Review article The pre-requisite of a second-generation glioma PET biomarker Katalin Borbely a, ⁎, Max Wintermark b,1 , Janos Martos c,2 , Imre Fedorcsak d,2 , Laszlo Bognar e,3 , Miklos Kasler f,4 a PET/CT Amb, National Institute of Oncology, 1122 Budapest, Rath Gyorgy 7-9, Hungary b Neuroradiology Division, University of Virginia, Department of Radiology, Charlottesville, VA, USA c Department of Neuroradiology, National Institute of Neurosurgery, 1145 Budapest, Amerikai 45, Hungary d Department of Neurosurgery, National Institute of Neurosurgery, 1145 Budapest, Amerikai 45, Hungary e Department of Neurosurgery, Debrecen University Medical Faculties, 4032 Debrecen, Nagyerdei krt 98, Hungary f National Institute of Oncology, 1122 Budapest, Rath Gyorgy 7-9, Hungary abstract article info Article history: Received 2 June 2010 Received in revised form 23 July 2010 Accepted 27 July 2010 Available online 23 August 2010 Keywords: Glioma PET Biomarker Since the introduction of FDG into the field of molecular imaging with positron emission tomography (PET) more than three decades ago, FDG has been the tracer of choice for oncology PET imaging. Despite the relative disadvantages of FDG and the relative benefits of its challengers, FDG remains the most commonly used glioma tracer nowadays. The present article surveys the expectations of the field and gives a concise summary of recent developments; including the issues pertaining to the continued search for an optimal second-generation PET biomarker for glioma. Mini-abstract: The present article gives a concise summary of recent developments; including the issues pertaining to the continued search for an optimal PET biomarker for glioma. © 2010 Elsevier B.V. All rights reserved. Contents 1. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 1.1. Clinical considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 1.2. Biological considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 1.3. Regulatory issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 2. Glioma biomarkers in recent clinical practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 3. Challengers—2008 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 3.1. Combination of FDG and MET . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 3.1.1. FET . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 3.1.2. FLT. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 3.1.3. F-choline . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 3.1.4. F-miso . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 3.1.5. Acetate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 3.1.6. Other challenger imaging biomarkers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 3.1.7. VEGFR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 3.1.8. EGFR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 4. Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 Journal of the Neurological Sciences 298 (2010) 11–16 ⁎ Corresponding author. Tel.: +36 1 224 8600; fax: +36 1 224 8720. E-mail addresses: katalin.borbely@oncol.hu (K. Borbely), Max.Wintermark@virginia.edu (M. Wintermark), martjan@oiti.hu (J. Martos), ifedorcsak@sugarsebeszet.hu (I. Fedorcsak), bognarlaszlo@t-online.hu (L. Bognar), m.kasler@oncol.hu (M. Kasler). 1 Tel.: +1 434 243 9312; fax: +1 434 982 5753. 2 Tel.: +36 1 2512999; fax: +36 1 2515678. 3 Tel.: +36 52 411 717; fax: +36 52 419 418. 4 Tel.: +36 1 224 8600; fax: +36 1 8667. 0022-510X/$ – see front matter © 2010 Elsevier B.V. All rights reserved. doi:10.1016/j.jns.2010.07.024 Contents lists available at ScienceDirect Journal of the Neurological Sciences journal homepage: www.elsevier.com/locate/jns