Assessment of the short-lived non-pure positron-emitting nuclide (120)I for PET imaging

IUPAC Periodic Table of the Elements and Isotopes (IPTEI) for the Education Community (IUPAC Technical Report)

The IUPAC (International Union of Pure and Applied Chemistry) Periodic Table of the Elements and Isotopes (IPTEI) was created to familiarize students, teachers, and non-professionals with the existence and importance of isotopes of the chemical elements. The IPTEI is modeled on the familiar Periodic Table of the Chemical Elements. The IPTEI is intended to hang on the walls of chemistry laboratories and classrooms. Each cell of the IPTEI provides the chemical name, symbol, atomic number, and standard atomic weight of an element. Color-coded pie charts in each element cell display the stable isotopes and the relatively long-lived radioactive isotopes having characteristic terrestrial isotopic compositions that determine the standard atomic weight of each element. The background color scheme of cells categorizes the 118 elements into four groups: (1) white indicates the element has no standard atomic weight, (2) blue indicates the element has only one isotope that is used to determine its standard atomic weight, which is given as a single value with an uncertainty, (3) yellow indicates the element has two or more isotopes that are used to determine its standard atomic weight, which is given as a single value with an uncertainty, and (4) pink indicates the element has a well-documented variation in its atomic weight, and the standard atomic weight is expressed as an interval. An element-by-element review accompanies the IPTEI and includes a chart of all known stable and radioactive isotopes for each element. Practical applications of isotopic measurements and technologies are included for the following fields: forensic science, geochronology, Earth-system sciences, environmental science, and human health sciences, including medical diagnosis and treatment.

Positron range in PET imaging: non-conventional isotopes

In addition to conventional short-lived radionuclides, longer-lived isotopes are becoming increasingly important to positron emission tomography (PET). The longer half-life both allows for circumvention of the in-house production of radionuclides, and expands the spectrum of physiological processes amenable to PET imaging, including processes with prohibitively slow kinetics for investigation with short-lived radiotracers. However, many of these radionuclides emit 'high-energy' positrons and gamma rays which affect the spatial resolution and quantitative accuracy of PET images. The objective of the present work is to investigate the positron range distribution for some of these long-lived isotopes. Based on existing Monte Carlo simulations of positron interactions in water, the probability distribution of the line of response displacement have been empirically described by means of analytic displacement functions. Relevant distributions have been derived for the isotopes (22)Na, (52)Mn, (89)Zr, (45)Ti, (51)Mn, (94 m)Tc, (52 m)Mn, (38)K, (64)Cu, (86)Y, (124)I, and (120)I. It was found that the distribution functions previously found for a series of conventional isotopes (Jødal et al 2012 Phys. Med. Bio. 57 3931-43), were also applicable to these non-conventional isotopes, except that for (120)I, (124)I, (89)Zr, (52)Mn, and (64)Cu, parameters in the formulae were less well predicted by mean positron energy alone. Both conventional and non-conventional range distributions can be described by relatively simple analytic expressions. The results will be applicable to image-reconstruction software to improve the resolution.

Multimodal neuroimaging in humans at 9.4 T: a technological breakthrough towards an advanced metabolic imaging scanner

The aim of this paper is twofold: firstly, to explore the potential of simultaneously acquiring multimodal MR-PET-EEG data in a human 9.4 T scanner to provide a platform for metabolic brain imaging. Secondly, to demonstrate that the three modalities are complementary, with MRI providing excellent structural and functional imaging, PET providing quantitative molecular imaging, and EEG providing superior temporal resolution. A 9.4 T MRI scanner equipped with a PET insert and a commercially available EEG device was used to acquire in vivo proton-based images, spectra, and sodium- and oxygen-based images with MRI, EEG signals from a human subject in a static 9.4 T magnetic field, and demonstrate hybrid MR-PET capability in a rat model. High-resolution images of the in vivo human brain with an isotropic resolution of 0.5 mm and post-mortem brain images of the cerebellum with an isotropic resolution of 320 µm are presented. A (1)H spectrum was also acquired from 2 × 2 × 2 mm voxel in the brain allowing 12 metabolites to be identified. Imaging based on sodium and oxygen is demonstrated with isotropic resolutions of 2 and 5 mm, respectively. Auditory evoked potentials measured in a static field of 9.4 T are shown. Finally, hybrid MR-PET capability at 9.4 T in the human scanner is demonstrated in a rat model. Initial progress on the road to 9.4 T multimodal MR-PET-EEG is illustrated. Ultra-high resolution structural imaging, high-resolution images of the sodium distribution and proof-of-principle (17)O data are clearly demonstrated. Further, simultaneous MR-PET data are presented without artefacts and EEG data successfully corrected for the cardioballistic artefact at 9.4 T are presented.

Effects of magnetic fields of up to 9.4 T on resolution and contrast of PET images as measured with an MR-BrainPET

