44Sc production from enriched 47TiO2 targets with a medical cyclotron

44Sc is a β+-emitter which has been extensively studied for nuclear medicine applications. Its promising decay characteristics [t1/2 = 3.97 h, E [Formula: see text] = 632 keV (94.3%), Eγ = 1157 keV (99.9%); 1499 keV (0.91%)] make it highly attractive for clinical PET imaging, offering an alternative to the widely used 68Ga [t1/2 = 67.7 min, E [Formula: see text] = 836 keV (87.7%)]. Notably, its nearly fourfold longer half-life opens avenues for applications with biomolecules having extended biological half-lives and enables the centralized distribution of 44Sc radiopharmaceuticals. An additional advantage of employing 44Sc as a diagnostic radioisotope lies in its counterpart, the β--emitter 47Sc, which is currently under investigation for targeted radiotherapy. Together, they form an ideal theranostic pair, providing a comprehensive solution for both diagnostic imaging and therapeutic applications in nuclear medicine. At the Bern medical cyclotron, a study to optimize the production of scandium radioisotopes is currently ongoing. In this context, proton irradiation of titanium targets has been investigated, exploiting the reactions 47Ti(p,α)44Sc and 50Ti(p,α)47Sc. This approach enables the production of Sc radioisotopes within a single PET medical cyclotron facility, employing identical chemical procedures for target preparation and post-irradiation processing. In this paper, we report on cross-section measurements of the 47Ti(p,α)44Sc nuclear reaction using 95.7% enriched 47TiO2 targets. On the basis of the obtained results, the production yield and purity were calculated to assess the optimal irradiation conditions. Production tests were performed to confirm these findings.

A combined inorganic-organic titanium-44/scandium-44g radiochemical generator

Scandium-44g (t1/2 = 4.0 h) is an emerging radioisotope for positron emission tomography. It can be produced with a radiochemical generator using its long-lived parent, titanium-44 (t1/2 = 59.1 years). This work presents a new inorganic substrate for 44Ti/44gSc radiochemical generator design based on porous TiO2 microbeads (80 µm and 110 µm particle size, 60 Å pores). Comprehensive evaluation of conditions optimal for generator construction (44Ti loading) and use (44gSc elution) is provided in three steps. For stable 44Ti loading onto titania, heat-treatment at 180 °C for 90 min is shown to be effective while 0.3 M HCl(aq) is identified as the medium of choice for 44gSc elution. Two titania-based 3.6 MBq generators prepared under optimized conditions are characterized with respect to 44gSc recovery and 44Ti breakthrough. Each of these generators employed a different guard substrate to minimize 44Ti breakthrough, TiO2 microbeads and ZR resin. Both are shown to provide comparable 44gSc recoveries close to 50% but differ in 44Ti breakthrough, which is significantly lower with the organic ZR resin guard substrate at 0.0002%. This concept represents a new inorganic-organic approach to 44Ti/44gSc generator design. Benefits of both substrates are exploited: TiO2 has potential for durability necessary for utilizing the long half-life of the 44Ti parent while ZR resin guard segments minimize 44Ti breakthrough.

Engineering a modular 44Ti/44Sc generator: eluate evaluation in preclinical models and estimation of human radiation dosimetry

BACKGROUND

⁴⁴Sc/⁴⁷Sc is an attractive theranostic pair for targeted in vivo positron emission tomographic (PET) imaging and beta-particle treatment of cancer. The ⁴⁴Ti/⁴⁴Sc generator allows daily onsite production of this diagnostic isotope, which may provide an attractive alternative for PET facilities that lack in-house irradiation capabilities. Early animal and patient studies have demonstrated the utility of ⁴⁴Sc. In our current study, we built and evaluated a novel clinical-scale ⁴⁴Ti/⁴⁴Sc generator, explored the pharmacokinetic profiles of ⁴⁴ScCl₃, [⁴⁴Sc]-citrate and [⁴⁴Sc]-NODAGA (1,4,7-triazacyclononane,1-glutaric acid-4,7-acetic acid) in naïve mice, and estimated the radiation burden of ⁴⁴ScCl₃ in humans.

