Pioneering and Fundamental Achievements on the Development of Positron Emission Tomography (PET) in Oncology

Review

Pioneering and Fundamental Achievements on the Development of Positron Emission Tomography (PET) in Oncology

HIROSHI FUKUDA,¹ KAZUO KUBOTA² and TAIJU MATSUZAWA³

¹Department of Nuclear Medicine and Radiology, Institute of Development, Aging and Cancer (IDAC), Tohoku University, Sendai, Miyagi, Japan
²Division of Nuclear Medicine, Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan
³Tokyo Kyobashi Mirai Clinic, Tokyo, Japan

Positron emission tomography (PET) with ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG), a glucose analog, is widely used throughout the world as an indispensable imaging modality for the management of cancer treatment. This article reviews the pioneering achievements of PET in oncology with a focus on the development of PET that occurred from 1980 through the early-1990s. ¹⁸F-FDG was first applied for imaging of animal tumors in 1980 and for brain tumor imaging clinically in 1982. ¹⁸F-FDG enabled to visualize liver metastasis as clear positive image that could not be obtained by conventional nuclear imaging. Subsequently, ¹⁸F-FDG was used for imaging various cancers, such as lung, pancreas, colorectal and hepatoma. ¹¹C-L-methionine (¹¹C-MET) that reflects amino acid transport of cancers has an advantage that its uptake is lower in the brain and inflammatory tissue compared to ¹⁸F-FDG, and was first applied for imaging lung cancer and brain tumor. ¹⁸F-FDG and ¹¹C-MET were proved to be sensitive tracers that can be used to objectively evaluate the effectiveness of cancer treatment. The diagnostic accuracy of PET, which is critical in clinical practice, was evaluated for the differential diagnosis of malignant and benign lung nodules using ¹⁸F-FDG or ¹¹C-MET. In addition to ¹⁸F-FDG and ¹¹C-MET, many radiopharmaceuticals were developed, such as ¹⁸F-labled thymidine analogs for evaluating proliferative activity, ¹⁸F-fluoromisonidazole for imaging of hypoxia, and ¹⁸F-fluorodeoxygalactose for evaluating liver-specific galactose metabolism and for imaging of hepatoma that retains galactose metabolic activity. These early efforts and achievements have greatly contributed to the development and clinical application of ¹⁸F-FDG PET in oncology.

keywords —— cancer imaging; cancer management; ¹¹C-methionine; ¹⁸F-fluorodeoxyglucose; positron emission tomography

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Tohoku J. Exp. Med., 2013, 230, 155-169

Correspondence: Hiroshi Fukuda, M.D., Ph.D., Department of Nuclear Medicine and Radiology, Institute of Development, Aging and Cancer (IDAC), Tohoku University, 4-4-1 Komatsushima, Aoba-ku, Sendai, Miyagi 981-8558, Japan.

e-mail: hirofuku@tohoku-pharm.ac.jp