Revisit 18F-fluorodeoxyglucose oncology positron emission tomography: “systems molecular imaging” of glucose metabolism

// Baozhong Shen 1,2 , Tao Huang 3,* , Yingying Sun 1,2,* , Zhongnan Jin 1,2 and Xiao-Feng Li 1,2 1 PET/CT/MRI Center, The Fourth Hospital of Harbin Medical University, Harbin, China 2 Molecular Imaging Research Center, Harbin Medical University, Harbin, China 3 Department of Radiology, The Fourth Hospital of Harbin Medical University, Harbin, China * These authors have contributed equally to this article Correspondence to: Baozhong Shen, email: // Xiao-Feng Li, email: // Keywords : 18 F-FDG, positron emission tomography, cancer, hypoxia, glucose metabolism Received : February 02, 2017 Accepted : March 11, 2017 Published : March 29, 2017 Abstract 18 F-fluorodeoxyglucose ( 18 F-FDG) positron emission tomography has become an important tool for detection, staging and management of many types of cancer. Oncology application of 18 F-FDG bases on the knowledge that increase in glucose demand and utilization is a fundamental features of cancer. Pasteur effect, Warburg effect and reverse Warburg effect have been used to explain glucose metabolism in cancer. 18 F-FDG accumulation in cancer is reportedly microenvironment-dependent, 18 F-FDG avidly accumulates in poorly proliferating and hypoxic cancer cells, but low in well perfused (and proliferating) cancer cells. Cancer is a heterogeneous and complex “organ” containing multiple components, therefore, cancer needs to be investigated from systems biology point of view, we proposed the concept of “systems molecular imaging” for much better understanding systems biology of cancer. This article revisits 18 F-FDG uptake mechanisms, its oncology applications and the role of 18 F-FDG PET for “systems molecular imaging”.