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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.


Figure 1
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  		Fig. 1 —Photograph shows 62Zn/62Cu generator with synthesis kits for production of 62Cu-ATSM (Cu-diacetyl-bis[N4-methylthiosemicarbazone]) and 62Cu-PTSM (Cu-pyruvaldehyde-bis[N4-methylthiosemicarbazone]).

 

Figure 2
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  		Fig. 2A —71-year-old woman with adenocarcinoma (patient 1). Axial CT scan shows 1.6 x 1.2 cm right upper lobe pulmonary nodule.

 

Figure 3
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  		Fig. 2B —71-year-old woman with adenocarcinoma (patient 1). Corresponding axial PET images obtained using 18F-FDG (B), Cu-pyruvaldehyde-bis(N4-methylthiosemicarbazone) (62Cu-PTSM) (C), and Cu-diacetyl-bis(N4-methylthiosemicarbazone) (62Cu-ATSM) (D) show high accumulation of all three radiotracers in lesion.

 

Figure 4
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  		Fig. 2C —71-year-old woman with adenocarcinoma (patient 1). Corresponding axial PET images obtained using 18F-FDG (B), Cu-pyruvaldehyde-bis(N4-methylthiosemicarbazone) (62Cu-PTSM) (C), and Cu-diacetyl-bis(N4-methylthiosemicarbazone) (62Cu-ATSM) (D) show high accumulation of all three radiotracers in lesion.

 

Figure 5
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  		Fig. 2D —71-year-old woman with adenocarcinoma (patient 1). Corresponding axial PET images obtained using 18F-FDG (B), Cu-pyruvaldehyde-bis(N4-methylthiosemicarbazone) (62Cu-PTSM) (C), and Cu-diacetyl-bis(N4-methylthiosemicarbazone) (62Cu-ATSM) (D) show high accumulation of all three radiotracers in lesion.

 

Figure 6
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  		Fig. 2E —71-year-old woman with adenocarcinoma (patient 1). Photomicrograph of surgical pathology specimen reveals moderately differentiated adenocarcinoma with acinar and papillary features. (H and E, x100)

 

Figure 7
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  		Fig. 3A —58-year-old man with granuloma (patient 2). Axial CT scan shows spiculated 2.8 x 1.8 cm left upper lobe pulmonary nodule.

 

Figure 8
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  		Fig. 3B —58-year-old man with granuloma (patient 2). Corresponding axial PET images obtained using 18F-FDG (B), Cu-pyruvaldehyde-bis (N4-methylthiosemicarbazone) (62Cu-PTSM) (C), and Cu-diacetyl-bis(N4-methylthiosemicarbazone) (62Cu-ATSM) (D) show high accumulation of FDG and PTSM but relatively low ATSM accumulation in nodule.

 

Figure 9
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  		Fig. 3C —58-year-old man with granuloma (patient 2). Corresponding axial PET images obtained using 18F-FDG (B), Cu-pyruvaldehyde-bis (N4-methylthiosemicarbazone) (62Cu-PTSM) (C), and Cu-diacetyl-bis(N4-methylthiosemicarbazone) (62Cu-ATSM) (D) show high accumulation of FDG and PTSM but relatively low ATSM accumulation in nodule.

 

Figure 10
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  		Fig. 3D —58-year-old man with granuloma (patient 2). Corresponding axial PET images obtained using 18F-FDG (B), Cu-pyruvaldehyde-bis (N4-methylthiosemicarbazone) (62Cu-PTSM) (C), and Cu-diacetyl-bis(N4-methylthiosemicarbazone) (62Cu-ATSM) (D) show high accumulation of FDG and PTSM but relatively low ATSM accumulation in nodule.

 

Figure 11
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  		Fig. 3E —58-year-old man with granuloma (patient 2). Photomicrograph of surgical pathology specimen shows necrotizing granuloma with prominent giant cell response and no evidence of malignancy. (H and E, x100)

 

Figure 12
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  		Fig. 4A —Copper-diacetyl-bis(N4-methylthiosemicarbazone) (62Cu-ATSM) and copper-pyruvaldehyde-bis(N4-methylthiosemicarbazone) (62Cu-PTSM) time–activity curves. Representative regions of interest in lung and mediastinum were also evaluated. Steady-state distribution is achieved 10–15 minutes after injection for both radiotracers. Standardized uptake values (SUVs) for 62Cu-ATSM (A) and 62Cu-PTSM (B) in adenocarcinoma (patient 1).

 

Figure 13
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  		Fig. 4B —Copper-diacetyl-bis(N4-methylthiosemicarbazone) (62Cu-ATSM) and copper-pyruvaldehyde-bis(N4-methylthiosemicarbazone) (62Cu-PTSM) time–activity curves. Representative regions of interest in lung and mediastinum were also evaluated. Steady-state distribution is achieved 10–15 minutes after injection for both radiotracers. Standardized uptake values (SUVs) for 62Cu-ATSM (A) and 62Cu-PTSM (B) in adenocarcinoma (patient 1).

 

Figure 14
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  		Fig. 4C —Copper-diacetyl-bis(N4-methylthiosemicarbazone) (62Cu-ATSM) and copper-pyruvaldehyde-bis(N4-methylthiosemicarbazone) (62Cu-PTSM) time–activity curves. Representative regions of interest in lung and mediastinum were also evaluated. Steady-state distribution is achieved 10–15 minutes after injection for both radiotracers. SUVs for 62Cu-ATSM (C) and 62Cu-PTSM (D) in granulomatous disease (patient 2).

 

Figure 15
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  		Fig. 4D —Copper-diacetyl-bis(N4-methylthiosemicarbazone) (62Cu-ATSM) and copper-pyruvaldehyde-bis(N4-methylthiosemicarbazone) (62Cu-PTSM) time–activity curves. Representative regions of interest in lung and mediastinum were also evaluated. Steady-state distribution is achieved 10–15 minutes after injection for both radiotracers. SUVs for 62Cu-ATSM (C) and 62Cu-PTSM (D) in granulomatous disease (patient 2).

 

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