Molecular PET imaging: Unlocking the secrets of cancer metabolism

Cancer metabolism is a dynamic and complex field, offering insights into tumor growth, progression, and therapy resistance. Molecular positron emission tomography (PET) imaging has emerged as a pivotal tool for visualizing and quantifying metabolic alterations in cancer, shedding light on processes like glycolysis, amino acid metabolism, lipid synthesis, and hypoxia. This review explores the foundational principles of PET imaging, highlighting key radiotracers such as [¹⁸F]-FDG, glutamine-based tracers, and hypoxia-sensitive agents. Clinical applications, including tumor detection, treatment response monitoring, and prognostic assessments, are discussed in detail. Additionally, the review delves into recent innovations such as novel tracers, AI-driven image analysis, and theranostic approaches, while addressing existing challenges and limitations. By integrating molecular imaging with advances in precision oncology, PET holds the potential of revolutionizing the understanding and management of cancer metabolism. This article underscores the transformative potential of molecular PET imaging in cancer research and its implications for future clinical applications.