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F-18 FMISO accumulation (red) in hypoxic components of a cervix tumour
SU images tumour hypoxia in vivo
Author: Alex Doruyter
Published: 29/06/2023

​​This week as part of a project led by Prof James Warwick, SU scientists performed the first local imaging of F-18 fluoromisonidazole (FMISO) in patients.  The project forms part of a collaboration between the Divisions of Nuclear Medicine and Radiation Oncology investigating the prognostic significance of hypoxia (low oxygen) in advanced cervix cancers. The radiopharmaceutical was labelled at specialist facilities at the NuMeRI Node for Infection Imaging (NII), a Central Analytical Facillity which is also performing the patient imaging.

F-18 FMISO is a radiolabelled nitroimidazole molecule which  undergoes reduction upon entering a cell. In cells with normal oxygen levels , F-18 FMISO is rapidly oxidised and diffuses out of the cell but in hypoxic cells, the radiopharmaceutical remains in its reduced state and accumulates. This accumulation can then be visualised and quantified using a positron emission tomography (PET-CT) scan.

Identifying areas of hypoxia in tumours can potentially be valuable in predicting the prognosis of these patients and guiding how they are treated.

The work represents an important milestone for SU's NII, which was commissioned in 2019 as a dedicated research PET-CT unit and radiopharmacy. The unit plans to expand research access to other non-commercial radiopharmaceuticals radiolabelled on site in the near future.