ATC Group: V09IX Other diagnostic radiopharmaceuticals for tumour detection

Fluciclovine ¹⁸F is a synthetic amino acid which is transported across mammalian cell membranes by amino acid transporters such as LAT-1 and ASCT2. The activities of LAT-1 and ASCT2 are known to be upregulated in prostate cancer, providing a mechanism for the enhanced accumulation of fluciclovine ¹⁸F in prostate cancer. Fluciclovine ¹⁸F is indicated for Positron Emission Tomography (PET) imaging to detect recurrence of prostate cancer.

Fludeoxyglucose F18 is a glucose analog that concentrates in cells that rely upon glucose as an energy source, or in cells whose dependence on glucose increases under pathophysiological conditions. Fludeoxyglucose F18 is used to assess glucose metabolism. It is a positron emitting radiopharmaceutical that is used for diagnostic purposes in conjunction with positron emission tomography (PET) imaging.

Fluorodopa F18 is a radioactive diagnostic agent used in PET imaging. In dopaminergic nerve terminals in the brain, fluorodopa (FDOPA) F18 is decarboxylated by amino acid decarboxylase to fluorodopamine (FDA) F18 and stored in presynaptic vesicles in the brain. The accumulation of F18 FDA in the striatum is visually detected in the PET scan.

Fluoroestradiol ¹⁸F binds estrogen receptor (ER) and is indicated for use with positron emission tomography (PET imaging) for characterization of ER status of known or suspected metastatic lesions in patients with confirmed ER-positive breast cancer.

Gallium ⁶⁸Ga edotreotide binds to somatostatin receptors, with highest affinity (K_i = 2.5 ± 0.5 nanomolar) for subtype 2 receptors (sstr2). Gallium ⁶⁸Ga edotreotide binds to cells that express somatostatin receptors including malignant neuroendocrine cells, which overexpress sstr2 receptors.

Iobenguane is similar in structure to the antihypertensive drug guanethedine and to the neurotransmitter norepinephrine (NE). Iobenguane is, therefore, largely subject to the same uptake and accumulation pathways as NE. Iobenguane accumulates in adrenergically innervated tissues such as the adrenal medulla, salivary glands, heart, liver, spleen and lungs as well as tumors derived from the neural crest. By labeling iobenguane with the isotope iodine 123, it is possible to obtain scintigraphic images of the organs and tissues in which the radiopharmaceutical accumulates.

Piflufolastat (¹⁸F) is a selective secondgeneration fluorine-18-labeled small-molecule PSMA inhibitor. Based on the intensity of the signals, PET images obtained using piflufolastat (¹⁸F) indicate the presence of PSMA expressing tissues.

Sodium fluoride F18 is a radioactive diagnostic agent for positron emission tomography (PET) indicated for imaging of bone to define areas of altered osteogenic activity. Increased fluoride F18 ion deposition in bone can occur in areas of increased osteogenic activity during growth, infection, malignancy (primary or metastatic) following trauma, or inflammation of bone.