Comparison of iron-59, indium-111, and gallium-69 transferrin as a macromolecular tracer of vascular permeability and the transferrin receptor

Tracer amounts of [59Fe++]citrate, [111In+++]chloride, and [68Ga+++]chloride were complexed with autologous plasma transferrin. Each of these complexes were co-administered with [125I]albumin by i.v. injection and their biodistribution was studied in Wistar rats. The plasma clearance of 59Fe and [125I]albumin was monoexponential with half-times of 49-70 and 277 min, respectively. The plasma clearance of 68Ga and 111In was biexponential with second component half-times of 157 and 232 min, respectively. Indium-111 tissue distribution was similar to that of [125I]albumin in heart, lung, muscle, brain and Walker-256 allograft. Iron-59 distribution spaces were generally the highest of the metal complexes in all tissues except muscle, where the 68Ga space was highest. The effects of transferrin-specific receptor-mediated endocytosis can be avoided in many organs and Walker-256 allografts by using the indium-transferrin complex, and the radiolabeled complex may be a convenient macromolecular tracer to estimate vascular permeability and vessel pore size in tumor and systemic tissue. In contrast, the iron-transferrin complex may be useful for measuring and imaging transferrin-specific receptors in brain and tumor tissue.     

Stable labelling of serum albumin microspheres with gallium-68

A highly efficient and rapid technique for labelling serum albumin microspheres with ⁶⁸Ga is described. Measurements of the in vivo stability of the radiopharmaceutical in the rabbit and the baboon show that less than 0.2% of the injected activity is eluted from the microspheres in 2 h.     

Metabolic imaging with gallium-68- and indium-111-labeled low-density lipoprotein

Low-density lipoprotein (LDL) labeled with either gallium-68 (68Ga) or indium-111 (111In) was evaluated as a potential PET or SPECT radiopharmaceutical for determination of hepatic lipoprotein metabolism in rabbits. Gallium-68 or 111In was linked to LDL via diethylenetriaminepentaacetic acid (DTPA) with a 25-70% radiochemical yield. Studies in vivo that compared 68Ga- or 111In-DTPA-LDL with dilactitol-[125I]-tyramine LDL and 131I-LDL showed that both 68Ga- and 111In-labeled LDL behaved as residualizing radiotracers. Localization of radioactivity within the liver of normal rabbits was visualized clearly with [68Ga]DTPA-LDL by PET and with [111In]DTPA-LDL by gamma scintigraphy. Significant differences were observed in hepatic uptake of normal compared with hypercholesterolemic rabbits in which low-capacity LDL receptor-mediated catabolism was saturated. Gallium-68 and 111In-DTPA-LDL are attractive radiopharmaceuticals for noninvasive delineation of tissue LDL metabolism under normal and pathophysiologic conditions.     

Correlation of flow cytometric parameters and transferrin receptors with gallium-67 scintigraphic images in lymphoma patients

The purpose of this study was to determine the correlation of flow cytometric parameters and transferrin receptors with gallium-67 scintigraphic imaging results in Hodgkin's and non-Hodgkin's lymphoma patients. DNA content and cell cycle analyses were performed using flow cytometry and transferrin receptor analysis was carried out by the immunohistochemistry technique in 24 patients aged between 16 and 62 years. All patients underwent gallium-67 scintigraphy, and tumour to background ratios were calculated. The findings were correlated with computed tomography and/or magnetic resonance imaging. A strong relationship was observed between flow cytometry and transferrin receptor expression with gallium-67 tumour scintigraphy [P = 0.005, r = 0.054 and P = 0.038, r = 0.54 (Spearman test), respectively]. The results of this study show that there is a close correlation between each of these modalities and, as they reflect the biological activity of the tumour, together they have a major role in treatment and follow-up.     

Maturation of a key resource - the germanium-68/gallium-68 generator: development and new insights

(68)Ge/(68)Ga radionuclide generators have been investigated for almost fifty years, since the cyclotron-independent availability of positron emitting (68)Ga via the (68)Ge/(68)Ga system had always attracted researches working in basic nuclear chemistry as well as radiopharmaceutical chemistry. However, it took decades and generations of research (and researchers) to finally reach a level of (68)Ge/(68)Ga radionuclide generator designs adequate to the modern requirements of radiometal labelling chemistry. Nevertheless, most of the existing commercial generator systems address aspects of (68)Ge breakthrough and safe synthesis of (68)Ga radiopharmaceuticals by adopting eluate post-processing technologies. Among the strategies to purify (68)Ga eluates, the cation exchange based version is relevant in terms of purification efficiency. In addition, it offers more options towards further developments of (68)Ga radiopharmaceuticals. Today, one may expect that the (68)Ge/(68)Ga radionuclide generator systems could contribute to the clinical impact of nuclear medicine diagnoses for PET similar to the established (99)Mo/(99m)Tc generator system for SPECT. The exciting perspective for the (68)Ge/(68)Ga radionuclide generator system, in turn, asks for systematic chemical, radiochemical, technological and radiopharmaceutical efforts, to guarantee reliable, highly-efficient and medically approved (68)Ge/(68)Ga generator systems.     

