Biodistribution and Internal Radiation Dosimetry of 99mTc-IDA-D-[c(RGDfK)]2 (BIK-505), a Novel SPECT Radiotracer for the Imaging of Integrin αvβ3 Expression

Validation of dosimetry programs (Olinda & IDAC) for evaluation of absorbed dose in 177LuPSMA therapy of metastatic castration-resistant prostate cancer (mCRPC) using Monte Carlo simulation

PURPOSE

Clinical trials have yielded promising results for 177Lutetium Prostate Specific Membrane Antigen (177Lu-PSMA) therapy in metastatic castration resistant prostate cancer (mCRPC) patients. However, the development of precise methods for internal dosimetry and accurate dose estimation has been considered ongoing research. This study aimed to calculate the absorbed dose to the critical organs and metastasis regions using GATE 9.0 Monte Carlo simulation (MCS) as a gold standard to compare the OLINDA 1.1 and IDAC 2.1 software.

MATERIAL AND METHODS

This study investigated absorbed doses to different organs in 9 mCRPC patients during their first treatment cycle. Whole-body planar images were acquired at 1 ± 0.5, 4 ± 0.5, 24 ± 2, 48 ± 2, 72 ± 2, and 144 ± 2 h post-injection, with SPECT/CT images obtained at 24 ± 2 h. Absorbed doses were calculated for five organs and the entire metastasis regions using GATE, OLINDA, and IDAC platforms. The spherical method was used to determine and compare the absorbed doses in metastatic regions and undefined organs in OLINDA and IDAC Phantom.

RESULTS

The organ-absorbed dose calculations produced by GATE were consistent with those obtained from OLINDA and IDAC. The average percentage differences in absorbed dose for all organs between Monte Carlo calculations and the estimated from IDAC and OLINDA were -0.24 ± 2.14% and 5.16 ± 5.66%, respectively. There was a significant difference between GATE and both IDAC (17.55 ± 29.1%) and OLINDA (25.86 ± 18.04%) in determining absorbed doses to metastatic areas using the spherical model.

CONCLUSION

The absorbed dose of organs in the first treatment cycle remained below tolerable limits. However, cumulative absorbed doses should be considered for the administered activities in the next cycles of treatment. While Monte Carlo, IDAC, and OLINDA results were aligned for organ dose calculations, patient-specific dosimetry may be necessary due to anatomical and functional changes. Accurate dose estimation for undefined organs and metastatic regions using the spherical model is significantly influenced by tissue density, highlighting the value of CT imaging.

Surface-modified nanotherapeutics targeting atherosclerosis

Atherosclerosis is a chronic and metabolic-related disease that is a serious threat to human health. Currently available diagnostic and therapeutic measures for atherosclerosis lack adequate efficiency which requires promising alternative approaches. Nanotechnology-based nano-delivery systems allow for new perspectives for atherosclerosis therapy. Surface-modified nanoparticles could achieve highly effective therapeutic effects by binding to specific receptors that are abnormally overexpressed in atherosclerosis, with less adverse effects on non-target tissues. The main purpose of this review is to summarize the research progress and design ideas to target atherosclerosis using a variety of ligand-modified nanoparticle systems, discuss the shortcomings of current vector design, and look at future development directions. We hope that this review will provide novel research strategies for the design and development of nanotherapeutics targeting atherosclerosis.

Experimental evaluation of absolute quantification in 99m Tc-TRODAT-1 SPECT/CT brain dopamine transporter (DAT) studies

Objective

To evaluate the quantitative accuracy of clinical brain dopamine transporters (DAT) investigations utilizing ^99mTc‐TRODAT‐1 single‐photon emission computed tomography (SPECT)/computed tomography (CT) in experimental and clinical settings.

Materials and methods

The study used an experimental phantom evaluation and a clinical dataset. Three‐dimensional‐ordered subsets expectation–maximization reconstructed the original and resampled datasets using attenuation correction, scatter correction, and resolution recovery. The reconstructed data were analyzed and reported as percentage difference, standardized uptake value reference (SUVr), and a coefficient of variation (CoV). The Taguchi method tested the impact of the three different parameters on signal‐to‐noise ratio (SNR) and SUVr, including number iteration, Poisson resampling, and phantom setup, with and without the plaster of Paris (POP). Six ^99mTc‐TRODAT‐1 SPECT/CT scans were acquired in healthy subjects for verification purposes.