METHODS

⁴⁴Ti/⁴⁴Sc (101.2 MBq) in 6 M HCl solution was utilized to assemble a modular ZR resin containing generator. After assembly, ⁴⁴Sc was eluted with 0.05 M HCl for further PET imaging and biodistribution studies in female Swiss Webster mice. Based on the biodistribution data, absorbed doses of ^44/47ScCl₃ in human adults were calculated for 18 organs and tissues using the IDAC-Dose software.

RESULTS

⁴⁴Ti in 6 M HCl was loaded onto the organic resin generator with a yield of 99.97%. After loading and initial stabilization, ⁴⁴ScCl₃ was eluted with 0.05 M HCl in typical yields of 82.9 ± 5.3% (N = 16), which was normalized to the estimated generator capacity. Estimated generator capacity was computed based on elution time interval and the total amount of ⁴⁴Ti loaded on the generator. Run in forward and reverse directions, the ⁴⁴Sc/⁴⁴Ti ratio from a primary column was significantly improved from 1038 ± 440 to 3557 ± 680 (Bq/Bq) when a secondary, replaceable, ZR resin cartridge was employed at the flow outlet. In vivo imaging and ex vivo distribution studies of the reversible modular generator for ⁴⁴ScCl₃, [⁴⁴Sc]-citrate and [⁴⁴Sc]-NODAGA show that free ⁴⁴Sc remained in the circulation significantly longer than the chelated ⁴⁴Sc. The dose estimation of ⁴⁴ScCl₃ reveals that the radiation burden is 0.146 mSv/MBq for a 70 kg adult male and 0.179 mSv/MBq for a 57 kg adult female. Liver, spleen and heart wall will receive the highest absorbed dose: 0.524, 0.502, and 0.303 mGy/MBq, respectively, for the adult male.

CONCLUSIONS

A clinical-scale ⁴⁴Ti/⁴⁴Sc generator system with a modular design was developed to supply ⁴⁴ScCl₃ in 0.05 M HCl, which is suitable for further radiolabeling and in vivo use. Our data demonstrated that free ⁴⁴ScCl₃ remained in the circulation for extended periods, which resulted in approximately 10 times greater radiation burden than stably chelated ⁴⁴Sc. Stable ⁴⁴Sc/⁴⁷Sc-complexation will be more favorable for in vivo use and for clinical utility.

Emerging chelators for nuclear imaging

Chelators are necessary in nuclear medicine imaging to direct an inorganic radionuclide, a radiometal, to a desired target; unfortunately, there is no 'one-size-fits-all' chelator. As the toolbox of radiometals is expanding, new chelators are required to prevent off-target side effects. 1,4,7,10-Tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA) is the current gold standard chelator for several radiometals, but typically, chelation requires harsh conditions, making it unsuitable to label biological vectors. The ideal chelator would allow labelling under mild conditions (near-neutral pH and low temperatures [∼37 °C]) and be both thermodynamically and kinetically stable. Over the past 2-3 years, several exciting chelators have been developed that have superior properties to make them worth investigating for future clinical applications.

Improved Sc-44 production in a siphon-style liquid target on a medical cyclotron

In order to use new and promising radiometals for molecular imaging, it is important that they can be obtained as inexpensively and easily as possible. This often requires a cyclotron with solid target hardware or a radionuclide generator, which are not widely available for rarely used radionuclides. Here, we investigate the improved production of ⁴⁴Sc with a siphon-style liquid target system and compare to our previous work with a simple liquid target. A metal salt solution with a high concentration of natural abundance Ca(NO₃)₂ (0.14 g/cm³) was irradiated with a medical cyclotron (12 MeV protons; 20 μA). ⁴⁴Sc was produced via the ^natCa(p,x)⁴⁴Sc reaction. As the pressure increase during irradiation was reduced in the siphon-style target, it was possible to irradiate with a higher proton beam current (20 μA) than with the simple liquid target system (7.9 μA). In addition, the saturation yield per μA of ⁴⁴Sc was increased by a factor of 3.18 ± 0.05 (6.2 ± 0.1 MBq/μA with the siphon target versus 1.94 ± 0.08 MBq/μA with the simple target). This results in an overall increase in ⁴⁴Sc activity by a factor of 11.