Simple,fast preparation of gallium-68-labelled human serum albumin microspheres

Following a study of the main factors involved in the 68-Ga labelling of human serum albumin microspheres (H.S.A.M.), especially methods of production and preparation of active solution and conditions of radioelement fixation on the protein support, the practical details of a fast technique (60 min) based on the process described by Hnatowich are presented. This method gives high labelling yields (93±3%), and after washing of the microspheres leads to a radiopharmaceutical product almost without free⁶⁸Ga (less than 2%). The spheres ready for use carry a total radioactivity corresponding to about 35%, including decay, of the activity originally recovered in the generator eluate and to more than 98% of that, found in the final suspension.The labelled product is sterile, non-pyrogenic and non-toxic. When it is injected in animals by left ventricle catheterization the uptake rates in the heart, lungs, spleen, left kidney and right kidney are similar to those observed with reference⁸⁵Sr-labelled carbonized microspheres. This radiopharmaceutical, casy to prepared and having excellent biological and nuclear properties, seems ideally suited for the scanning of organs by positron emission tomoscintig raphy.     

Procedure guidelines for PET/CT tumour imaging with 68Ga-DOTA-conjugated peptides: 68Ga-DOTA-TOC, 68Ga-DOTA-NOC, 68Ga-DOTA-TATE

The aim of these guidelines is to assist nuclear medicine physicians in recommending, performing, reporting and interpreting the results of somatostatin (SST) receptor PET/CT imaging using ⁶⁸Ga-DOTA-conjugated peptides, analogues of octreotide, that bind to SST receptors. This imaging modality should not be regarded as the only approach to visualizing tumours expressing SST receptors or as excluding other imaging modalities useful for obtaining comparable results. The corresponding guidelines of ¹¹¹In-pentetreotide scintigraphy imaging have been considered and partially integrated with this text. The same has been done with the relevant and recent literature in this field and the final result has been discussed by distinguished experts.     

Nitric oxide protects against contrast media-increased pulmonary vascular permeability in rats

RATIONALE AND OBJECTIVES: Nitric oxide (NO) regulation of endothelial function is involved in the development of acute lung injury. The role of NO in contrast media-induced increases in pulmonary vascular permeability was investigated in a rat model. METHODS: Nonionic (iohexol) and ionic (ioxaglate) contrast media were intravenously injected at 1.5 mL/min in rats. Pulmonary vascular permeability was evaluated by measuring the amount of Evans blue dye uptake as a quantitative marker of albumin extravasation in lung tissue. RESULTS: Intravenous injections of contrast media at doses of 4 and 6 g I/kg induced a dose-dependent increase in pulmonary vascular permeability. L-Arginine (an NO synthase substrate) and N(G)-nitro-L-arginine (L-NNA) (an NO synthase inhibitor) prevented and aggravated, respectively, the increase in pulmonary vascular permeability induced by the contrast medium. An aggravating action of L-NNA was confirmed by morphological and histological observations, this action being blocked by L-arginine (300 mg/kg) but not by D-arginine. Isosorbide dinitrate (1-20 mg/kg), an NO donor, had a dose-dependent protective effect on ioxaglate-increased vascular permeability. CONCLUSIONS: Our experimental findings suggest that contrast media at high doses produce pulmonary edema by inhibiting endothelial NO production, and nitrovasodilators protect against this adverse effect in rats.     

Inhibition of gallium-67 uptake in melanoma by an anti-human transferrin receptor monoclonal antibody

The effect of an anti-human transferrin receptor (anti-TFR) monoclonal antibody (MoAb), designated B3/25, and an anti-melanoma antibody, designated 96.5, on the uptake of gallium-67 (67Ga) by tumor was studied. Three groups of six athymic mice bearing a human melanoma were injected via tail vein with (a) 0.55 mg human serum albumin (HSA) (control group), (b) 0.5 mg MoAb B3/25 + 0.55 mg HSA, and (c) 0.5 mg MoAb 96.5 + 0.55 mg HSA, respectively. Twenty-four hours later, each mouse was given an intravenous dose of 5 microCi [67Ga] citrate. Biodistribution of activity (percent injected dose per gram) determined 48 hr after injection of 67Ga showed a 75% decrease in tumor uptake in the group of mice that received B3/25 (anti-TFR MoAb) compared with the control group. In contrast, MoAb 96.5 did not show any effect on melanoma uptake of 67Ga. Histologic findings suggest that the decreased uptake was not due to cellular damage resulting from binding of B3/25 to TFR. The results of this study strongly suggest the involvement of TFR in the in vivo tumor uptake of 67Ga.     

Gallium-67 distribution in a man with a decrease in both transferrin and hepatic gallium-67 concentration.

