PT - JOURNAL ARTICLE AU - Lucy Vivash AU - Terence J. O’Brien TI - Imaging Microglial Activation with TSPO PET: Lighting Up Neurologic Diseases? AID - 10.2967/jnumed.114.141713 DP - 2016 Feb 01 TA - Journal of Nuclear Medicine PG - 165--168 VI - 57 IP - 2 4099 - http://jnm.snmjournals.org/content/57/2/165.short 4100 - http://jnm.snmjournals.org/content/57/2/165.full SO - J Nucl Med2016 Feb 01; 57 AB - Neuroinflammation is implicated in the pathogenesis of a wide range of neurologic and neuropsychiatric diseases. For over 20 years, 11C-PK11195 PET, which aims to image expression of the translocator protein (TSPO) on activated microglia in the brain, has been used in preclinical and clinical research to investigate neuroinflammation in vivo in patients with brain diseases. However, 11C-PK11195 suffers from two major limitations: its low brain permeability and high nonspecific and plasma binding results in a low signal-to-noise ratio, and the use of 11C restricts its use to PET research centers and hospitals with an on-site cyclotron. In recent years, there has been a great deal of work into the development of new TSPO-specific PET radiotracers. This work has focused on fluorinated radiotracers, which would enable wider use and improved signal-to-noise ratios. These radiotracers have been utilized in preclinical and clinical studies of several neurologic diseases with varying degrees of success. Unfortunately, the application of these second-generation TSPO radiotracers has revealed additional problems, including a polymorphism that affects TSPO binding. In this review, the developments in TSPO imaging are discussed, and current limitations and suggestions for future directions are explored.