Whole-body PET/CT evaluation of tumor perfusion using generator-based 62Cu-ethylglyoxal bis(Thiosemicarbazonato) copper(II): Validation by direct comparison to 15O-water in metastatic renal cell carcinoma

James W. Fletcher, Theodore F. Logan, Jacob A. Eitel, Carla J. Mathias, Yen Ng, Jeffrey L. Lacy, Gary D. Hutchins, Mark A. Green

Research output: Contribution to journalArticle

4 Scopus citations


This study was undertaken to demonstrate the feasibility of whole-body 62Cu-ethylglyoxal bis(thiosemicarbazonato)copper(II) (62Cu-ETS) PET/CT tumor perfusion imaging in patients with metastatic renal carcinoma and to validate 62Cu-ETS as a quantitative marker of tumor perfusion by direct comparison with 15O-water perfusion imaging.

Methods: PET/CT imaging of 10 subjects with stage IV renal cell cancer was performed after intravenous administration of 15O-water (10-min dynamic list-mode study) with the heart and at least 1 tumor in the PET field of view, followed 10 min later by intravenous 62Cu-ETS (6-min list-mode study). Whole-body 62Cu imaging was then performed from 6 to 20 min at 2-3 min/bed position. Blood flow (K1) was quantified with both agents for normal and malignant tissues in the 21.7-cm dynamic field of view. The required arterial input functions were derived from the left atrium and, in the case of 62Cu-ETS, corrected for partial decomposition of the agent by blood with data from an in vitro analysis using a sample of each patient's blood. This imaging protocol was repeated at an interval of 3-4 wk after initiation of a standard clinical treatment course of the antiangiogenic agent sunitinib.

Results: All subjects received the scheduled 62Cu-ETS doses for the dynamic and subsequent whole-body PET/CT scans, but technical issues resulted in no baseline 15O-water data for 2 subjects. Direct comparisons of the perfusion estimates for normal tissues and tumor metastases were made in 18 paired baseline and treatment studies (10 subjects; 8 baseline studies, 10 repeated studies during treatment). There was an excellent correlation between the blood flow estimates made with 62Cu-ETS and 15O-water for normal tissues (muscle, thyroid, myocardium) and malignant lesions (pulmonary nodules, bone lesions); the regression line was y 5 0.85x 1 0.15, R2 5 0.83, for the 88 regions analyzed.

Conclusion: 62Cu-ETS provided high-quality whole-body PET/CT images, and 62Cu-ETS measures of blood flow were highly and linearly correlated with 15O-water- derived K1 values (mL-1-min-1-g). This tracer is suitable for use as a PET tracer of tumor perfusion in patients with metastatic renal cell carcinoma.

Original languageEnglish (US)
Pages (from-to)56-62
Number of pages7
JournalJournal of Nuclear Medicine
Issue number1
StatePublished - Jan 1 2015


  • O-water
  • Cu PET
  • Cu-ETS [ethylglyoxal bis (thiosemicarbazonato)copper(II)]
  • Renal cell carcinoma
  • Tumor perfusion

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

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