| Summary: | The development of 4-<sup>10</sup>B-borono-2-<sup>18</sup>F-fluoro-L-phenylalanine (<sup>18</sup>FBPA) for use in positron emission tomography (PET) has contributed to the progress of boron neutron capture therapy (BNCT). <sup>18</sup>FBPA has shown similar pharmacokinetics and distribution to 4-<sup>10</sup>B-borono-L-phenylalanine (BPA) under various conditions in many animal studies. <sup>18</sup>FBPA PET is useful for treatment indication. A higher <sup>18</sup>FBPA accumulation ratio of the tumor to the surrounding normal tissue (T/N ratio) indicates that a superior treatment effect is expected. In clinical settings, a T/N ratio of higher than 2.5 or 3 is often used for patient selection. Moreover, <sup>18</sup>FBPA PET is useful for predicting the <sup>10</sup>B concentration delivered to the tumor and surrounding normal tissues, enabling high-precision treatment planning. Precise dose prediction using <sup>18</sup>FBPA PET data has greatly improved the treatment accuracy of BNCT. However, the methodology used for the data analysis of <sup>18</sup>FBPA PET findings varies; thus, data should be evaluated using a consistent methodology so as to be more reliable. In addition to PET applications, the development of <sup>18</sup>FBPA as a contrast agent for magnetic resonance imaging that combines gadolinium and <sup>10</sup>B is also in progress.
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