Radiopharmaceuticals: state of the art

99mTc-labeling experiments on CCK(4) by a direct method

99mTc-labeling studies have been performed on CCK(4) fragment of cholecystokinin, starting from 99mTc-pertechnetate, by using tin(II)pyrophosphate or tin(II)gluconate as reducing agents, together with NaBH(4) acting as a stabilizing agent of tin(II). Gluconate has been used as exchange ligand in the carrier added experiments and in the syntheses of 99Tc-CCK(4) and Re-CCK(4) complexes to be able to reproduce at macroscopic level the same chemical reactions occurring at non carrier added conditions. 99mTc-labeling yields higher than 95% have been achieved depending on Sn(II) concentration, CCK(4)/gluconate ratio, reaction time and applied temperature. The species produced with 99mTc, 99Tc, and cold rhenium nuclides have been compared by means of HPLC measurements, which showed similar retention times and thus probably the same species in the three situations.

Evolution of Tc-99m in diagnostic radiopharmaceuticals

The progress in diagnostic nuclear medicine over the years since the discovery of 99mTc is indeed phenomenal. Over 80% of the radiopharmaceuticals currently being used make use of this short-lived, metastable radionuclide, which has reigned as the workhorse of diagnostic nuclear medicine. The preeminence of 99mTc is attributable to its optimal nuclear properties of a short half-life and a gamma photon emission of 140 keV, which is suitable for high-efficiency detection and which results in low radiation exposure to the patient. 99mTcO4-, which is readily available as a column eluate from a 99Mo/99mTc generator, is reduced in the presence of chelating agents. The versatile chemistry of technetium emerging from the 8 possible oxidation states, along with a proper understanding of the structure-biologic activity relationship, has been exploited to yield a plethora of products meant for morphologic and functional imaging of different organs. This article reviews the evolution of 99mTc dating back to its discovery, the development of 99Mo/99mTc generators, and the efforts to exploit the diverse chemistry of the element to explore a spectrum of compounds for diagnostic imaging, planar, and single photon emission computed tomography. A brief outline of the 99mTc radiopharmaceuticals currently being used has been categorically presented according to the organs being imaged. Newer methods of labeling involving bifunctional chelating agents (which encompass the "3 + 1" ligand system, Tc(CO)3(+1)-containing chelates, hydrazinonicotinamide, water-soluble phosphines, and other Tc-carrying moieties) have added a new dimension for the preparation of novel technetium compounds. These developments in technetium chemistry have opened new avenues in the field of diagnostic imaging. These include fundamental aspects in the design and development of target-specific agents, including antibodies, peptides, steroids, and other small molecules that have specific receptor affinity.

Water-soluble adamantane-terminated dendrimers possessing a rhenium core

A novel type of radiometal-containing dendrimer with potential radiotherapeutical applications is described. Different generations of this adamantane-terminated, Fréchet-type dendrimer (28, 29, 30), each consisting of two dendritic wedge ligands around a rhenium core, have been synthesized in organic solvent via reaction with ReO(PPh(3))(2)Cl(3). Through complexation of their adamantane groups by beta-cyclodextrins (beta-CDs), these dendrimers were made water soluble (9.6, 0.4, and 0.2 mM, respectively). beta-CD-induced solubilization of the wedges in water allowed the complexes to be made under aqueous conditions, via reaction with rhenium gluconate. Not only does this strategy enable the facile synthesis of the radioactive analogue, the yields for these complex-formation reactions in water also turned out to be far higher than those observed for the reactions in organic solvents.

