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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     
  1. CIT conventional imaging technique
  2. HCC hepatocellular carcinoma