Incidental findings in a patient undergoing a movement disorder diagnosis resulted in a coincidental discovery of a malignant glioma, indicating the potential applicability of F-DOPA also for glioma imaging. Selected radiotracers applicable in (brain-)tumor imaging. As a diagnostic tool for the investigation of the neuronal dopaminergic metabolism, a high specific activity (SA) of F-DOPA is not mandatory. For example, its uptake in the striatum is increased during dopamine replacement therapies in Parkinson’s disease and modulated by administration of dopamine D 2 receptor antagonist-based antipsychotic compounds. Likewise, the F-DOPA uptake can also be relevant for determining the effects of treatment of the underlying pathophysiology. As DOPA is the precursor of the neurotransmitter dopamine, the extent of accumulation of F-DOPA in the brain reflects the functional integrity of the presynaptic dopaminergic synthesis and visualizes the activity of aromatic amino acid decarboxylase (AADC), which converts F-DOPA to 18F-dopamine.
The 18F-radiolabeled nonproteinogenic amino acid 3,4-dihydroxy-6-fluoro- L-phenylalanine (F-DOPA) (Figure 1) has been used for over 30 years to image the presynaptic dopaminergic system in the human brain in order to investigate a number of CNS disorders, in particular schizophrenia and Parkinson’s disease with positron emission tomography (PET). This review summarizes the developments in the field of F-DOPA syntheses using electrophilic synthesis pathways as well as recent developments of nucleophilic syntheses of F-DOPA and compares the different synthesis strategies regarding the accessibility and applicability of the products for human in vivo PET tumor imaging. The nucleophilic syntheses which were developed recently are able to provide F-DOPA by automated syntheses in very high specific activities, radiochemical yields, and enantiomeric purities. Among these, the no-carrier-added nucleophilic introduction of fluorine-18, especially, has gained increasing attention as it gives F-DOPA in higher specific activities and shorter reaction times by less intricate synthesis protocols. With the application of this tracer in neuroendocrine tumor imaging, improved radiosyntheses have been developed. Recent findings however point to very favorable results of this tracer for the imaging of other malignant diseases such as neuroendocrine tumors, pheochromocytoma, and pancreatic adenocarcinoma expanding its application spectrum.
From here, we then work to make these technologies, tools, and principles available to flight academies, as affordably and flexibly as possible.For many years, the main application of F-DOPA has been the PET imaging of neuropsychiatric diseases, movement disorders, and brain malignancies. The purpose of CTS is to determine which already proven innovations are best suited for aircrew training, and to work with our partners and regulators to develop and prove other innovations that hold the most promise. The latest developments in traditional and non-traditional flight simulators, targeted cognitive training devices, physiological and biofeedback tools, artificial intelligence, modern and efficient aircraft, advanced high-quality courseware, and interconnected learning management systems, all hold the potential to dramatically improve both the efficiency and effectiveness of pilot training. As it relates to pilot training, recent exciting innovations have been proven in several areas that we believe commercial flight training programs can strongly benefit from. These may be recent advancements that have already been approved for aviation, relevant developments that have been trialed, tested and proven within related fields, or else innovations that have been shown to be effective within other spheres like the military. The answer to this challenge is to seek out and implement proven innovations. Today, companies that fail to innovate quickly fail, but this can pose a significant hurdle within industries like aviation that have very low risk tolerances. The importance of innovation in all commercial sectors is indisputable. The Demand for Proven Innovation in Pilot Training
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