Table 1.
Main non-FDG-PET tracers and their principal indications
| 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 | ||||
CIT conventional imaging technique
HCC hepatocellular carcinoma