Results

The percentage activity difference between the phantom with and without POP is 20% and 5%, respectively. The SUVr reveals a 10% underestimate for both with and without POP. When it comes to the influence of Poisson resampling, the SUVr value for 75% Poisson resampling indicates 10% underestimation on both sides of the caudate and putamen area, with and without POP. When 25% of Poisson resampling is applied, the SUVr value is overestimated (±35%). In the Taguchi analysis, iteration numbers were the most dominant factor with the F‐value of 9.41 and the contribution rate of 52.66% (p < 0.05) for SNR. In comparison, F‐value of 9.1 for Poisson resampled with contribution rate of 58.91% (p < 0.05) for SUVr. Reducing counts by 25% from the original dataset resulted in a minimal bias in SUVr, compared to 50% and 75%.

Conclusion

The optimal absolute SPECT/CT quantification of brain DAT studies using ^99mTc‐TRODAT‐1 appears achievable with at least 4i10s and SUVr as the surrogate parameter. In clinical investigations, it is possible to reduce the recommended administered dose by up to 25% while maintaining accurate measurement.

A Brief History of Nuclear Medicine Physics, Instrumentation, and Data Sciences in Korea

We review the history of nuclear medicine physics, instrumentation, and data sciences in Korea to commemorate the 60^th anniversary of the Korean Society of Nuclear Medicine. In the 1970s and 1980s, the development of SPECT, nuclear stethoscope, and bone densitometry systems, as well as kidney and cardiac image analysis technology, marked the beginning of nuclear medicine physics and engineering in Korea. With the introduction of PET and cyclotron in Korea in 1994, nuclear medicine imaging research was further activated. With the support of large-scale government projects, the development of gamma camera, SPECT, and PET systems was carried out. Exploiting the use of PET scanners in conjunction with cyclotrons, extensive studies on myocardial blood flow quantification and brain image analysis were also actively pursued. In 2005, Korea's first domestic cyclotron succeeded in producing radioactive isotopes, and the cyclotron was provided to six universities and university hospitals, thereby facilitating the nationwide supply of PET radiopharmaceuticals. Since the late 2000s, research on PET/MRI has been actively conducted, and the advanced research results of Korean scientists in the fields of silicon photomultiplier PET and simultaneous PET/MRI have attracted significant attention from the academic community. Currently, Korean researchers are actively involved in endeavors to solve a variety of complex problems in nuclear medicine using artificial intelligence and deep learning technologies.

Effect of Peptide Receptor Radionuclide Therapy in Combination with Temozolomide against Tumor Angiogenesis in a Glioblastoma Model

Cell adhesion receptor integrin α_vβ₃ is a promising biomarker for developing tumor-angiogenesis targeted theranostics. In this study, we aimed to examine the therapeutic potential of peptide receptor radionuclide therapy (PRRT) with ¹⁸⁸Re-IDA-D-[c(RGDfK)]₂ (11.1 MBq). The results showed that the tumor volume was significantly decreased by 81% compared with the vehicle-treated group in U87-MG xenografts. The quantitative in vivo anti-angiogenic responses of PRRT were obtained using ^99mTc-IDA-D-[c(RGDfK)]₂ SPECT and corresponded to the measured tumor volume. PRRT combined with temozolomide (TMZ) resulted in a 93% reduction in tumor volume, which was markedly greater than that of each agent used individually. In addition, histopathological characterization showed that PRRT combined with TMZ was superior to PRRT or TMZ alone, even when TMZ was used at half dose. Overall, our results indicated that integrin-targeted PRRT and TMZ combined therapy might be a new medical tool for the effective treatment of glioblastoma.

Current State of Targeted Radiometal-Based Constructs for the Detection and Treatment of Disease in the Brain

The continual development of radiopharmaceutical agents for the field of nuclear medicine is integral to promoting the necessity of personalized medicine. One way to greatly expand the selection of radiopharmaceuticals available is to broaden the range of radionuclides employed in such agents. Widening the scope of development to include radiometals with their variety of physical decay characteristics and chemical properties opens up a myriad of possibilities for new actively targeted molecules and bioconjugates. This is especially true to further advance the imaging and treatment of disease in the brain. Over the past few decades, imaging of disease in the brain has heavily relied on agents which exploit metabolic uptake. However, through utilizing the broad range of physical characteristics that radiometals offer, the ability to target other processes has become more available. The varied chemistries of radiometals also allows for them to incorporated into specifically designed diverse constructs. A major limitation to efficient treatment of disease in the brain is the ability for relevant agents to penetrate the blood-brain barrier. Thus, along with efficient disease targeting, there must be intentional thought put into overcoming this challenge. Here, we review the current field of radiometal-based agents aimed at either imaging or therapy of brain disease that have been evaluated through at least in vivo studies.

