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Metabolic Positron Emission Tomography Imaging in Cancer Detection and Therapy Response
Open accessAbstract
Positron emission tomography (PET) is a noninvasive imaging technique that provides a functional or metabolic assessment of normal tissue or disease conditions. Fluorine 18-fluorodeoxyglucose PET imaging (FDG-PET) is widely used clinically for tumor imaging due to increased glucose metabolism in most types of tumors, and has been shown to improve the diagnosis and subsequent treatment of cancers. We review its use in cancer diagnosis, staging, restaging, and assessment of response to treatment. In addition, other metabolic PET imaging agents in pre-clinical research or clinical trial stages of development are discussed, including amino acid analogs based on increased protein synthesis, and choline, which is based on increased membrane lipid synthesis. Amino acid analogs and choline are more specific to tumor cells than FDG, so they play an important role in differentiating cancers from benign conditions and in the diagnosis of cancers with low FDG uptake or high background FDG uptake. For decades, researchers have shown that tumors display altered metabolic profiles with elevated uptake of glucose, amino acids, and lipids. This can be used for cancer diagnosis and monitoring of the therapeutic response with excellent signal-to-noise ratios.
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“Despite challenges associated with targeting glucose metabolism directly, glucose uptake by cancer cells has been successfully exploited in patients through the use of the fluoro-deoxyglucose positron-emission-tomography (FDG-PET) imaging to stage cancers and assess response to therapy (d’Amico, 2015; Farwell et al., 2014; Zhu et al., 2011).”
From Targeting Metabolism for Cancer Therapy (2017) · cites this paper as Zhu et al., 2011
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BackgroundStrategies on Nanodiagnostics and Nanotherapies of the Three Common Cancers
Leng, F., Liu, F., Yang, Y., Wu, Y., & Tian, W. (2018) · Nanomaterials · doi:10.3390/nano8040202 · Cited by 37
“PET/CT has relatively high specificity and accuracy for lung cancer imaging compared with PET alone, and has additional value in detecting extrathoracic metastasis, such as metastasis in the liver [3,4].”
BackgroundPeng, Y., Bi, L., Guo, Y., Feng, D. D., FULHAM, M. J., & Kim, J. (2019) · Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC) · doi:10.1109/embc.2019.8857666 · Cited by 36
Optical and Magnetic Resonance Imaging Using Fluorous Colloidal Nanoparticles
Wallat, J. D., Czapar, A. E., Wang, C. Y., Wen, A. M., Wek, K. S., Yu, X., Steinmetz, N. F., & Pokorski, J. K. (2016) · Biomacromolecules · doi:10.1021/acs.biomac.6b01389 · Cited by 37
Möck, A., Zschäbitz, S., Kirsten, R., Scheffler, M., Wolf, B., Herold‐Mende, C. C., Kramer, R., Busch, E., Jenzer, M., Jäger, D., et al. (2019) · Cancer Immunology Immunotherapy · doi:10.1007/s00262-019-02428-3 · Cited by 35
Wållberg, H., Grafström, J., Cheng, Q., Lu, L., Ahlzén, H.-S. M., Samén, E., Thorell, J.-O., Johansson, K., Dunås, F., Olofsson, M. H., et al. (2012) · Journal of Nuclear Medicine · doi:10.2967/jnumed.111.102194 · Cited by 34
“With the rapidly expanding use of 18FFDG PET for detecting lesions with aberrant metabolic rates (36), the availability of PET centers with cyclotrons (and cyclotron-produced radionuclides) has increased, and clinical applications of positron-emitting nuclides have widened.”
BackgroundImaging joint infections using D-methyl-11C-methionine PET/MRI: initial experience in humans
Polvoy, I., Seo, Y., Parker, M. F. L., Stewart, M. N., Siddiqua, K., Manacsa, H. S., Ravanfar, V., Blecha, J. E., Hope, T. A., VanBrocklin, H. F., et al. (2022) · European Journal of Nuclear Medicine and Molecular Imaging · doi:10.1007/s00259-022-05858-x · Cited by 32
Recent Advances in the Development and Application of Radiolabeled Kinase Inhibitors for PET Imaging
Bernard‐Gauthier, V., Bailey, J. J., Berke, S., & Schirrmacher, R. (2015) · Molecules · doi:10.3390/molecules201219816 · Cited by 32
Ilter, D., Drápela, S., Schild, T., Ward, N. P., Adhikari, E., Low, V., Asara, J. M., Óskarsson, T., Lau, E. K., DeNicola, G. M., et al. (2023) · Redox Biology · doi:10.1016/j.redox.2023.102627 · Cited by 32
“These differences have been used to diagnose tumors, such as the use of 18F-fluorodeoxyglucose PET imaging [6], and have been considered a hallmark of cancer [7].”
