Fig. 1. Overview of major metabolic pathways that can be detected using different imaging modalities. Glucose uptake can be detected using PET with 18F-FDG; using SIRM or MRS with 13C-Glucose; using 2DG probes for optical imaging. Contribution of pyruvate and lactate to TCA cycle can be measured using SIRM or MRS with 13C-Pyruvate and 13C-Lactate. Glutamine uptake can be detected using PET with 18F-Glutamine or 11C-Glutamine; using SIRM with 13C-Glutamine. Additional probes based on amino acids can be used to detect contribution of amino acids to cellular biomass synthesis. Fatty acid uptake by tumor cells can be evaluated using PET probe 11C-Acetate or using optical imaging with luciferase-tagged free fatty acid. PET probes 18F-FLT, 18F-FAC, 18F-FMAU can be used to determine reliance of tumors on thymidine kinase (TK) and/or deoxycitidine kinase (dCK) and/or cytidine deamidase (CDA). Combining imaging modalities with qIHC allows for quantification of total protein levels as well as phosphorylation.
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