Role of glutamine in cancer: therapeutic and imaging implications

Metabolic imaging has great clinical potential in cancer because perturbations of metabolism are common hallmarks of malignant cellular transformation. Novel imaging strategies focused on glutamine could provide a valuable complement to (18)F-FDG PET, because glutamine complements glucose in the metabolic platforms that support tumor growth at the cellular level. Furthermore, recent work has demonstrated that distinct aspects of glutamine metabolism are under the control of oncogenes and tumor suppressors. It is plausible that imaging glutamine metabolism could predict both the presence of specific transforming mutations in the tumor and the sensitivity to therapeutic agents designed to target glutamine use. Here, we review the essential aspects of glutamine metabolism in cancer cells and discuss opportunities for imaging in cancer patients.