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

OBJECTIVE. Copper-diacetyl-bis(N-4-methylthiosemicarbazone)(Cu-ATSM) and copper-pyruvaldehyde-bis(N-4-methylthiosemicarbazone) (Cu-PTSM) are being studied as potential markers of hypoxia and perfusion, respectively. The use of short-lived radionuclides (e. g., Cu-62) has advantages for clinical PET, including a lower radiation dose than long-lived radionuclides and serial imaging capability. A Zn-62/Cu-62 microgenerator and rapid synthesis kits now provide a practical means of producing Cu-62-PTSM and Cu-62-ATSM on-site. Tumors can be characterized with Cu-62-PTSM, Cu-62-ATSM, and F-18-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 Cu-62-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.