Modern radiopharmaceuticals for lung cancer imaging with positron emission tomography/computed tomography scan: A systematic review

Abstract

Introduction: In this study, we evaluated the use and the contribution of radiopharmaceuticals to the field of lung neoplasms imaging using positron emission tomography/computed tomography. Methods: We conducted review of the current literature at PubMed/MEDLINE until February 2020. The search language was English. Results: The most widely used radiopharmaceuticals are the following: Experimental/pre-clinical approaches: (18)F-Misonidazole (18F-MISO) under clinical development, D(18)F-Fluoro-Methyl-Tyrosine (18F-FMT), 18F-FAMT (L-[3-18F] (18)F-Fluorothymidine (18F-FLT)), (18)F-Fluoro-Azomycin-Arabinoside (18F-FAZA), (68)Ga-Neomannosylated-Human-Serum-Albumin (68Ga-MSA) (23), (68)Ga-Tetraazacyclododecane (68Ga-DOTA) (as theranostic agent), (11)C-Methionine (11C-MET), 18F-FPDOPA, ανβ3 integrin, 68Ga-RGD2, 64Cu-DOTA-RGD, 18F-Alfatide, Folate Radio tracers, and immuno-positron emission tomography radiopharmaceutical agents. Clinically approved procedures/radiopharmaceuticals agents: (18)F-Fluoro-Deoxy-Glucose (18F-FDG), (18)F-sodium fluoride (18F-NaF) (bone metastases), and (68)Ga-Tetraazacyclododecane (68Ga-DOTA). The quantitative determination and the change in radiopharmaceutical uptake parameters such as standard uptake value, metabolic tumor volume, total lesion glycolysis, FAZA tumor to muscle ratio, standard uptake value tumor to liver ratio, standard uptake value tumor to spleen ratio, standard uptake value maximum ratio, and the degree of hypoxia have prognostic and predictive (concerning the therapeutic outcome) value. They have been associated with the assessment of overall survival and disease free survival. With the positron emission tomography/computed tomography radiopharmaceuticals, the sensitivity and the specificity of the method have increased. Conclusion: In terms of lung cancer, positron emission tomography/computed tomography may have clinical application and utility (a) in personalizing treatment, (b) as a biomarker for the estimation of overall survival, disease free survival, and (c) apply a cost-effective patient approach because it reveals focuses of the disease, which are not found with the other imaging methods.

NSCLC Biomarkers to Predict Response to Immunotherapy with Checkpoint Inhibitors (ICI): From the Cells to In Vivo Images

“…The 64Cu-labeled diacetyl-bis(N-methylthiosemicarbazone) analog ([64Cu]Cu-ATSM) is an alternative class of agents with low molecular weight and lipophilicity, resulting in high membrane permeability. Its use in the clinical setting is more easily handled [ 210 , 211 ].…”

NSCLC Biomarkers to Predict Response to Immunotherapy with Checkpoint Inhibitors (ICI): From the Cells to in-Vivo Images

“…Unfortunately, imaging of this tracer is also challenging because image quality (resolution of tissue-hypoxia ratios) depends on renal clearance, which could lead to measurements variability; -64Cu-labeled diacetyl-bis(N-methylthiosemicarbazone) analogs ([64Cu]Cu-ATSM) is an alternative class of agents with low molecular weight and lipophilicity, resulting in high membrane permeability. Its use in the clinical setting is more handleable [200,201].…”

Aktueller Stellenwert und Perspektiven der Positronen-Emissions-Tomografie/Computertomografie (PET/CT) in der Diagnostik und Therapie des Lungenkarzinoms

“…Neue PET/CT-Tracer Theodorooulos et al beleuchten in ihrer Übersichtsarbeit den derzeitigen Forschungsstand von neuen PET/CT-Pharmaka, die zukünftig neben den derzeit verwandten Tracern 18 F-FDG (Glukosestoffwechsel) sowie 68 Ga-DOTA-TOC und 68 Ga-DOTATATE (Somatostatinrezeptor-Bindung) als diagnostische, prädiktive und prognostische Biomarker bei der PET/CT des Lungenkarzinoms Anwendung finden können. Hierbei konzentrieren sich translationale Ansätze auf die Charakterisierung von Aminosäuren-und Fettsäuren-Metabolismus, Hypoxie-Stoffwechsel, DNS-Synthese sowie neue Targets wie Folatrezeptoren oder Integrine für die Anwendung der PET/CT bei Lungenkarzinomen [22].…”