Fluorine-18 radiopharmaceuticals beyond [18F]FDG for use in oncology and neurosciences

Positron emission tomography (PET) is a rapidly expanding clinical modality worldwide thanks to the availability of compact medical cyclotrons and automated chemistry for the production of radiopharmaceuticals. There is an armamentarium of fluorine-18 (¹⁸F) tracers that can be used for PET studies in the fields of oncology and neurosciences. However, most of the ¹⁸F-tracers other than 2-deoxy-2-[18F]fluoro-D-glucose (FDG) are in less than optimum human use and there is considerable scope to bring potentially useful ¹⁸F-tracers to clinical investigation stage.The International Atomic Energy Agency (IAEA) convened a consultants' group meeting to review the current status of ¹⁸F-based radiotracers and to suggest means for accelerating their use for diagnostic applications. The consultants reviewed the developments including the synthetic approaches for the preparation of ¹⁸F-tracers for oncology and neurosciences. A selection of three groups of ¹⁸F-tracers that are useful either in oncology or in neurosciences was done based on well-defined criteria such as application, lack of toxicity, availability of precursors and ease of synthesis. Based on the recommendations of the consultants' group meeting, IAEA started a coordinated research project on “Development of ¹⁸F radiopharmaceuticals (beyond [¹⁸F]FDG) for use in oncology and neurosciences” in which 14 countries are participating in a 3-year collaborative program. The outcomes of the coordinated research project are expected to catalyze the wider application of several more ¹⁸F-radiopharmaceuticals beyond FDG for diagnostic applications in oncology and neurosciences.