2-[18F]fluoro-D-glucose ([18F]FDG) is a versatile molecule in nuclear
medicine that has evolved into a vital radiotracer in medical imaging applications via
positron emission tomography (PET) [18F]FDG is derived from its derivative, 2-deoxyD-glucose (2-DG), where the triflate group is attached to carbon-2 [18F]FDG serves as a
crucial non-invasive diagnostic tool and is prominently utilized in non-invasive
imaging of various metastatic diseases, particularly cancer imaging. Its importance as a
tracer has been further enhanced by its unexpected attribute of generating a low body
background through excretion, leading to its effective application in PET/CT for
highly-sensitive and specific tumor detection. This chapter provides insight into the
synthesis of [18F]FDG, employing various reaction protocols such as electrophilic and
nucleophilic processes. This chapter also summarized the purification and their quality
assurance methods and highlighted the distinct challenges associated with each. The
nucleophilic technique produces [18F]FDG with a higher yield and purity than the
electrophilic method for routine manufacture. Commercially devoted automated
modules for FDG production use this method, demonstrating its widespread use in
clinical imaging. Nucleophilic reactions of [18F]fluoride ions attacking the C-2 position
of mannose triflate to produce FDG are routine in clinical imaging. The final [18F]FDG
product satisfies safety, purity, and efficacy standards through rigorous quality control
and assurance. The trajectory from glucose discovery to the development of [18F]FDG
exemplifies the continuing advancement of medical imaging methods. FDG's
accomplishment shows how biology, chemistry, and medical technology are
interrelated, providing a better understanding and treatment of complicated diseases
like cancer.
Keywords: Cancer, Imaging, Nuclear medicine, PET/CT, [18F]FDG.
