Molecular imaging in oncologyMetabolic Positron Emission Tomography Imaging in Cancer Detection and Therapy Response
Section snippets
FDG
FDG, an analogue of glucose, is metabolized similarly to glucose. FDG is transported across cell membranes by glucose transporters and is enzymatically phosphorylated to FDG-6-phosphate, which cannot further undergo glycolysis and becomes metabolically trapped intracellularly, in contrast to glucose-6-phosphate.4 The primary exception to the metabolic trapping is in the liver, where a large concentration of phosphatase enzymes results in dephosphorylation of the FDG-6-phosphate and clearance of
Amino Acid Analogs
Due to increased proliferation requiring active protein synthesis, many types of tumors have increased amino acid uptake and upregulated amino acid transporters. Radiolabeled amino acids and their analogs are another class of tumor imaging agents. They are metabolized similarly to amino acids, which are transported across the cell membranes by amino acid transporter proteins. Sodium-independent amino acid transport system L is a major route for providing cells with large neutral amino acids,
Choline
Choline is a precursor of phosphatidylcholine, which is a major constituent of membrane lipids. Membrane lipid synthesis, as well as protein synthesis, is activated during cell proliferation. Therefore, choline is consumed in large quantities by tumor cells.100 11C-cholin has been introduced as an oncological PET tracer for evaluation of a variety of malignant tumors such as brain tumors, and lung, esophageal, colon, bladder, prostate, and many other cancers.101 11C-choline uptake is
Conclusion
FDG-PET is an excellent imaging tool for the diagnosis of primary tumor, recurrence, and metastasis, staging, restaging, and monitoring treatment response in almost all common tumors. Combined PET/CT, which provides functional and anatomical information together, enhances the capability of PET. This enormous capability of PET in oncology is recognized not only by research scientists and clinicians, but also by CMS, which has approved coverage of FDG-PET applications in the initial and
References (117)
- et al.
Hypoxia response elements in the aldolase A, enolase 1, and lactate dehydrogenase A gene promoters contain essential binding sites for hypoxia-inducible factor 1
J Biol Chem
(1996) - et al.
Transcriptional regulation of genes encoding glycolytic enzymes by hypoxia-inducible factor 1
J Biol Chem
(1994) - et al.
Deregulation of glucose transporter 1 and glycolytic gene expression by c-Myc
J Biol Chem
(2000) - et al.
Clinical stage I non-small cell lung cancer including FDG-PET Imaging: sites and time to recurrence
J Thorac Oncol
(2007) - et al.
Bone metastasis in patients with non-small cell lung cancer: the diagnostic role of F-18 FDG PET/CT
Eur J Radiol
(2010) - et al.
Usefulness of FDG-PET for early prediction of the response to gefitinib in non-small cell lung cancer
Lung Cancer
(2008) - et al.
PET/CT imaging in recurrent head and neck cancer
Semin Ultrasound CT MR
(2003) - et al.
Tumor relapse after pancreatic cancer resection is detected earlier by 18F-FDG PET than by CT
J Gastrointest Surg
(2010) - et al.
Human L-type amino acid transporter 1 (LAT1): characterization of function and expression in tumor cell lines
Biochim Biophys Acta
(2001) - et al.
Staging of carcinoid tumours with 18F-DOPA PET: a prospective, diagnostic accuracy study
Lancet Oncol
(2006)
Radiolabeled choline as a proliferation marker: comparison with radiolabeled acetate
Nucl Med Biol
A combined PET/CT scanner: the path to true image fusion
Br J Radiol
PET/CT: form and function
Radiology
Clinical applications of PET in oncology
Radiology
A fluorinated glucose analog, 2-fluoro-2-deoxy-D-glucose (F-18): nontoxic tracer for rapid tumor detection
J Nucl Med
A unique glucose-dependent apoptotic pathway induced by c-Myc
Proc Natl Acad Sci U S A
c-Myc transactivation of LDH-A: implications for tumor metabolism and growth
Proc Natl Acad Sci U S A
Tumor mitochondria and the bioenergetics of cancer cells
Prog Exp Tumor Res
Positron-emission tomography and assessment of cancer therapy
N Engl J Med
Medicare National Coverage determinations manual c, part 4 (sections 200 - 310.1) Coverage determinations 220.6 – positron emission tomography (PET) scans (effective April 3, 2009)
Cancer statistics, 2010
CA Cancer J Clin
