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Background  Hypoxia within solid tumors confers radiation resistance and a poorer prognosis.  124 I-iodoazomycin galactopyranoside ( 124 I-IAZGP) has shown promise as a hypoxia radiotracer in animal models. We performed a clinical study to evaluate the safety, biodistribution, and imaging characteristics of  124 I-IAZGP in patients with advanced colorectal cancer and head and neck cancer using serial positron emission tomography (PET) imaging.    Methods  Ten patients underwent serial whole-torso (head/neck to pelvis) PET imaging together with multiple whole-body counts and blood sampling. These data were used to generate absorbed dose estimates to normal tissues for  124 I-IAZGP. Tumors were scored as either positive or negative for  124 I-IAZGP uptake.    Results  There were no clinical toxicities or adverse effects associated with  124 I-IAZGP administration. Clearance from the whole body and blood was rapid, primarily via the urinary tract, with no focal uptake in any parenchymal organ. The tissues receiving the highest absorbed doses were the mucosal walls of the urinary bladder and the intestinal tract, in particular the lower large intestine. All  124 I-IAZGP PET scans were interpreted as negative for tumor uptake.    Conclusions  It is safe to administer  124 I-IAZGP to human subjects. However, there was insufficient tumor uptake to support a clinical role for  124 I-IAZGP PET in colorectal cancer and head and neck cancer patients.    Trial registration  ClinicalTrials.gov  NCT00588276

ejnmmi research

Pilot study of PET imaging of 124I-iodoazomycin galactopyranoside (IAZGP), a putative hypoxia imaging agent, in patients with colorectal cancer and head and neck cancer