Molecular imaging agents for clinical positron emission tomography in oncology other than fluorodeoxyglucose (FDG):...

Recent efforts in radiopharmaceutical design for positron emission tomography (PET) imaging in clinical oncology have provided a library of tracers that have the potential to contribute to individualizing cancer patient management. These tracers can provide PET images that reveal aspects of the fundamental underlying biochemistry in the tumor before and during treatment. For a number of these PET tracers the cellular processing has been well described and they are now generally referred to as molecular imaging agents. Despite their recognized value in clinical oncology these tracers have not yet obtained widespread acceptance and are not generally available at centers performing PET scans. There are a number of barriers and challenges to the widespread use of these PET tracers that include; a limited clinical demand, challenges presented by the chemistry and formulation for clinical acceptability, the short physical half life of the PET radionuclides, regulatory issues and the overall costs associated with PET radiopharmaceutical production. In addition the interpretation of the PET images requires a clear understanding of the biochemical processes involved at the cellular level. A concerted effort is required among stakeholders including clinicians, scientists, industry and governmental agencies if the potential of these agents in clinical oncology is to be realized.