Impact of prompt gamma emission of 44Sc on quantification in preclinical and clinical PET systems

⁴⁴Sc is an increasingly investigated positron emitter for use in positron emission tomography (PET) imaging. However, ⁴⁴Sc is a non-pure positron emitter, since prompt photons are co-emitted during the decay process. This study investigates coincidence energy spectra of ⁴⁴Sc and its impact on PET quantification on a preclinical and clinical PET system in comparison with ¹⁸F. The raw data of the coincidence events revealed characteristic differences comparing the photon energy distribution of ⁴⁴Sc and ¹⁸F. Due to prompt gamma emission of ⁴⁴Sc, activity recovery is underestimated on PET systems. However, clinical PET imaging of ⁴⁴Sc with acceptable quantitative accuracy appears feasible by using a single, constant correction factor.

Synthesis, radiolabeling, and pre-clinical evaluation of [44Sc]Sc-AAZTA conjugate PSMA inhibitor, a new tracer for high-efficiency imaging of prostate cancer

PURPOSE

The aim of this work was to demonstrate the suitability of AAZTA conjugated to PSMA inhibitor (B28110) labeled with scandium-44 as a new PET tracer for diagnostic imaging of prostate cancer.

BACKGROUND

Nowadays, scandium-44 has received significant attention as a potential radionuclide with favorable characteristics for PET applications. A polyaminopolycarboxylate heptadentate ligand based on a 1,4-diazepine scaffold (AAZTA) has been thoroughly studied as chelator for Gd³⁺ ions for MRI applications. The excellent results of the equilibrium, kinetic, and labeling studies led to a preliminary assessment of the in vitro and in vivo behavior of [⁴⁴Sc][Sc-(AAZTA)]^- and two derivatives, i.e., [⁴⁴Sc][Sc (CNAAZTA-BSA)] and [⁴⁴Sc][Sc (CNAAZTA-cRGDfK)].

RESULTS

B28110 was synthesized by hybrid approach, combining solid-phase peptide synthesis (SPPS) and solution chemistry to obtain high purity (97%) product with an overall yield of 9%. Subsequently, the radioactive labeling was performed with scandium-44 produced from natural calcium target in cyclotron, in good radiochemical yields (RCY) under mild condition (pH 4, 298 K). Stability study in human plasma showed good RCP% of [⁴⁴Sc]Sc-B28110 up to 24 h (94.32%). In vivo PET/MRI imaging on LNCaP tumor-bearing mice showed high tracer accumulation in the tumor regions as early as 20 min post-injection. Ex vivo biodistribution studies confirmed that the accumulation of ⁴⁴Sc-PSMA-617 was two-fold lower than that of the radiolabeled B28110 probes.

CONCLUSIONS

This work demonstrated the suitability of B28110 for the complexation with scandium-44 at room temperature and the high performance of the resulting new tracer based on AAZTA chelator for the diagnosis of prostate cancer using PET.

68Ga, 44Sc and 177Lu-labeled AAZTA5-PSMA-617: synthesis, radiolabeling, stability and cell binding compared to DOTA-PSMA-617 analogues

BACKGROUND

The AAZTA chelator and in particular its bifunctional derivative AAZTA⁵ was recently investigated to demonstrate unique capabilities to complex diagnostic and therapeutic trivalent radiometals under mild conditions. This study presents a comparison of ⁶⁸Ga, ⁴⁴Sc and ¹⁷⁷Lu-labeled AAZTA⁵-PSMA-617 with DOTA-PSMA-617 analogues. We evaluated the radiolabeling characteristics, in vitro stability of the radiolabeled compounds and evaluated their binding affinity and internalization behavior on LNCaP tumor cells in direct comparison to the radiolabeled DOTA-conjugated PSMA-617 analogs.

