The role of new PET tracers for lung cancer

Abstract

18F-Fluorodeoxyglucose ( 18 F-FDG) positron emission tomography-computed tomography (PET/CT) is integral to the investigation and management of suspected or proven lung cancer (1) despite the nonspecific nature of the 18 F-FDG, which is a glucose analogue. An improved understanding in tumour biology and advances in therapeutic options has driven the need to better characterise tumours, and predict and monitor treatment response to new targeted cancer therapies. Some of the cancer-related cellular processes being investigated include tumour proliferation, amino acid metabolism, tumour hypoxia and angiogenesis. The majority of tracers being used to evaluate these processes remain restricted to preclinical and clinical research. There are also certain receptors which are expressed by specific cancers which can then be targeted by peptides, e.g. neuroendocrine tumours express somatostatin receptors which have an affinity to somatostatin analogues such as DOTA-peptides. 68 Ga-DOTA-peptides have an established role in PET imaging, including imaging of carcinoid tumours, but these are not specific to lung lesions.