Ứng dụng lâm sàng PET/CT sử dụng dược chất phóng xạ không phải 18F-FDG trong ung thư

Clinical Non-FDG PET/CT Applications in Oncology

SUMMARY

In clinical practice 18FDG-PET is applied in almost cancers in staging, re-staging, monitoring therapy response and the follow-up. On the other hand, at no time do all tumors show significant increase of 18FDG uptake on PET imaging. Particularly in prostate cancer, neuroendocrine and hepatocellular carcinoma... In this review we have introduced those already used for clinical applications like 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 if low grade being labelled with either 11C or 18F, the former being the preference by dint of lower urinary excretion and patients exposure. The latter is more beneficial for centers without on-site cyclotron. Methionine is required for protein synthesis and tumor cells which have been used for imaging of CNS neoplasms. NET tumors demonstrate an increased activity of L-DOPA decarboxylase, hence high uptake of 18FDOPA. 18F-FLT is a specific marker in application of FLT is lung cancer. Other tracers are used in PET utilized include 18F-MISO, 64Cu- ATSM, 18F-EF5, which highlight the presence of hypoxic areas are useful for radiotherapy.

Key words: radiopharmaceuticals, choline, methionine, DOPA, DOTA, FLT.