Hypoxia imaging-directed radiation treatment planning

J. G. Rajendran, K. R.G. Hendrickson, A. M. Spence, M. Muzi, K. A. Krohn, D. A. Mankoff

Research output: Contribution to journalArticlepeer-review

104 Scopus citations


Increasing evidence supports the role of the tumor microenvironment in modulating cancer behavior. Tissue hypoxia, an important and common condition affecting the tumor microenvironment, is well established as a resistance factor in radiotherapy. Increasing evidence points to the ability of hypoxia to induce the expression of gene products, which confer aggressive tumor behavior and promote broad resistance to therapy. These factors suggest that determining the presence or absence of tumor hypoxia is important in planning cancer therapy. Recent advances in PET hypoxia imaging, conformal radiotherapy, and imaging-directed radiotherapy treatment planning now make it possible to perform hypoxia-directed radiotherapy. We review the biological aspects of tumor hypoxia and PET imaging approaches for measuring tumor hypoxia, along with methods for conformal radiotherapy and image-guided treatment, all of which provide the underpinnings for hypoxia-directed therapy. As a case example, we review emerging data on PET imaging of hypoxia to direct radiotherapy.

Original languageEnglish (US)
Pages (from-to)S44-S53
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Issue numberSUPPL. 13
StatePublished - Jul 2006
Externally publishedYes


  • Image-guided treatment
  • PET
  • Radiotherapy
  • Tissue hypoxia

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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