Unconventional non-amino acidic PET radiotracers for molecular imaging in gliomas

Purpose The objective of this review was to explore the potential clinical application of unconventional non-amino acid PET radiopharmaceuticals in patients with gliomas. Methods A comprehensive search strategy was used based on SCOPUS and PubMed databases using the following string: (perfusion OR angiogenesis OR hypoxia OR neuroinflammation OR proliferation OR invasiveness) AND (brain tumor OR glioma) AND (Positron Emission Tomography OR PET). From all studies published in English, the most relevant articles were selected for this review, evaluating the mostly used PET radiopharmaceuticals in research centers, beyond amino acid radiotracers and 2-[F-18]fluoro-2-deoxy-d-glucose ([F-18]FDG), for the assessment of different biological features, such as perfusion, angiogenesis, hypoxia, neuroinflammation, cell proliferation, tumor invasiveness, and other biological characteristics in patients with glioma. Results At present, the use of non-amino acid PET radiopharmaceuticals specifically designed to assess perfusion, angiogenesis, hypoxia, neuroinflammation, cell proliferation, tumor invasiveness, and other biological features in glioma is still limited. Conclusion The use of investigational PET radiopharmaceuticals should be further explored considering their promising potential and studies specifically designed to validate these preliminary findings are needed. In the clinical scenario, advancements in the development of new PET radiopharmaceuticals and new imaging technologies (e.g., PET/MR and the application of the artificial intelligence to medical images) might contribute to improve the clinical translation of these novel radiotracers in the assessment of gliomas.

Automated summary

The current use of non-amino acid PET radiopharmaceuticals for assessing perfusion, angiogenesis, hypoxia, neuroinflammation, cell proliferation, tumor invasiveness, and other biological features in glioma patients is limited. Further exploration of investigational PET radiopharmaceuticals and studies validating their potential are necessary for clinical translation in glioma assessment.