Non-FDG Radiopharmaceuticals in Head and Neck PET Imaging: Current Techniques and Future Directions

Positron emission tomography has become a standard in the staging of head and neck cancer as well as can be used in locating unknown primary malignancies, monitoring disease response, and identifying disease recurrence. Although 18F-fluoro-2-deoxy-d-glucose is by far the most frequently used radiopharmaceutical in head and neck imaging, glycolysis is not the only metabolic process or biochemical pathway that can be visualized. In addition, 18F-fluoro-2-deoxy-d-glucose positron emission tomography can be limited due to the nonspecific nature of alterations in glucose metabolism. In this review, we will cover multiple of the emerging radiotracers that have been applied clinically or are in development as promising tools to better image certain malignancies and delineate disease from treatment effects. The potential advantages and disadvantages of these radiopharmaceuticals will also be discussed.