You are here:

Intervention protocol 11

Evaluation of hypoxic bio-imaging with PET/CT in uterine cervical cancer patients

Objectives To evaluate if hypoxic PET tracers (18F-FAZA or 64Cu-ATSM PET) qualitatively and quantitatively can detect radiobiological hypoxia in patients with uterine cervical tumours using pimonidazole as reference. To evaluate the prognostic value of hypoxic PET bioimaging and test the clinical feasibility of hypoxic dose painting using dynamic arc therapy.
Study outline (intervention) The study involves 3 elements. A) Preoperative FDG and PET/CT hypoxia imaging and MRI/MRS of 20 patients, Figo stage IA-IIA, and comparative assessment of PET tracer (by autoradiography) and pimonidazole in the surgical specimen for evaluation of the spatial localization of the PET tracer, and correlated with genetic markers for individual (hypoxic) sensitivity. B) Prior to chemo-radiotherapy, n=100 and during treatment, n=20 patients with primary bulky disease, Figo stage IIB-IVA will be examined with FDG and PET/CT hypoxia imaging, MRI/MRS and pimonidazole and correlated with genetic markers for individual (hypoxic) sensitivity. C) Patients included in element B will serve as objects for studying the additional diagnostic value of baseline and during treatment hypoxia PET/CT. With onset in PET-bioimaging evaluation of biological dosimetry and dose painting will be studied and if found feasible and successful, eventually implemented in a clinical registration protocol.
Expected impact The study will evaluate the prognostic/predictive importance of radiobiological hypoxia as a cause of radioresistance in cervical cancer. Imaging of hypoxia will be used as a model for clinical evaluation of biological dosimetry and dose planning. The study will create the basis for biological treatment planning (dose painting) and novel treatment delivery using arc therapy.
Linkages with work packages WP 1, 2, 3, 4, 6, 8, 9. From WP01 for genetic hypoxia markers, WP02 hypoxia imaging, WP03 Image management, WP04 Functional imaging for RT, WP06 Adaptive IG-IMRT, WP08 RT dose verification, WP09 tools for dose plan evaluation and reporting.

Protocol: CIRRO-IP110110 - Feasibility studium med henblik på indtroduktion af hypoksi tracer hos patienter med cervixcancer