18F-fluoroerythronitroimidazole versus 18F-fluoromisonidazole PET/CT in the noninvasive hypoxia imaging of lung cancer: a randomized controlled trial

130 Objectives This is a clinical study to compare noninvasive hypoxia imaging using 18F-fluoroerythronitroimidazole (18F-FETNIM) and 18F-fluoromisonidazole (18F-FMISO) positron emission tomography/computed tomography (PET/CT) in patients with inoperable stages III-IV lung cancer. Methods A total of forty-two patients with inoperable stages III-IV lung cancer underwent 18F-FETNIM PET/CT (n=18) and 18F-FMISO PET/CT (n=24) before chemo/radiation therapy. The maximum standard uptake value (SUVmax) of malignant and mean standard uptake value (SUVmean) of normal tissues depict 18F-FETNIM PET/CT and 18F-FMISOPET/CT uptake. Tumor-to-blood ratios (T/B) were used to quantify hypoxia. Results All patients with lung cancer underwent 18F-FETNIM PET/CT and 18F-FMISO PET/CT successfully. Compared to 18F-FMISO, 18F-FETNIM showed similar uptake in muscle, thyroid, spleen, pancreas, heart, lung and different uptake in blood, liver, and kidney. A significantly higher SUVmax and T/B ratio with 18F-FMISO (2.56±0.77, 1.98±0.54), as compared to 18F-FETNIM (2.12±0.56, 1.42±0.33) was seen in tumor, P=0.022, Conclusions 18F-FMISO showed significantly higher uptake than 18F-FETNIM in tumors and might be the better hypoxia biomarker in lung cancer.