Advances in Development of Radiometal Labeled Amino Acid-Based Compounds for Cancer Imaging and Diagnostics

Radiolabeled biomolecules targeted at tumor-specific enzymes, receptors, and transporters in cancer cells represent an intensively investigated and promising class of molecular tools for the cancer diagnosis and therapy. High specificity of such biomolecules is a prerequisite for the treatment with a lower burden to normal cells and for the effective and targeted imaging and diagnosis. Undoubtedly, early detection is a key factor in efficient dealing with many severe tumor types. This review provides an overview and critical evaluation of novel approaches in the designing of target-specific probes labeled with metal radionuclides for the diagnosis of most common death-causing cancers, published mainly within the last three years. Advances are discussed such traditional peptide radiolabeling approaches, and click and nanoparticle chemistry. The progress of radiolabeled peptide based ligands as potential radiopharmaceuticals is illustrated via novel structure and application studies, showing how the molecular modifications reflect their binding selectivity to significant onco-receptors, toxicity, and, by that, practical utilization. The most impressive outputs in categories of newly developed structures, as well as imaging and diagnosis approaches, and the most intensively studied oncological diseases in this context, are emphasized in order to show future perspectives of radiometal labeled amino acid-based compounds in nuclear medicine.

Non-oncological applications of RGD-based single-photon emission tomography and positron emission tomography agents

INTRODUCTION

Non-invasive imaging techniques (especially single-photon emission tomography and positron emission tomography) apply several RGD-based imaging ligands developed during a vast number of preclinical and clinical investigations. The RGD (Arg-Gly-Asp) sequence is a binding moiety for a large selection of adhesive extracellular matrix and cell surface proteins. Since the first identification of this sequence as the shortest sequence required for recognition in fibronectin during the 1980s, fundamental research regarding the molecular mechanisms of integrin action have paved the way for development of several pharmaceuticals and radiopharmaceuticals with clinical applications. Ligands recognizing RGD may be developed for use in the monitoring of these interactions (benign or pathological). Although RGD-based molecular imaging has been actively investigated for oncological purposes, their utilization towards non-oncology applications remains relatively under-exploited.

METHODS AND SCOPE

This review highlights the new non-oncologic applications of RGD-based tracers (with the focus on single-photon emission tomography and positron emission tomography). The focus is on the last 10 years of scientific literature (2009-2020). It is proposed that these imaging agents will be used for off-label indications that may provide options for disease monitoring where there are no approved tracers available, for instance Crohn's disease or osteoporosis. Fundamental science investigations have made progress in elucidating the involvement of integrin in various diseases not pertaining to oncology. Furthermore, RGD-based radiopharmaceuticals have been evaluated extensively for safety during clinical evaluations of various natures.

CONCLUSION

Clinical translation of non-oncological applications for RGD-based radiopharmaceuticals and other imaging tracers without going through time-consuming extensive development is therefore highly plausible. Graphical abstract.

Superparamagnetic iron oxide nanoparticles drive miR-485-5p inhibition in glioma stem cells by silencing Tie1 expression

Gliomas are highly malignant nervous system tumours. Studies shown that cancer stem cells are one of the main reasons underlying recurrence, metastasis, and poor prognosis in glioma cases. Our previous studies have found that superparamagnetic iron oxide nanoparticles (SPIONs) can act as nucleic acid carriers to drive intracellular overexpression of these nucleic acids. In this study, CD44+/CD133+ glioma stem cells (HuGSCs) were first isolated from surgically resected tissues from patients. qPCR and western blot results showed that Tie1 expression in HuGSCs was significantly higher thanexpression in CD44-/CD133- glioma cells. Bioinformatic analysis and luciferase reporter assays showed that miR-485-5p binds to specific loci on the 3′-UTR of Tie1 mRNA to inhibit Tie1 expression. Subsequently, miR-485-5p/miR-mut and SPION complexes were transfected into HuGSCs. Transmission electron microscopy showed that a highly dense metallic electron cloud is present in HuGSCs. At the same time, in vivo and in vitro studies showed that miR-485-5p@SPIONs can significantly inhibit HuGSC proliferation, invasion, tumourigenicity, and angiogenesis. In-depth analysis showed that Tie1 interacts with neuronal growth factors such as FGF2, BDNF, GDNF, and GFAP. qPCR and western blot results showed that in miR-485-5p@SPIONs-HuGSCs, the expression levels of Tie1 and stem cell markers (Oct4, Sox2, Nanog, CD44, and CD133), and even FGF2, BDNF, GDNF, and GFAP were significantly lower than thelevels in the control group (miR-mut@SPIONs-HuGSCs). Therefore, this study showedthat Tie1 is an important factor that maintains glioma stem cell activity. SPIONs drive miR-485-5p overexpression in cells and inhibit endogenous Tie1 expression to downregulate the protein expression levels of Fgf2/GDNF/GFAP/BDNF and significantly weaken the in vivo and in vitro viability of gliomas.