RESULTS

AAZTA⁵ was synthesized in a five-step synthesis and coupled to the PSMA-617 backbone on solid phase. Radiochemical evaluation of AAZTA⁵-PSMA-617 with ⁶⁸Ga, ⁴⁴Sc and ¹⁷⁷Lu achieved quantitative radiolabeling of > 99% after less than 5 min at room temperature. Stabilities against human serum, PBS buffer and EDTA and DTPA solutions were analyzed. While there was a small degradation of the ⁶⁸Ga complex over 2 h in human serum, PBS and EDTA/DTPA, the ⁴⁴Sc and ¹⁷⁷Lu complexes were stable at 2 h and remained stable over 8 h and 1 day. For all three compounds, i.e. [^natGa]Ga-AAZTA⁵-PSMA-617, [^natSc]Sc-AAZTA⁵-PSMA-617 and [^natLu]Lu-AAZTA⁵-PSMA-617, in vitro studies on PSMA-positive LNCaP cells were performed in direct comparison to radiolabeled DOTA-PSMA-617 yielding the corresponding inhibition constants (K_i). K_i values were in the range of 8-31 nM values which correspond with those of [^natGa]Ga-DOTA-PSMA-617, [^natSc]Sc-DOTA-PSMA-617 and [^natLu]Lu-DOTA-PSMA-617, i.e. 5-7 nM, respectively. Internalization studies demonstrated cellular membrane to internalization ratios for the radiolabeled ⁶⁸Ga, ⁴⁴Sc and ¹⁷⁷Lu-AAZTA5-PSMA-617 tracers (13-20%IA/10⁶ cells) in the same range as the ones of the three radiolabeled DOTA-PSMA-617 tracers (17-20%IA/10⁶ cells) in the same assay.

CONCLUSIONS

The AAZTA⁵-PSMA-617 structure proved fast and quantitative radiolabeling with all three radiometal complexes at room temperature, excellent stability with ⁴⁴Sc, very high stability with ¹⁷⁷Lu and medium stability with ⁶⁸Ga in human serum, PBS and EDTA/DTPA solutions. All three AAZTA⁵-PSMA-617 tracers showed binding affinities and internalization ratios in LNCaP cells comparable with that of radiolabeled DOTA-PSMA-617 analogues. Therefore, the exchange of the chelator DOTA with AAZTA⁵ within the PSMA-617 binding motif has no negative influence on in vitro LNCaP cell binding characteristics. In combination with the faster and milder radiolabeling features, AAZTA⁵-PSMA-617 thus demonstrates promising potential for in vivo application for theranostics of prostate cancer.

Image quality analysis of 44Sc on two preclinical PET scanners: a comparison to 68Ga

Background

⁴⁴Sc has been increasingly investigated as a potential alternative to ⁶⁸Ga in the development of tracers for positron emission tomography (PET). The lower mean positron energy of ⁴⁴Sc (0.63 MeV) compared to ⁶⁸Ga (0.83 MeV) can result in better spatial image resolutions. However, high-energy γ-rays (1157 keV) are emitted at high rates (99.9%) during ⁴⁴Sc decay, which can reduce image quality. Therefore, we investigated the impact of these physical properties and performed an unbiased performance evaluation of ⁴⁴Sc and ⁶⁸Ga with different imaging phantoms (image quality phantom, Derenzo phantom, and three-rod phantom) on two preclinical PET scanners (Mediso nanoScan PET/MRI, Siemens microPET Focus 120).

Results

Despite the presence of high-energy γ-rays in ⁴⁴Sc decay, a higher image resolution of small structures was observed with ⁴⁴Sc when compared to ⁶⁸Ga. Structures as small as 1.3 mm using the Mediso system, and as small as 1.0 mm using the Siemens system, could be visualized and analyzed by calculating full width at half maximum. Full widths at half maxima were similar for both isotopes. For image quality comparison, we calculated recovery coefficients in 1–5 mm rods and spillover ratios in either air, water, or bone-equivalent material (Teflon). Recovery coefficients for ⁴⁴Sc were significantly higher than those for ⁶⁸Ga. Despite the lower positron energy, ⁴⁴Sc-derived spillover ratio (SOR) values were similar or slightly higher to ⁶⁸Ga-derived SOR values. This may be attributed to the higher background caused by the additional γ-rays. On the Siemens system, an overestimation of scatter correction in the central part of the phantom was observed causing a virtual disappearance of spillover inside the three-rod phantom.

