Clinical Non-FDG PET/CT Applications in Oncology

Dr Le Ngoc Ha1, Dr Mai Hong Son2
1 Department of Nuclear Medicine, 108 Central Hospital
2 Department of Diagnostic Imaging, Institute of Medical Research Clinical 108

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Abstract

In clinical practice 18FDG-PET is applied in almost cancers in staging, re-staging, monitoring therapy response and the follow-up. On the other hand, at no time do all tumors show significant increase of 18FDG uptake on PET imaging. Particularly in prostate cancer, neuroendocrine and hepatocellular carcinoma... In this review we have introduced those already used for clinical applications like 11C- and 18F-Choline, 11C-Methionine and 18F-FET, 18F-DOPA, 68Ga-DOTA-somatostatine analogues, 11C-acetate and 18F-FLT. Choline has indicated a high affinity for prostate cancer, even if low grade being labelled with either 11C or 18F, the former being the preference by dint of lower urinary excretion and patients exposure. The latter is more beneficial for centers without on-site cyclotron. Methionine is required for protein synthesis and tumor cells which have been used for imaging of CNS neoplasms. NET tumors demonstrate an increased activity of L-DOPA decarboxylase, hence high uptake of 18FDOPA. 18F-FLT is a specific marker in application of FLT is lung cancer. Other tracers are used in PET utilized include 18F-MISO, 64Cu- ATSM, 18F-EF5, which highlight the presence of hypoxic areas are useful for radiotherapy.

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References

1. Schiavina R Farsad M, Castellucci P, Nanni C, Corti B, Martorana G, et al. (2005), “Detection and localization of prostate cancer: Correlation of (11) C-choline PET/CT with histopathologic step-section analysis”, J Nucl Med. 46, 1642-9.
2. Sarlis NJ Gourgiotis L, Reynolds JC, VanWaes C, Merino MJ, Pacak K. (2003), “Localization of Medullary Thyroid Carcinoma Metastasis in a Multiple Endocrine Neoplasia Type 2A Patient by 6-[18F]- Fluorodopamine Positron Emission Tomography”, JClin Endocrinol Metab. 88, 637-41.
3. Ghanem N Hoegerle S, Altehoefer C, Schipper J, Brink I, Moser E, et al. (2003), “positron emission tomography for the detection of glomus tumors”, Eur J Nucl Med Mol Imaging. 30, 689-94.
4. Chung JK Kim S, Im SH, Jeong JM, Lee DS, Kim DG, et al. (2005), “11C-methionine PET as a prognostic marker in patients with glioma: Comparison with 18F-FDG PET”, Eur J Nucl Med Mol Imaging. 52-59.
5. Landoni C Picchio M, Messa C, Gianolli L, Matarrese M, De Cobelli F, et al. (2002), “Positive [11C] choline and negative [18F]FDG with positron emission tomography in recurrence of prostate cancer”, AJR Am J Roentgenol. 179, 482-484.
6. Goldman S Pirotte B, Massager N, David P, Wikler D, Vandesteene A, et al (2004), “Comparison of 18F-FDG and 11C-Methionine for PET-Guided
Stereotactic Brain Biopsy of Gliomas”, J Nucl Med. 45, 1293-8.