MethodTosi, D., Pieropan, S., Cattoni, M., Bonitta, G., Franzi, S., Mendogni, P., Imperatori, A. S., Rotolo, N., Castellani, M., Cuzzocrea, M., et al. (2021) · Clinical Nuclear Medicine · doi:10.1097/rlu.0000000000003714 · Cited by 31
Expanding Role for Gallium-68 PET Imaging in Oncology
Kleynhans, J., Ebenhan, T., & Sathekge, M. M. (2024) · Seminars in Nuclear Medicine · doi:10.1053/j.semnuclmed.2024.06.001 · Cited by 30
68Ga-labelled NOTA-RGD-GE11 peptide for dual integrin and EGFR-targeted tumour imaging
Chen, C.-J., Chan, C., Lin, K., Chen, J., Tseng, C.-H., Wang, P., Chien, C., Yu, H., & Lin, W. (2018) · Nuclear Medicine and Biology · doi:10.1016/j.nucmedbio.2018.11.003 · Cited by 30
Wong, T. Z., Benefield, T., Masters, S. C., Kiser, J. W., Crowley, J., Osborne, D., Mawlawi, O. R., Barnwell, J., Gupta, P. K., Mintz, A., et al. (2019) · Journal of Nuclear Medicine Technology · doi:10.2967/jnmt.119.228098 · Cited by 30
“Oncologists use PET/CT images to help diagnose and stage disease, choose and plan therapy, and assess tumor response or longitudinally monitor patients (1,18).”
Intercomparison of MR‐informed PET image reconstruction methods
Bland, J., Mehranian, A., Belzunce, M. A., Ellis, S., da Costa-Luis, C. O., McGinnity, C. J., Hammers, A., & Reader, A. J. (2019) · Medical Physics · doi:10.1002/mp.13812 · Cited by 30
“45 Specifically, for brain and neck cancers [ 18 F]FDG PET has played an increasing role in the diagnosis and planning.”
Lin, G., & Chung, Y. (2014) · BioMed Research International · doi:10.1155/2014/625095 · Cited by 31
“Over the past decade, (18)F-FDG PET/CT has become a routine clinical test for staging and restaging of a variety of malignant tumors, including head and neck cancer, lymphoma, colorectal, cervical cancer (Figure 2, [56]), and many other solid organ cancers [48], with a sensitivity of about or above 90% [110].”
BackgroundKnight, J. C., Mosley, M. J., Bravo, L. C., Kersemans, V., Allen, P. D., Mukherjee, S., O’Neill, E. E., & Cornelissen, B. T. (2017) · Clinical Cancer Research · doi:10.1158/1078-0432.ccr-17-0664 · Cited by 29
“(8,9) More recently, molecular imaging techniques including positron emission tomography (PET) and single-photon emission computed tomography (SPECT) have also been recognised as valuable tools for evaluating treatment response.(10-13) These imaging techniques allow visualisation and quantitation of cellular and bioch…”
BackgroundMori, M., Passoni, P., Incerti, E., Bettinardi, V., Broggi, S., Reni, M., Whybra, P., Spezi, E., Vanoli, E. G., Gianolli, L., et al. (2020) · Radiotherapy and Oncology · doi:10.1016/j.radonc.2020.07.003 · Cited by 29
“PET images have been garnering more interest because the intensity heterogeneity is expected to be directly associated to tumor biology [14,15] and few studies tried to explore the pancreatic cancer scenario [16-18].”
BackgroundPET Metabolic Biomarkers for Cancer
Croteau, É., Renaud, J. M., Richard, M. A., Ruddy, T. D., Bénard, F., & deKemp, R. A. (2016) · Biomarkers in Cancer · doi:10.4137/bic.s27483 · Cited by 28
Challapalli, A., Barwick, T. D., Pearson, R., Merchant, S., Mauri, F. A., Howell, E. C., Sumpter, K. A., Maxwell, R. J., Aboagye, E. O., & Sharma, R. (2015) · European Journal of Nuclear Medicine and Molecular Imaging · doi:10.1007/s00259-015-3000-2 · Cited by 28
Fan, W. Q., Shi, W., Zhang, W., Jia, Y., Zhou, Z., Brusnahan, S. K., & Garrison, J. C. (2016) · Biomaterials · doi:10.1016/j.biomaterials.2016.05.036 · Cited by 29
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Application of Metabolic PET Imaging in Radiation Oncology
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“Radiotherapy is mainly applied in three areas: (1) adjuvant radiation therapy after breast surgery, (2) radiation therapy for isolated recurrence after surgery, and (3) radiation therapy for metastatic disease.”
