyl-bis(N4-methylthiosemicarbazone) (Cu-ATSM) and copper-pyruvaldehyde-bis(N4-methylthiosemicarbazone) (Cu-PTSM) are being studied as potential markers of hypoxia and perfusion, respectively. The use of short-lived radionuclides (e.g., 62Cu) has advantages for clinical PET, including a lower radiation dose than long-lived radionuclides and serial imaging capability. A 62Zn/62Cu microgenerator and rapid synthesis kits now provide a practical means of producing 62Cu-PTSM and 62Cu-ATSM on-site. Tumors can be characterized with 62Cu-PTSM, 62Cu-ATSM, and 18F-FDG PET scans during one session. We present the initial clinical data in two patients with lung neoplasms.

CONCLUSION. Hypoxia and perfusion are important parameters in tumor physiology and can have major implications in diagnosis, prognosis, treatment planning, and response to therapy. We have shown the feasibility of performing 62Cu-ATSM and 62Cu-PTSM PET together with FDG PET/CT during a single imaging session to provide information on both perfusion and hypoxia and tumor anatomy and metabolism.

Keywords: granuloma • lung cancer • perfusion imaging • PET/CT • radionuclides • tumor hypoxia


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