Peptide and antibody imaging in lung cancer

Noninvasive differentiation of malignant from benign pulmonary nodules and the staging of lung cancer are major challenges and opportunities for radionuclide imaging. Despite the performance of (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET) imaging in addressing these needs, access to PET imaging in the United States and other countries is still limited for many people. Furthermore, FDG-PET imaging has left room for improvement. Thus, the need for addressing these diagnostic issues exists for a significant portion of the population of the United States and the rest of the world. Labeled antibody and peptide single-photon emission computed tomography imaging offers a reasonable alternative for these indications and comes close to FDG-PET imaging in performance, along with a lower cost when all overhead is included. Although these tracers have a high sensitivity in the diagnosis of primary and metastatic tumors, their specificity is limited by uptake in granulomatous disease, similar to that of FDG-PET. Regardless of these daunting challenges, radiolabeled antibody and peptide imaging deserves a recognized role in the clinical management of lung cancer.