BackgroundMethodSelf-citationVisualization, imaging and new preclinical diagnostics in radiation oncology
Cyran, C. C., Paprottka, P. M., Eisenblätter, M., Clevert, D., Rist, C., Nikolaou, K., Lauber, K., Wenz, F. K., Hausmann, D., Reiser, M. F., et al. (2014) · Radiation Oncology · doi:10.1186/1748-717x-9-3 · Cited by 27
“[118-120].”
Exploitation of CD133 for the Targeted Imaging of Lethal Prostate Cancer
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“[(18)F]fluorodeoxyglucose ([(18)F]FDG) is commonly used in the clinic to image types of cancer that are dependent on glucose metabolism (15).”
BackgroundVaidya, T. P., Agrawal, A., Mahajan, S., Thakur, M., & Mahajan, A. (2018) · Molecular Diagnosis & Therapy · doi:10.1007/s40291-018-0366-4 · Cited by 26
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“Aerobic glycolysis is an essential feature of tumours, which are different from normal tissue, as demonstrated by the widespread use of positron emission tomography scanning to diagnose cancer cells with active glucose uptake [38].”
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Novel Approaches to Imaging Tumor Metabolism
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What do cellular responses to acidity tell us about cancer?
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Song, H., Yu, Q., Yao, G.-D., Tian, Z., Fu, S., & Geng, J. (2014) · Mediators of Inflammation · doi:10.1155/2014/287381 · Cited by 24
Radiolabelling of lipid-based nanocarriers with fluorine-18 for in vivo tracking by PET
Nagachinta, S., Becker, G., Dammicco, S., Navacerrada, M. E. S., Leroi, N., Bahri, M. A., Plenevaux, A., Lemaire, C. F., López‐López, R., Luxen, A., et al. (2020) · Colloids and Surfaces B Biointerfaces · doi:10.1016/j.colsurfb.2020.110793 · Cited by 24
John, B. V., Aubuchon, S., Dahman, B. A., Konjeti, V. R., Heuman, D. M., Hubert, J., Thomas, S., Deng, Y., Solomon, C., Sundaram, L. T., et al. (2020) · Liver Transplantation · doi:10.1002/lt.25743 · Cited by 23
“Use of [18F]fluorodeoxyglucose ([18F]FDG) positron emission tomography (PET) with CT for staging has become increasingly common in many cancers due to the ability to detect occult disease, identify metastatic lymphadenopathy, and, in some cases, predict tumor biology and aggressiveness.(3,4) For example, a meta-analys…”
BackgroundMethod
Metadata
- Authors
- Zhu, A., Lee, D., & Shim, H.
- Affiliations
- Emory University (US)
- Corresponding author
- Shim, Hyunsuk
- Venue
- Seminars in Oncology
- Publisher
- Elsevier BV
- Published
- 2011-02
- Volume
- 38
- Issue
- 1
- Pages
- 55-69
- ISSN
- 0093-7754 (ISSN-L)
- PMC
- PMC3075495
- OpenAlex
- W1982620463
- Cited by
- 368
- References
- 121
- Citations by year
- 2026: 16 · 2025: 31 · 2024: 35 · 2023: 24 · 2022: 35 · 2021: 33 · 2020: 38 · 2019: 36 · 2018: 30 · 2017: 26 · 2016: 17 · 2015: 13 · 2014: 11 · 2013: 11 · 2012: 10
- FWCI
- 8.32
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Seminars in Oncology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Cancer Institute (P50CA128301)
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Medical Imaging Techniques and Applications
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer, Hypoxia, and Metabolism
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiopharmaceutical Chemistry and Applications
- Keywords
- FDG-PET, cancer diagnosis, tumor staging, restaging, treatment response assessment, amino acid analogs, choline PET, tumor glucose metabolism, tumor lipid metabolism, tumor imaging agents
- MeSH terms
- Choline, Humans, Neoplasm Staging, Neoplasms, Sensitivity and Specificity, Tyrosine, Drug Monitoring, Radiopharmaceuticals, Fluorodeoxyglucose F18, Positron-Emission Tomography, Molecular Imaging
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