CLINICAL NON-FDG PET/CT APPLICATION IN ONCOLOGY.

Abstract

       In clinical practice, 18FDG-PET is applied in almost cancers in staging, restaging, monitoring therapy response and the follow-up. However, at no time do all tumors show a significant increase of 18FDG uptake, particularly in prostate cancer, neuroendocrine and hepatocellular carcinoma... In this review, we have introduced some clinical applications of such non-18FDG radioactive medicines as 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 lower grade, and also been labelled with either 11C or 18F, the former is characterized by lower urinary excretion and patients’ exposure, while the latter is more beneficial for centers without on-site cyclotron. Methionine is required for protein synthesis of tumor cells, which have been used for assessing CNS neoplasms. NET tumors demonstrate an increased activity of L-DOPA decarboxylase, leading to higher uptake of 18F-DOPA. 18F-FLT is a specific marker, especially in lung cancer. Other tracers have been studied and used clinically in PET including 18F-MISO, 64Cu-ATSM, 18FEF5.