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Objective:The aims of this study were to evaluate potential side effects of 18F-fluoroerythronitroimidazole(18F-FETNIM)as a new-type hypoxia-imaging agent and to investigate the feasibility of 18F-FETNIM PET imaging in advanced non-small cell lung cancer(NSCLC)patients and the correlations of hypoxia extent with tumor volume or pathological type.Methods:Twenty-six NSCLC patients were prospectively included in the study.PET/CT scans were performed 2 h after intravenous injection of 18F-FETNIM in all 26 patients.A pixel-by-pixel calculation of tumor to blood(T/B)activity ratio for all image planes was calculated.The number of pixels in the tumor volume with a T/B ratio ≥ 1.5,indicating significant hypoxia,was determined and converted to mL units to measure the hypoxia volume(HV).Results:The images were clearly identified after 2h post-injection of 18F-FETNIM.The tumors in 4 cases were not distinguished from background,while the remaining 22 displayed local 18F-FETNIM uptake in thoracic lesions moderately to markedly higher than background.There was no correlation between 18F-FETNIM uptake with pathological type.There were significant correlations of HV and also the T/B ratio with tumor volume.Conclusion:18F-FETNIM is a promising hypoxia-imaging agent which clinical use is safe and satisfactory.The preliminary study provides valuable methods and experience to its further research.