Fluorinated positron emitters could be produced with relative ease in the United States, and the methodology for handling the fluorine-18 radioisotope has been vetted by decades of use and millions of procedures involving FDG without mishap, said Spoor. Fluorine-18 has a lower dose profile than SPECT radioisotopes, reducing the overall radiation burden placed on the patient. Dual isotope SPECT scans may expose the patient to between 25 and 30 mSv of radiation. SPECT rest-stress with technetium exposes the patient to between 8 and 10 mSv. In contrast, exposure from fluorine-18 scans range from 4 to 8 mSv, Spoor explained.

To the benefit of the molecular imaging community and the future growth of this modality, the widespread use of FDG with its utility in oncology led to a rapid expansion of the installed base of PET/CT scanners and establishment of an extensive and nationwide FDG distribution network. About 1,800 PET/CTs are operating in the United States and are served by about 100 commercial FDG production sites. Many of these scanners are running at only about half capacity. Consequently, early adopters of the next generation of PET radiopharmaceuticals will have ready access to the needed hardware to perform scans.

“It makes sense when performing medical imaging procedures to go with the modality that delivers the best image quality at the lowest dose, one that renders reproducible results regardless of the skill of the practitioner and is not vulnerable to supply-line disruptions. The case is that much stronger when this modality gains access to specialized radiopharmaceuticals that promise cost-effective and clinically significant testing that will expand the capability of routine healthcare practitioners in neurology, oncology and cardiology,” Spoor said.