Quantum Entanglement Degree, Mean Positronium Lifetime, and the $3\gamma$/$2\gamma$ Annihilation-Rate Ratio as Novel PET Biomarkers for Hypoxia – Concept, Challenges, and Predictions

arXiv:2605.00021v3 Announce Type: replace-cross Abstract: This manuscript introduces a novel method to assess tissue oxygen concentration via the quantum entanglement (QE) of photons originating from positronium which is produced within the patient's body during positron emission tomography. We also investigate the possibility of assessing hypoxia by simultaneously detecting positronium lifetime and the positronium decay rate ratio. We introduce two distinct quantum sensing approaches. Method 1 utilizes the correlation between oxygen concentration and ortho-positronium (o-Ps) decay rates, relying on the simultaneous measurement of the mean o-Ps lifetime ($\tau_{\mathrm{oPs}}$) and the $3\gamma$-to-$2\gamma$ annihilation rate ratio of o-Ps ($R_{\mathrm{oPs-3\gamma/2\gamma}}$). Method 2 introduces a novel hypothesis: that the degree of QE is sensitive to the relative contribution of annihilation mechanisms (pick-off vs. conversion), which in turn depends on oxygen concentration. We derive a formula for partial pressure of oxygen ($p\mathrm{O}_2$) as a function of $R_{\mathrm{oPs-3\gamma/2\gamma}}$ and $\tau_{\mathrm{oPs}}$ and estimate the measurement accuracy required for these parameters - and for the degree of QE - to sense in-vivo oxygen pressure in the range between hypoxic and physoxic conditions. Theoretical models and quantitative estimates for $R_{\mathrm{oPs-3\gamma/2\gamma}}$, $\tau_{\mathrm{oPs}}$ and for the degree of QE ($C_{\mathrm{QE}}$ ) as a function of $p\mathrm{O}_2$ are provided for water, isopropanol, cyclohexane, isooctane, and adipose tissue. In particular, applying the formulas derived under the working hypothesis that in pick-off process the photons are not entangled, we estimated that for $p\mathrm{O}_2 = 0$, the degree of quantum entanglement $C_{\mathrm{QE}}$ is equal to 0.890 for adipose, 0.886 for isopropanol, 0.867 for water, 0.818 for cyclohexane, and 0.784 for isooctane.