A patient with reduced transferrin concentration had a 67Ga scintigram that showed uptake in a peritoneal abscess, pericarditis and pleural effusion but only faint liver uptake. Gallium-67 activity was measured in liver, lung, muscle and plasma samples obtained at autopsy. The percent injected dose/kg for liver and plasma samples was considerably lower than previously reported while that in muscle and lung tissues values were comparable to prior data. In this patient, sites on transferrin available to bind 67Ga were reduced from the normal 40 microM to 5.2 microM; this in turn increased the concentration of radiogallate from 1% to 7%. This elevated free activity increased 67Ga excretion and reduced the amount of 67Ga*transferrin species. These results and those of previous studies suggest that liver uptake is slower than abscess uptake and more sensitive to concentration of 67Ga*transferrin. Iron status is an important facet of the interpretation of 67Ga scintigrams.     

Simple, fast preparation of gallium-68-labelled human serum albumin microspheres.

Following a study of the main factors involved in the 68-Ga labelling of human serum albumin microspheres (H.S.A.M.), especially methods of production and preparation of active solution and conditions of radioelement fixation on the protein support, the practical details of a fast technique (60 min) based on the process described by Hnatowich are presented. This method gives high labelling yields (93 +/- 3%), and after washing of the microspheres leads to a radiopharmaceutical product almost without free 68Ga (less than 2%). The spheres ready for use carry a total radioactivity corresponding to about 35%, including decay, of the activity originally recovered in the generator eluate and to more than 98% of that, found in the final suspension. The labelled product is sterile, non-pyrogenic and non-toxic. When it is injected in animals by left ventrical catheterization the uptake rates in the heart, lungs, spleen, left kidney and right kidney are similar to those observed with reference 85Sr-labelled carbonized microspheres. This radiopharmaceutical, easy to prepare and having excellent biological and nuclear properties, seems ideally suited for the scanning of organs by position emission tomoscintigraphy.     

Absence of gallium-67 avidity in diffuse pulmonary calcification

Diffuse pulmonary uptake by bone-seeking radiopharmaceuticals has been reported previously but, in the same patient, would pulmonary uptake of Ga-67 citrate yield clinically meaningful results? A patient with hypercalcemia and renal failure in whom bone scintigraphy demonstrated striking diffuse bilateral pulmonary uptake, but subsequent gallium imaging demonstrated no evidence of pulmonary uptake greater than body background, is discussed. We conclude that pulmonary uptake of gallium cannot be attributed to calcium deposition and should carry the same clinical significance in regard to inflammatory and malignant lesions as would be assigned to patients without pulmonary calcific deposits.     

68Ga-labeled oligonucleotides for in vivo imaging with PET.

The biologic evaluation in living rats of (68)Ga-labeled oligonucleotides as imaging agents for PET is reported. METHODS: (68)Ga, a positron-emitting radionuclide (half-life, 68 min), along with a macrocyclic chelating agent, 1,4,7,10-tetraazacyclododecane-N,N',N",N"'-tetraacetic acid (DOTA), was used for labeling of antisense oligonucleotides targeting activated human K-ras oncogene. The biologic properties of 3 different forms of the oligonucleotides-that is, 2'-deoxyphosphodiester (PO), 2'-deoxyphosphorothioate (PS), and 2'-O-methyl phosphodiester (OMe)-were studied first. The biodistribution and biokinetics were evaluated in vivo in athymic rats, each bearing a tumor of A549 cells, containing K-ras point mutation in codon 12, and a tumor of BxPC-3 cells, containing wild-type K-ras. Dynamic PET imaging lasting up to 2 h was performed immediately after intravenous injection of (68)Ga-oligonucleotide. Blank studies were performed using (68)GaCl(3) or (68)Ga-DOTA alone without oligonucleotide. The (68)Ga-antisense oligonucleotide uptake in tumors was also compared with the (18)F-FDG and (68)Ga-sense oligonucleotide uptakes. In addition, oligonucleotide binding to human plasma proteins and to human albumin was examined by means of ultrafiltration. RESULTS: The oligonucleotides can be stably labeled with (68)Ga and DOTA chelate. Intravenously injected (68)Ga-oligonucleotides of 17-mer length revealed high-quality PET images, allowing quantification of the biokinetics in major organs and in tumors. The biodistribution and biokinetics of intravenously administered (68)Ga-oligonucleotide varied considerably with the nature of the oligonucleotide backbone. CONCLUSION: We conclude that (68)Ga labeling of oligonucleotides is a convenient approach for in vivo imaging and quantification of oligonucleotide biokinetics in living animals with PET.     

PET imaging of inflammation and adenocarcinoma xenografts using vascular adhesion protein 1 targeting peptide 68Ga-DOTAVAP-P1: comparison with 18F-FDG

Purpose  

The aim of this study was to evaluate inflammation and tumour imaging with a vascular adhesion protein 1 (VAP-1) targeting peptide ⁶⁸Ga-DOTAVAP-P1 in comparison with ¹⁸F-FDG.