title: Imaging of Tumor Metabolism Using Positron Emission Tomography (PET).
abstract: Molecular imaging employing PET/CT enables in vivo visualization, characterization, and measurement of biologic processes in tumors at a molecular and cellular level. Using specific metabolic tracers, information about the integrated function of multiple transporters and enzymes involved in tumor metabolic pathways can be depicted, and the tracers can be directly applied as biomarkers of tumor biology. In this review, we discuss the role of F-18-fluorodeoxyglucose (FDG) as an in vivo glycolytic marker which reflects alterations of glucose metabolism in cancer cells. This functional molecular imaging technique offers a complementary approach to anatomic imaging such as computed tomography (CT) and magnetic resonance imaging (MRI) and has found widespread application as a diagnostic modality in oncology to monitor tumor biology, optimize the therapeutic management, and guide patient care. Moreover, emerging methods for PET imaging of further biologic processes relevant to cancer are reviewed, with a focus on tumor hypoxia and aberrant tumor perfusion. Hypoxic tumors are associated with poor disease control and increased resistance to cytotoxic and radiation treatment. In vivo imaging of hypoxia, perfusion, and mismatch of metabolism and perfusion has the potential to identify specific features of tumor microenvironment associated with poor treatment outcome and, thus, contribute to personalized treatment approaches.
authors.affiliation: Department of Radiology and Nuclear Medicine, Medical School, Otto-von-Guericke University, Magdeburg A.ö.R., Magdeburg, Germany.
authors.forename: Ivayla
authors.initials: I
authors.lastname: Apostolova
authors.affiliation: Department of Nuclear Medicine, University Medicine Charité, Berlin, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Wedel
authors.affiliation: Department of Nuclear Medicine, University Medicine Charité, Berlin, Germany. Winfried.Brenner@charite.de.
authors.forename: Winfried
authors.initials: W
authors.lastname: Brenner
mesh_terms: D019788:Fluorodeoxyglucose F18 / Q000378:metabolism; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D053858:Metabolic Networks and Pathways / Q000502:physiology; D057054:Molecular Imaging / Q000379:methods; D009369:Neoplasms / Q000175:diagnosis* / Q000378:metabolism* / Q000473:pathology; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods; D049268:Positron-Emission Tomography / Q000379:methods; D019275:Radiopharmaceuticals / Q000378:metabolism; D059016:Tumor Microenvironment / Q000502:physiology
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: FDG-PET; Molecular imaging; PET/CT; Tumor hypoxia