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Fluproxiadine (also referred to as fluproxadine or AF78) is a fluorine-18 labeled positron emission tomography (PET) radiotracer designed to target the norepinephrine transporter (NET). Built on a phenethylguanidine scaffold, it exhibits high affinity and selectivity for NET, mimicking the physiological transport and storage kinetics of norepinephrine at sympathetic nerve terminals. It is developed for cardiac sympathetic nerve imaging, neurological imaging, and the delineation of neuroendocrine tumors such as pheochromocytoma and paraganglioma. The tracer features a streamlined, one-step radiosynthesis using an unprotected guanidine precursor, which facilitates automated clinical production. First-in-human studies have demonstrated its safety, favorable biodistribution, and clear myocardial visualization with acceptable radiation dosimetry.
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