Sample PET Tracers Used in Oncology

Target pathophysiologyTracerWorking principle
Metabolism (glycolysis)18F-FDGUptake and metabolism: tumor cells have higher rate of glucose, to which 18F-FDG is analog.
Cell proliferation3′-deoxy-3′-18F-fluorothmidine (18F-FLT)Malignant transformation increases cell proliferation, which upregulates thymidine.
Gene expression9-(4-fluoro-18F-3-hydroxymethylbutyl) guanine (18F-FHBG)Radiolabeled probe is phosphorylated by selected gene product and is trapped within cell. Thus, magnitude of probe accumulation in cell reflects level of gene expression.
Tumor angiogenesis89Zr-bevacizumabVascular endothelial growth factor (VEGF) plays pivotal roles in regulating tumor angiogenesis. 89Zr-bevacizumab is anti-VEGF antibody and binds to VEGF.
Hypoxia18F-fluoromisonidazole (18F-FMISO)Rapid tumor growth leads to underdeveloped new vascularization, which creates hypoxia. 18F-FMISO takes advantage of increased tracer retention in hypoxic tissues with partial pressure of oxygen < 10 mm Hg.
Apoptosis18F-fluorobenzyl triphenylphosphonium cation (18F-FBnTP)Apoptosis involves permanent collapse of mitochondrial membrane electrochemical potential. 18F-FBnTP is voltage-sensitive probe.