The voice of medical imaging and clinical oncology

Non-FDG PET tracers in oncology: the story so far

FAPI Gopinath Gnanasegaran oncology PET PSMA

The role of radionuclide molecular imaging in oncology with 2-deoxy-2-[fluorine-18] fluoro-D-glucose (18F-FDG) is well established. There is ample evidence to support the role of 18F-FDG PETCT in various clinical scenarios and cancer types. However, there has been a phenomenal expansion in non-FDG PET radiopharmaceuticals for use in clinical oncology. 68Ga is a well established radionuclide […]The role of radionuclide molecular imaging in oncology with 2-deoxy-2-[fluorine-18] fluoro-D-glucose (18F-FDG) is well established. There is ample evidence to support the role of 18F-FDG PETCT in various clinical scenarios and cancer types. However, there has been a phenomenal expansion in non-FDG PET radiopharmaceuticals for use in clinical oncology. 68Ga is a well established radionuclide for PET imaging and is produced using a 68Ge/68Ga generator. 68Ga-labelled tracers such as 68Ga-DOTA and 68Ga-PSMA are currently used in imaging neuroendocrine tumours (NET) and prostate cancer respectively. In addition, other agents have been developed (amino acid derivatives, nitro-imidazole derivatives, glycosylated human serum albumin, etc), both in clinical and trial settings. There are several advantages, limitations and challenges with these tracers. In general, to provide an accurate interpretation of non-FDG-based studies, it is essential to understand the physiologic distribution of the tracers, pattern of uptake in cancer types, tracer avidity, potential pitfalls and challenges. This article aims to provide basic information about several established non-FDG tracers in oncology.

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