Role of FDG-PET in the diagnosis and management of lung cancer
Expert Rev Anticancer Ther
Staging of recurrent and advanced lung cancer with 18F-FDG PET in a coincidence technique (hybrid PET)
Nucl Med Commun
The utility of 18F-FDG PET for suspected recurrent non-small cell lung cancer after potentially curative therapy: impact on management and prognostic stratification
J Nucl Med
Role of 18F-FDG PET in assessment of response in non-small cell lung cancer
J Nucl Med
Cost-effectiveness of FDG-PET in staging non-small cell lung cancer: the PLUS study
Eur J Nucl Med Mol Imaging
FDG-PET for clinical useResults of the 3rd German Interdisciplinary Consensus Conference, “Onko-PET III”, 21 July and 19 September 2000
Eur J Nucl Med
18F-FDG PET for assessment of therapy response and preoperative re-evaluation after neoadjuvant radio-chemotherapy in stage III non-small cell lung cancer
Eur J Nucl Med Mol Imaging
Diagnostic performance and prognostic impact of FDG-PET in suspected recurrence of surgically treated non-small cell lung cancer
Eur J Nucl Med Mol Imaging
Small bowel metastasis from lung cancer detected on FDG PET/CT
Clin Nucl Med
Early assessment of therapeutic response using FDG PET in small cell lung cancer
Mol Imaging Biol
Chemotherapy response evaluation with 18F-FDG PET in patients with non-small cell lung cancer
J Nucl Med
Staging of non-small-cell lung cancer with integrated positron-emission tomography and computed tomography
N Engl J Med
Umbilical metastasis from breast cancer detected by FDG PET
Clin Nucl Med
18F-FDG PET/CT for early prediction of response to neoadjuvant chemotherapy in breast cancer
Eur J Nucl Med Mol Imaging
A different role for FDG PET/CT in axillary lymph node staging in breast cancer
Eur J Nucl Med Mol Imaging
The use of FDG-PET in assessing axillary lymph node status in breast cancer: a systematic review and meta-analysis of the literature
Breast Cancer Res Treat
What is the role of FDG-PET in the initial staging of breast cancer?
Eur J Nucl Med Mol Imaging
Impact of FDG PET on the preoperative staging of newly diagnosed breast cancer
Eur J Nucl Med Mol Imaging
FDG-PET for axillary lymph node staging in primary breast cancer
Eur J Nucl Med Mol Imaging
A quantitative review of the use of FDG-PET in the axillary staging of breast cancer
Med Sci Monit
Utility of 18F-fluoro-deoxyglucose emission tomography/computed tomography fusion imaging (18F-FDG PET/CT) in combination with ultrasonography for axillary staging in primary breast cancer
BMC Cancer
Feasibility of FDG PET/CT to monitor the response of axillary lymph node metastases to neoadjuvant chemotherapy in breast cancer patients
Eur J Nucl Med Mol Imaging
The role of 18F-FDG PET/CT in evaluation of early response to neoadjuvant chemotherapy in patients with locally advanced breast cancer
Eur Radiol
Early prediction of response to primary chemotherapy by sequential FDG -PET in patients with advanced breast cancer
Nippon Rinsho
Performance of integrated FDG PET/contrast-enhanced CT in the diagnosis of recurrent colorectal cancer: comparison with integrated FDG PET/non-contrast-enhanced CT and enhanced CT
Eur J Nucl Med Mol Imaging
Clinical impact of 18F-FDG-PET in the suspicion of recurrent colorectal cancer based on asymptomatically elevated serum level of carcinoembryonic antigen (CEA) in Taiwan
Hepatogastroenterology
The role of FDG-PET/CT in the detection of recurrent colorectal cancer
Eur J Nucl Med Mol Imaging
Chemotherapy plus involved-field radiation in early-stage Hodgkin's disease
N Engl J Med
Utility of positron emission tomography (PET) scanning in managing patients with Hodgkin lymphoma
Hematology Am Soc Hematol Educ Program
Cited by (252)
Manganese oxide nanoplatforms for disease diagnosis and treatment: Progress, challenges and opportunities
2024, Coordination Chemistry ReviewsClinical Application of <sup>18</sup>F-FDG-PET Quantification in Hematological Malignancies: Emphasizing Multiple Myeloma, Lymphoma and Chronic Lymphocytic Leukemia
2023, Clinical Lymphoma, Myeloma and LeukemiaComputer Vision Identifies Recurrent and Nonrecurrent Ductal Carcinoma in Situ Lesions with Special Emphasis on African-American Women
2023, American Journal of PathologyRadiotherapy for Lung Metastases: Conventional to Stereotactic Body Radiation Therapy
2023, Seminars in Radiation Oncology
Financial disclosures: D.J. Lee: Clinical Investigator for Immunomedics, Inc.