Simultaneous, hybrid MR-PET is expected to improve PET image resolution in the plane perpendicular to the static magnetic field of the scanner. Previous papers have reported this either by simulation or experiment with simple sources and detector arrangements. Here, we extend those studies using a realistic brain phantom in a recently installed MR-PET system comprising a 9.4 T MRI-scanner and an APD-based BrainPET insert in the magnet bore. Point and line sources and a 3D brain phantom were filled with 18F (low-energy positron emitter), 68Ga (medium energy positron emitter) or 120I, a non-standard positron emitter (high positron energies of up to 4.6 MeV). Using the BrainPET insert, emission scans of the phantoms were recorded at different positions inside and outside the magnet bore such that the magnetic field was 0 T, 3 T, 7 T or 9.4 T. Brain phantom images, with the 'grey matter' compartment filled with 18F, showed no obvious resolution improvement with increasing field. This is confirmed by practically unchanged transaxial FWHM and 'grey/white matter' ratio values between at 0T and 9.4T. Field-dependent improvements in the resolution and contrast of transaxial PET images were clearly evident when the brain phantom was filled with 68Ga or 120I. The grey/white matter ratio increased by 7.3% and 16.3%, respectively. The greater reduction of the FWTM compared to FWHM in 68Ga or 120I line-spread images was in agreement with the improved contrast of 68Ga or 120I images. Notwithstanding elongations seen in the z-direction of 68Ga or 120I point source images acquired in foam, brain phantom images show no comparable extension. Our experimental study confirms that integrated MR-PET delivers improved PET image resolution and contrast for medium- and high-energy positron emitters even though the positron range is reduced only in directions perpendicular to the magnetic field.

Development of novel positron emitters for medical applications: nuclear and radiochemical aspects

In molecular imaging, the importance of novel longer lived positron emitters, also termed as non-standard or innovative PET radionuclides, has been constantly increasing, especially because they allow studies on slow metabolic processes and in some cases furnish the possibility of quantification of radiation dose in internal radiotherapy. Considerable efforts have been invested worldwide and about 25 positron emitters have been developed. Those efforts relate to interdisciplinary studies dealing with basic nuclear data, high current charged particle irradiation, efficient radiochemical separation and quality control of the desired radionuclide, and recovery of the enriched target material for reuse. In this review all those aspects are briefly discussed, with particular reference to three radionuclides, namely 64Cu, 124I and 86Y, which are presently in great demand. For each radionuclide several nuclear routes were investigated but the ( p,n) reaction on an enriched target isotope was found to be the best for use at a small-sized cyclotron. Some other positron emitting radionuclides, such as 55Co, 76Br, 89Zr, 82mRb, 94mTc, 120I, etc., were also produced via the low-energy (p,n), (p,α) or (d,n) reaction. On the other hand, the production of radionuclides 52Fe, 73Se, 83Sr, etc. using intermediate energy (p,xn) or (d,xn) reactions needs special consideration, the nuclear data and chemical processing methods being of key importance. In a few special cases, a high intensity 3He- or α-particle beam could be an added advantage. The production of some potentially interesting positron emitters via generator systems, for example 44Ti/44Sc, 72Se/72As and 140N d/140Pr is considered. The significance of new generation high power accelerators is briefly discussed.

Resolution in PET hypoxia imaging: voxel size matters

INTRODUCTION

Tumor hypoxia adversely affects treatment outcome, especially in squamous cell carcinomas (SCCs). Image guided radiotherapy (IGRT) based on PET-generated tumor hypoxia maps allows dose boosting to hypoxic sub-volumes and has received considerable interest. However, the combination of slow oxygenation-dependent tracer retention, slow clearance of unbound tracer from non-hypoxic tissue and the necessity to average signal over large non-homogenous tissue areas due to the low PET resolution remains problematic.

MATERIALS AND METHODS

To assess pitfalls inherent to low-resolution imaging we have analyzed the fine-scale distribution of a PET hypoxia tracer (autoradiograms) and tissue architecture (immunofluorescence microscopy) in sectioned experimental SCCs, and compared the results to those obtained when applying macroscopic averaging mimicking the resolution in clinical PET scanners.

RESULTS AND DISCUSSION

We show that tumor areas that would be classified as non-hypoxic based on simple PET threshold identification, often contains foci of hypoxic cells, in particular in tumors where necrosis and severely hypoxic cells are intermixed. In contrast, in a non-necrotic tumor model we found that the risk of missing hypoxic cells was greatly reduced, however, its patchy hypoxic pattern made a clear delineation of a target to boost unfeasible. We discuss the implications of these and other complicating factors in PET hypoxia-imaging and outline future strategies to overcome or circumvent them.

An imaging comparison of 64Cu-ATSM and 60Cu-ATSM in cancer of the uterine cervix

Tumor uptake of copper(II)-diacetyl-bis(N(4)-methylthiosemicarbazone) (copper-ATSM), a hypoxia-targeting radiopharmaceutical, assessed by PET has been found to correlate with prognosis in several human cancers. Wide clinical utility of this tracer will require its labeling with a copper radionuclide having a longer half-life than the (60)Cu used in studies to date. The purpose of this work was to obtain the requisite preclinical data for copper-ATSM to file an investigational new drug application, followed by a crossover comparison of PET image quality and tumor uptake with (60)Cu-ATSM and (64)Cu-ATSM in women with cancer of the uterine cervix.

METHODS

The preclinical toxicology and pharmacology of a copper-ATSM formulation was examined using standard in vitro and in vivo assays, as well as 14-d toxicity studies in both rats and rabbits. For the clinical test-retest imaging study, 10 patients with cervical carcinoma underwent PET on separate days with (60)Cu-ATSM and (64)Cu-ATSM. Image quality was assessed qualitatively, and the tumor-to-muscle activity ratio was measured for each tracer.

RESULTS

The toxicology and pharmacology data demonstrated that the formulation has an appropriate margin of safety for clinical use. In the patient study, we found that the image quality with (64)Cu-ATSM was better than that with (60)Cu-ATSM because of lower noise. In addition, we found that the pattern and magnitude of tumor uptake of (60)Cu-ATSM and (64)Cu-ATSM on studies separated by 1-9 d were similar.

CONCLUSION

(64)Cu-ATSM appears to be a safe radiopharmaceutical that can be used to obtain high-quality images of tumor hypoxia in human cancers.