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Imaging of Tumor Metabolism: PET with Other Metabolites

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Functional Imaging in Oncology

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Abstract

As the research of metabolic imaging is expanding, the clinical applications of radiolabeled substrates have also been increasing. Apart from glycolysis, other biochemical processes including amino acid synthesis, peptide and nucleic acid sequencing, lipid metabolism, signal transduction, and neurotransmitter-receptor interactions are also known to represent various forms of metabolic changes possibly found in tumor cells. In the literature, there are increasing amount of research studies on non-18F-FDG PET radiopharmaceuticals targeted for specific biochemical processes other than glycolysis. This chapter discusses on the basic biochemistry of non-18F-FDG PET tracers and how a good understanding of the underlying metabolic pathways of individual tracers leads to various clinical applications, particularly in the improvement of tumor detection, diagnosis, and patient management. Specific discussion is focused on 11C-acetate, 18F-acetate, 11C-choline, 18F-choline, 11C-methionine, 18F-DOPA, 18F-FLT, and Gallium-68 (68Ga)-labeled somatostatin analogs, primarily because these PET tracers have been investigated in greater biochemical and pharmaceutical details. Some have already been clinically confirmed useful, while others have great potentials to add to our understanding and to guide our research development on tumor metabolism and growth.

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Abbreviations

18F-DOPA:

F-18-fluoro-l-phenylalanine

18F-FAC:

18F-acetate

18F-FLT:

18F-fluorothymidine

acetyl-CoA:

Acetyl-coenzyme A

APUD:

Amine Precursor Uptake and Decarboxylation

EGF:

Endothelial growth factors

FAS:

Fatty acid synthetase

FNH:

Focal Nodular Hyperplasia

HCC:

Hepatocellular carcinoma

MGUS:

Monoclonal gammopathy of undetermined significance

NET:

Neuroendocrine tumors

NSCLC:

Non-small cell lung carcinoma

PSA:

Prostate-specific antigen

RCC:

Renal cell carcinoma

SREBPs:

Sterol regulatory element-binding proteins

SUV:

Standardized uptake value

TCA:

Tricarboxylic acid cycle

TK1:

Thymidine kinase 1

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Authors and Affiliations

  1. Department of Nuclear Medicine and PET, Hong Kong Sanatorium and Hospital, 2 Village Road, Happy Valley, Hong Kong, China

    Chi-Lai Ho MD, Sirong Chen PhD & Man-Ki Cheung PhD

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  1. Chi-Lai Ho MD
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  2. Sirong Chen PhD
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  1. Health Time Group, Jaén, Spain

    Antonio Luna

  2. Dept. of MRI, Clínica Girona, Girona, Spain

    Joan C. Vilanova

  3. Botafogo - Rio de Janeiro/RJ, Brazil

    L. Celso Hygino da Cruz Jr.

  4. Centro de Diagnóstico Dr. Enrique Rossi, Buenos Aires, Argentina

    Santiago E. Rossi

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Ho, CL., Chen, S., Cheung, MK. (2014). Imaging of Tumor Metabolism: PET with Other Metabolites. In: Luna, A., Vilanova, J., Hygino da Cruz Jr., L., Rossi, S. (eds) Functional Imaging in Oncology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-40412-2_10

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