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3-[18F]fluoro-para-hydroxyphenethylguanidine is a radiopharmaceutical positron emission tomography (PET) imaging agent designed as a structural analog of norepinephrine. It acts as a substrate for the norepinephrine transporter (NET) and vesicular monoamine transporters (VMAT1, VMAT2), enabling visualization of sympathetic nerve terminals and neuroendocrine tumors that express these transporters. The compound is used primarily for functional imaging and staging of malignant paraganglioma, pheochromocytoma, and other neuroendocrine tumors, as well as quantification of regional cardiac sympathetic nerve density in heart failure patients. Its mechanism involves selective uptake by NET-expressing tissues, providing high lesion affinity with favorable imaging properties compared to other tracers such as [123I]mIBG or [68Ga]DOTATATE[1][2][5][6][7].
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