在过去几年中，分子影像学在病人脑转移（BM）评估中发挥了主要作用。因此，“神经肿瘤反应评估”（RANO）小组推荐使用氨基酸放射性示踪剂评估BM。我们的综述总结了现有的正电子发射断层扫描（PET）示踪剂在BM患者中的应用情况，从现在到未来的前景及新的PET示踪剂，包括放射组学和潜在的治疗诊断方法的角色。进行了对PubMed结果的广泛搜索。审查了截至2022年12月发布的所有英文研究。目前的证据证实了氨基酸PET示踪剂在BM范围描绘、治疗反应评估和尤其是肿瘤进展和放射性坏死的区分方面的重要作用。新型示踪剂以非侵入性方式探索不同的生物瘤体过程，尽管需要更大型临床试验中的更为一致的结果来证实初步结果。我们的综述阐述了分子影像在BM患者中的作用。除了磁共振成像（MRI）是BM诊断的金标准外，PET是一种有用的补充技术，用于无法单独从解剖学MRI获得的过程。

Over the last several years, molecular imaging has gained a primary role in the evaluation of patients with brain metastases (BM). Therefore, the "Response Assessment in Neuro-Oncology" (RANO) group recommends amino acid radiotracers for the assessment of BM. Our review summarizes the current use of positron emission tomography (PET) radiotracers in patients with BM, ranging from present to future perspectives with new PET radiotracers, including the role of radiomics and potential theranostics approaches. A comprehensive search of PubMed results was conducted. All studies published in English up to and including December 2022 were reviewed. Current evidence confirms the important role of amino acid PET radiotracers for the delineation of BM extension, for the assessment of response to therapy, and particularly for the differentiation between tumor progression and radionecrosis. The newer radiotracers explore non-invasively different biological tumor processes, although more consistent findings in larger clinical trials are necessary to confirm preliminary results. Our review illustrates the role of molecular imaging in patients with BM. Along with magnetic resonance imaging (MRI), the gold standard for diagnosis of BM, PET is a useful complementary technique for processes that otherwise cannot be obtained from anatomical MRI alone.