Conclusion

Based on these findings, ⁴⁴Sc appears to be a suitable alternative to ⁶⁸Ga. The superior image resolution makes it an especially strong competitor in preclinical settings. The additional γ-emissions have a small impact on the imaging resolution but cause higher background noises and can effect an overestimation of scatter correction, depending on the PET system and phantom.

Gallium-68 and scandium-44 labelled radiotracers based on curcumin structure linked to bifunctional chelators: Synthesis and characterization of potential PET radiotracers

Curcumin metal complexes showed widespread applications in medicine and can be exploited as a lead structure for developing new tracers for nuclear medicine application. Herein, the synthesis, chemical characterization and radiolabelling with gallium-68 and scandium-44 of two new targeting vectors based on curcumin scaffolds and linked to the chelators 1,4,7-triazacyclononane,1-glutaric acid-4,7-acetic acid (NODAGA) and 1,4-bis(carboxymethyl)-6-[bis(carboxymethyl)]amino-6-methylperhydro-1,4-diazepine (AAZTA) are reported. Synthesis of the precursors could be achieved with a 13% and 11% yield and radiolabelling generally afforded rapid incorporation under mild conditions (>95%). Stability in physiological media (~75% after 2 h in human blood for [⁶⁸Ga]Ga-/[⁴⁴Sc]Sc-AAZTA-PC21 and ~60% for [⁶⁸Ga]Ga-NODAGA-C21, respectively) are generally enhanced if compared to the previously radiolabelled analogues. MSⁿ fragmentation experiments showed high stability of the AAZTA-PC21 structure mainly due to the pyrazole derivatization of the curcumin keto-enol moiety and a more feasible radiolabelling was noticed both with gallium-68 and scandium-44 mainly due to the AAZTA-chelator properties. [⁶⁸Ga]Ga-NODAGA-C21 showed the most favorable lipophilicity value (logD = 1.3). Due to these findings, both compounds appear to be promising candidates for the imaging of colorectal cancer, but further studies such as in vitro uptake and in vivo biodistribution experiments are needed.

AAZTA5/AAZTA5-TOC: synthesis and radiochemical evaluation with 68Ga, 44Sc and 177Lu

PURPOSE

AAZTA (1,4-bis (carboxymethyl)-6-[bis (carboxymethyl)]amino-6-methylperhydro-1,4-diazepine) based chelators were initially developed in the context of magnetic resonance imaging. First radiochemical studies showed the capability of AAZTA to form stable complexes with radiolanthanides and moderately stable complexes with ⁶⁸Ga. For a systematic comparison of the labelling capabilities with current diagnostic and therapeutic trivalent radiometals, AAZTA⁵ (1,4-bis (carboxymethyl)-6-[bis (carboxymethyl)]amino-6-[pentanoic-acid]perhydro-1,4-diazepine) was synthesized representing a bifunctional version with a pentanoic acid at the carbon-6 atom. To evaluate the effect of adding a targeting vector (TV) to the bifunctional chelator on the complex formation, AAZTA⁵-TOC was synthesized, radiolabeled and tested in comparison to the uncoupled AAZTA⁵.

METHODS

AAZTA⁵ was synthesized in a 5-step synthesis. It was coupled to the cyclic peptide TOC (Phe¹-Tyr³ octreotide) via amide bound formation. AAZTA and AAZTA⁵-TOC complex formations with ⁶⁸Ga, ⁴⁴Sc and ¹⁷⁷Lu were investigated at different pH, temperature and precursor amounts. Stability studies against human serum, PBS buffer, EDTA and DTPA were performed.

