Positron emission tomographic imaging of angiogenesis and vascular function

Surrogate markers of clinical outcome are important in anticancer drug research, since clinical criteria of response develop only slowly and may be confounded by other processes than drug effect. The need for surrogate outcome markers is especially great with newer agents that may act by tumour stabilization as opposed to shrinkage. Neoplastic angiogenesis is associated with a number of detectable changes at molecular and microcirculatory levels. Therefore, direct study of angiogenic molecular biology and tumour circulation before during and after treatment may offer useful surrogate markers for vascular-targeted therapies. The main advantage of radiotracer imaging with positron emission tomography (PET) is its functional specificity. This article will review two main areas: (a) the methodology behind PET imaging of tumour blood supply with O-15-oxygen labelled compounds; and (b) newer tracers in development as markers of angiogenetic biology.