Fluoromisonidazole F-18 Injection [F-18 Miso]

Fluoromisonidazole F-18 Injection [F-18 Miso]

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Noninvasive positron emission tomography (PET) imaging evaluates the tumor and regional disease in a ‘‘snapshot’’ fashion and can provide serial quantitative measurements of hypoxia. PET imaging of tissue hypoxia using 18F]fluoromisonidazole (FMISO), the most widely used nitroimidazole imaging agent, was developed few years ago. Positive accumulation of FMISO is proportional to the extent of hypoxia in the pO2 range of a few mm Hg; high FMISO uptake implies a low tissue O2 concentration. [18F]MISO is only sensitive to the presence of hypoxia in viable cells; [18F]MISO is not retained in necrosis because the electron transport chain that reduces the nitroimidazole to a bioreductive alkylating agent is no longer active.

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