Glycolysis plays a central role in tumor metabolism and growth, and this is reflected in a high rate of glucose uptake. It is commonly assumed that the upregulation of the facilitated glucose transporter GLUT1 meets the tumor’s demand for sugar. This underlies the success in using 2FDG PET imaging in the clinic to identify and stage many tumors. However, 2FDG is not a substrate for a second class of glucose transporters, the sodium-dependent glucose cotransporters, SGLTs, and so 2FDG PET may not provide a complete picture. A specific new radiotracer to detect SGLT activity has been introduced, Me4FDG, and this provides an opportunity to explore the potential role of SGLTs in supporting tumor glycolysis. In this brief review, I highlight the development of Me4FDG and our preliminary studies of Me4FDG PET in cancer patients. We find that the renal isoform, SGLT2, is expressed in pancreatic and prostate tumors and glioblastomas, and Me4FDG PET introduces a new method to image tumors. As SGLT2 drugs are successful in treating type 2 diabetes mellitus, they may also provide a new therapy.

糖酵解在肿瘤代谢和生长中起核心作用，这反映在高葡萄糖摄取率上。通常认为促进葡萄糖转运蛋白 GLUT1 的上调满足了肿瘤对糖的需求。这是在临床上成功使用 2FDG PET 成像来识别和分期许多肿瘤的基础。然而，2FDG 不是第二类葡萄糖转运蛋白、钠依赖性葡萄糖协同转运蛋白、SGLT 的底物，因此 2FDG PET 可能无法提供完整的图像。已经引入了一种特定的新放射性示踪剂来检测 SGLT 活性，Me4FDG，这为探索 SGLT 在支持肿瘤糖酵解中的潜在作用提供了机会。在这篇简短的回顾中，我重点介绍了 Me4FDG 的发展以及我们在癌症患者中对 Me4FDG PET 的初步研究。我们发现肾脏同种型 SGLT2 在胰腺和前列腺肿瘤以及胶质母细胞瘤中表达，Me4FDG PET 引入了一种新的肿瘤成像方法。由于 SGLT2 药物成功地治疗了 2 型糖尿病，它们也可能提供一种新的治疗方法。