Exploring Tumor Heterogeneity Using PET Imaging: The Big Picture

Clément Bailly (1, 2) , Caroline M Bodet-Milin (1, 2) , Mickael Bourgeois (1, 2, 3) , Sébastien Gouard (1) , Catherine Ansquer (2) , Matthieu Barbaud (2) , Jean-Charles Sébille (2) , Michel Chérel (1, 3, 4) , Françoise Kraeber-Bodéré (1, 2, 4) , Thomas Carlier (1, 2)

1 CRCINA-ÉQUIPE 13 - Nuclear Oncology
2 Département de Médecine Nucléaire [CHU Nantes]
3 Institut de Recherche Public - ARRONAX - (GIP) Groupement d'Intérêt Public [Saint-Herblain]
4 Service de médecine nucléaire [Saint-Herblain]

Personalized medicine represents a major goal in oncology. It has its underpinning in the identification of biomarkers with diagnostic, prognostic, or predictive values. Nowadays, the concept of biomarker no longer necessarily corresponds to biological characteristics measured ex vivo but includes complex physiological characteristics acquired by different technologies. Positron-emission-tomography (PET) imaging is an integral part of this approach by enabling the fine characterization of tumor heterogeneity in vivo in a non-invasive way. It can effectively be assessed by exploring the heterogeneous distribution and uptake of a tracer such as 18F-fluoro-deoxyglucose (FDG) or by using multiple radiopharmaceuticals, each providing different information. These two approaches represent two avenues of development for the research of new biomarkers in oncology. In this article, we review the existing evidence that the measurement of tumor heterogeneity with PET imaging provide essential information in clinical practice for treatment decision-making strategy, to better select patients with poor prognosis for more intensive therapy or those eligible for targeted therapy.

Mots clés: PET; heterogeneity; radiomics; radiopharmaceuticals; SUV; nuclear medicine

Domaines: Cancer

Clément Bailly, Caroline M Bodet-Milin, Mickael Bourgeois, Sébastien Gouard, Catherine Ansquer, et al.. Exploring Tumor Heterogeneity Using PET Imaging: The Big Picture. Cancers, 2019, 11 (9), pp.1282. ⟨10.3390/cancers11091282⟩. ⟨inserm-02318425⟩