Imaging with non-FDG PET tracers: outlook for current clinical applications

Lopci, Egesta; Nanni, Cristina; Castellucci, Paolo; Montini, Gian Carlo; Allegri, Vincenzo; Rubello, Domenico; Chierichetti, Franca; Ambrosini, Valentina; Fanti, Stefano

doi:10.1007/s13244-010-0040-9

Insights into Imaging

Table 1 Main non-FDG-PET tracers and their principal indications

From: Imaging with non-FDG PET tracers: outlook for current clinical applications

Tracer	Metabolic process	Diagnostic imaging	Oncological indications	Clinical value
11C-Choline	Cellular membrane turnover	Prostate cancer	Diagnosis/Biopsy guidance	Identification of carcinoma foci in patients with multiple negative biopsies
18F-Choline (FCH)	Phosphatidylcholine metabolism	Other tumours:	Staging	Assessment of proper disease extent in high-risk patients
		Bladder cancer	Suspect of relapse	Early detection of relapse in patients with biochemical failure
		Brain tumours, etc.	Restaging	Therapeutic management in patients with documented carcinoma relapse
11C-Methionine	Amino acid transport and protein synthesis	Brain tumours	Diagnosis	Differential diagnosis between benign and malignant lesions/Inconclusive CIT
		Other tumours:	Grading	Direct correlation between 11C-methionine uptake and tumour grading
		Head and neck, etc.	Stereotactic biopsy	Detection of more suitable sites for brain biopsy
		Non-oncologic indication:	Treatment response/Prognostic value	Assessment of treatment efficacy/Direct correlation between uptake decline and patient outcome
		Hyperparathyroidism	Suspect of relapse or residual disease	Characterisation of suspect or inconclusive lesions at CIT
18F-DOPA	Dopamine uptake and metabolism	Neuroendocrine tumours (NET)	Diagnosis/Unknown primary	Diagnosis of NET/Documented NET metastasis in unknown primary
		Non-oncological indications:	Staging/restaging	Assessment of disease extent before treatment
		Congenital hyperinsulinism	Suspect of relapse	Early identification of relapse
		Parkinson
68Ga-DOTA-peptides	Somatostatin receptors	Neuroendocrine tumours (NET)	Diagnosis	Diagnosis of NET
		Other tumours:	Unknown primary	Identification of primary tumour in patients with documented NET metastasis
		Pheochromocytoma	Staging/restaging	Assessment of disease extent before treatment
		Paraganglioma	Suspect of relapse	Early identification of relapse
		Microcytoma	Treatment response	Assessment of treatment efficacy
11C-Acetate	Lipid synthesis and energetic metabolism	Prostate cancer	Similar to 11C-choline indications for prostate cancer
		HCC	Diagnosis of HCC	Differential diagnosis between benign and malignant hepatic lesions
		Non-oncological indications:	Staging/restaging HCC	Assessment of disease extent
		Myocardial metabolism	Suspect of relapsed HCC	Characterisation of suspect or inconclusive lesions at CIT
18F-FLT	Cellular proliferation and	Lymphoma	Diagnosis/Primary tumour	Differential diagnosis between benign and malignant lesions/T staging
TK-1 activity		Lung	Treatment response evaluation	Treatment response assessed with FLT-PET correlates with pathological response
		Colorectal cancer
		Gastric and pancreatic
18-NaF	Bone metabolism	Bone metastasis	Diagnosis	Identification of bone metastasis
		Non-oncological indications:	Staging	Detection of bone involvement in tumours with elevated risk of bone metastasis
		Orthopaedic pathological conditionsOrthopaedic pathological conditions
18F-FMISO	Tumour hypoxia	Solid tumours	Pre-treatment assessment	Detection of hypoxic quota in malignant tissue for prognostic value and treatment intensity modulation
18F-FAZA
18F-EF3 and 5
64Cu-ATSM

CIT conventional imaging technique
HCC hepatocellular carcinoma

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