Abstract
Poor radiotherapy outcome is in many cases related to hypoxia, due to the increased
radioresistance of hypoxic tumour cells. Positron emission tomography may be used
to non-invasively assess the oxygenation status of the tumour using hypoxia-specific
radiotracers. Quantification and interpretation of these images remains challenging,
since radiotracer binding and oxygen tension are not uniquely related. Computer simulation
is a useful tool to improve the understanding of tracer dynamics and its relation
to clinical uptake parameters currently used to quantify hypoxia. In this study, a
model for simulating oxygen and radiotracer distribution in tumours was implemented
to analyse the impact of physiological transport parameters and of the arterial input
function (AIF) on: oxygenation histograms, time-activity curves, tracer binding and
clinical uptake-values (tissue-to-blood ratio, TBR, and a composed hypoxia-perfusion
metric, FHP). Results were obtained for parallel and orthogonal vessel architectures
and for vascular fractions (VFs) of 1% and 3%. The most sensitive parameters were
the AIF and the maximum binding rate (). TBR allowed discriminating VF for different AIF, and FHP for different , but neither TBR nor FHP were unbiased in all cases. Biases may especially occur
in the comparison of TBR- or FHP-values between different tumours, where the relation
between measured and actual AIF may vary. Thus, these parameters represent only surrogates
rather than absolute measurements of hypoxia in tumours.
Keywords
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Article info
Publication history
Published online: January 29, 2020
Accepted:
January 11,
2020
Received in revised form:
January 10,
2020
Received:
October 7,
2019
Identification
Copyright
© 2020 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.
