Roles of facilitative glucose transporter GLUT1 in [18F]FDG positron emission tomography (PET) imaging of human diseases

ABSTRACT

The facilitative glucose transport protein GLUT1 has important roles in positron emission tomography (PET) imaging of human diseases.  GLUT1 has widespread expression and catalyses the energy-independent facilitated diffusion of glucose down its concentration gradient across red blood cell membranes, blood-brain and blood-tissue barriers and membranes of some oragnelles.  Import is usually the prevailing direction of transport for providing metabolic fuel, especially in proliferating cells.  PET imaging using 2-deoxy-2-[18F]fluoro-D-glucose ([18F]FDG) measures the uptake of [18F]FDG into cells and tissues as a marker of glucose transport and glycolytic activity.  Diseases can alter glycolytic activity in localised regions of tissues or organs, which can be visualised using [18F]FDG PET.  Expression and/or activity levels of GLUT1 contribute to the pattern and intensity of [18F]FDG.  [18F]FDG PET imaging is used in diagnosing and monitoring a range of human diseases and in analysing their response to treatments.  Proliferating cancer cells display overexpression of GLUT1 and a vastly higher rate of glycolysis for satisfying their increased nutrient demands.  Tumours therefore have significantly enhanced [18F]FDG uptake compared with normal cells, so [18F]FDG PET is routinely used in diagnosing and monitoring cancers.  [18F]FDG PET imaging of the brain allows identification of distinct patterns of hypometabolism and/or hypermetabolism associated with neurological disorders including Alzheimer’s disease, Parkinson’s disease, epilespsy, schizophrenia, multiple sclerosis and cerebral ischemia.  Cardiovascular diseases, along with underlying conditions such as inflammation, sarcoidosis, atherosclerosis, and infections of implants and prosthetics are routinely assessed using [18F]FDG PET.  Diabetes alters the distribution of [18F]FDG, which can affect diagnosis of other diseases.  The effects of anti-diabetic drugs on glucose metabolism and activation of brown adipose tissue as a preventative measure or treatment for obesity and diabetes have been investigated using [18F]FDG PET.  GLUT1 itself is a potential therapeutic target for treatment of some diseases, which has also been investigated using [18F]FDG PET.

Keywords: cancer; cardiovascular disease; diabetes; FDG-PET imaging; glucose metabolism; GLUT1; neurological disorders; positron emission tomography; radiochemistry; transport protein

Citation: Patching SG. Roles of facilitative glucose transporter GLUT1 in [18F]FDG positron emission tomography (PET) imaging of human diseases. Journal of Diagnostic Imaging in Therapy. 2015; 2(1): 30-102.

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DOI: http://dx.doi.org/10.17229/jdit.2015-0301-014 

Copyright: © 2015 Patching SG. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are cited.

Received: 09 February 2015 | Revised: 26 February 2015 | Accepted: 27 February 2015

Published Online 01 March 2015 www.openmedscience.com

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JDIT-2015-0301-014