RESULTS

AAZTA⁵ and AAZTA⁵-TOC achieved quantitative labelling (> 95%) at room temperature in less than 5 min with all three nuclides at pH ranges from 4 to 5.5 with low precursor amounts of 1 to 10 nmol. [⁴⁴Sc]Sc-AAZTA⁵ complexes as well as [⁴⁴Sc]Sc-AAZTA⁵-TOC were completely stable. The ¹⁷⁷Lu complexes of AAZTA⁵ and AAZTA⁵-TOC showed high stability comparable to the ⁴⁴Sc complexes. In contrast, the [⁶⁸Ga]Ga-AAZTA⁵ complex stability was rather low, but interestingly, [⁶⁸Ga]Ga-AAZTA⁵-TOC was completely stable.

CONCLUSION

AAZTA⁵ appears to be a promising bifunctional chelator for ⁶⁸Ga, ⁴⁴Sc and ¹⁷⁷Lu with outstanding labelling capabilities at room temperature. Complex stabilities are high in the case of ⁴⁴Sc and ¹⁷⁷Lu. While [⁶⁸Ga]Ga-AAZTA complexes alone lacking stability, [⁶⁸Ga]Ga-AAZTA⁵-TOC demonstrated high stability. The latter indicates an interesting feature of [⁶⁸Ga]Ga-AAZTA⁵-labelled radiopharmaceuticals.

Labeling of DOTA-conjugated HPMA-based polymers with trivalent metallic radionuclides for molecular imaging

BACKGROUND

In this work, the in vitro and in vivo stabilities and the pharmacology of HPMA-made homopolymers were studied by means of radiometal-labeled derivatives. Aiming to identify the fewer amount and the optimal DOTA-linker structure that provides quantitative labeling yields, diverse DOTA-linker systems were conjugated in different amounts to HPMA homopolymers to coordinate trivalent radiometals Me(III)* = gallium-68, scandium-44, and lutetium-177.

RESULTS

Short linkers and as low as 1.6% DOTA were enough to obtain labeling yields > 90%. Alkoxy linkers generally exhibited lower labeling yields than alkane analogues despite of similar chain length and DOTA incorporation rate. High stability of the radiolabel in all examined solutions was observed for all conjugates. Labeling with scandium-44 allowed for in vivo PET imaging and ex vivo measurements of organ distribution for up to 24 h.

CONCLUSIONS

This study confirms the principle applicability of DOTA-HPMA conjugates for labeling with different trivalent metallic radionuclides allowing for diagnosis and therapy.

Production of novel diagnostic radionuclides in small medical cyclotrons

The global network of cyclotrons has expanded rapidly over the last decade. The bulk of its industrial potential is composed of small medical cyclotrons with a proton energy below 20 MeV for radionuclides production. This review focuses on the recent developments of novel medical radionuclides produced by cyclotrons in the energy range of 3 MeV to 20 MeV. The production of the following medical radionuclides will be described based on available literature sources: Tc-99 m, I-123, I-124, Zr-89, Cu-64, Ga-67, Ga-68, In-111, Y-86 and Sc-44. Remarkable developments in the production process have been observed in only some cases. More research is needed to make novel radionuclide cyclotron production available for the medical industry.

Separation of cyclotron-produced 44Sc from a natural calcium target using a dipentyl pentylphosphonate functionalized extraction resin

Significant interest in ⁴⁴Sc as a radioactive synthon to label small molecules for positron emission tomography (PET) imaging has been recently observed. Despite the efforts of several research groups, the ideal ⁴⁴Sc production and separation method remains elusive. Herein, we propose a novel separation method to obtain ⁴⁴Sc from the proton irradiation of calcium targets based on extraction chromatography, which promises to greatly simplify current production methodologies. Using the commercially available Uranium and Tetravalent Actinides (UTEVA) extraction resin we were able to rapidly (<20min) recover >80% of the activity generated at end of bombardment (EoB) in small ~1M HCl fractions (400μL). The chemical purity of the ⁴⁴Sc eluates was evaluated through chelation with DOTA and DTPA, and by trace metal analysis using microwave induced plasma atomic emission spectrometry. The distribution coefficients (K_d) of Sc(III) and Ca(II) in UTEVA were determined in HCl medium in a range of concentrations from zero to 12.1M. The ⁴⁴Sc obtained with our method proved to be suitable for the direct labeling of small biomolecules for PET imaging, with excellent specific activities and radiochemical purity.