Schiff base chemistry of the rhenium(V)-oxo core with '3+2' ligand donor sets

Reactions of [ReOCl(3)(PPh(3))(2)] with the bidentate ligands 2-(2-hydroxyphenyl) benzoxazole and (2'-hydroxyphenyl)-2-thiazoline resulted in the isolation of the complexes [ReOCl(2)(OC(6)H(4)-2-C=NC(6)H(4)-2-O)(PPh(3))] (1) and [ReOCl(2)(OC(6)H(4)-2-C=NCH(2)CH(2)S)(PPh(3))] (2). Reactions of 1 with the tridentate Schiff base ligands salicylaldehyde 2-hydroxyanil (H(2)L(1b)), salicylaldehyde 2-mercaptoanil (H(2)L(2b)) afnd S-benzyl-2-[(2-hydroxyphenyl)methylene] dithiocarbazate (H(2)L(3b)) yielded the '3+2' rhenium(V) oxo species [ReO(OC(6)H(4)-2-C=NC(6)H(4)O) (OC(6)H(4)CH=NC(6)H(4)O)] (3), [ReO(OC(6)H(4)-2-C=NC(6)H(4)O)-(OC(6)H(4)CH=NC(6)H(4)S)] (4) and [ReO(OC(6)H(4)-2-C=NC(6)H(4)O){OC(6)H(4)CH=N-N=C(SCH(2)C(6)H(5))S}] (5). Similarly, the reactions of [ReOCl(2)(OC(6)H(4)-2-C=NC(6)H(4)S)(PPh(3))] (2) with H(2)L(2b), H(2)L(3b) and 2-[(2-hydroxyphenyl) methylene]-N-phenyl-hydrazinecarbothioamide (H(2)L(4b)) were exploited to prepare [ReO(OC(6)H(4)-2-C=NC(6)H(4)S)(OC(6)H(4)CH=NC(6)H(4)O)] (6), [ReO(OC(6)H(4)C=NC(6)H(4)S){OC(6)H(4)CH=N-N=C (SCH(2)C(6)H(5))S}] (7) and [ReO(OC(6)H(4)-2-C=NC(6)H(4)S){OC(6)H(4)CH=N-N=C(NHC(6)H(5))}] (8), respectively.

Synthesis and evaluation of the (99m)tc-complexes of L-cysteine acetyldiglycine (a hybrid of MAG3 and L,L-EC) and of L-beta-homocysteine acetyldiglycine

L-Cysteine acetyldiglycine (L-CAG2), a hybrid compound of L,L-EC and MAG3, and its L-beta-homocysteine analogue L-HAG2 were synthesized. After labeling with (99m)Tc, (99m)Tc-L-CAG2 and (99m)Tc-L-HAG2 gave two peaks on high performance liquid chromatography. Urinary excretion of both isomers of (99m)Tc-L-CAG2 and (99m)Tc-L-HAG2 was slower than for the "parent" complexes (99m)Tc-MAG3 or (99m)Tc-L,L-EC. Isomer B of (99m)Tc-L-CAG2 showed pronounced kidney retention in mice (57% of ID in kidneys at 30 min postinjection), but further evaluation in baboon did not reproduce this phenomenon.

Influence of the bifunctional chelate on the biological behavior of (99m)Tc-labeled chemotactic peptide conjugates

Conjugates of For-MLFK and For-NleLFNleYK with S-benzyl mercaptoacetyl dipeptides containing, respectively, zero, one, and two carboxyl functions in their structures were prepared and labeled with (99m)Tc. In vitro binding studies using isolated human granulocytes indicated specific receptor binding of the radiolabeled conjugates. The fraction of granulocyte-associated activity was determined after incubation with total blood. Biodistribution studies of the (99m)Tc-peptides in normal mice revealed a very fast blood clearance proceeding mainly via the hepatobiliary system. Urinary excretion was higher for conjugates containing carboxyl functions in their ligand structures.

Exploring oxorhenium '3+1' mixed-ligand complexes carrying the S-benzyl-3-[(2-hydroxyphenyl)methylene]dithiocarbazate [ONS]/monothiol [S] donor set: synthesis and characterization

The reaction of ReOCl(3)(PPh(3))(2) with the potentially tridentate ligand S-benzyl-3-[(2-hydroxyphenyl)methylene]dithiocarbazate ([ONS] donor set) and para-substituted benzenethiols [C(6)H(4)X-4-SH] (where X=H, F, Cl, Br and OCH(3)) in the presence of Et(3)N afforded a series of integrated '3+1' oxorhenium(V) complexes with general formula [ReO{eta(3)-OC(6)H(4)-2-CH=N-N=C(SCH(2)Ph)-S}(eta(1)-C(6)H(4)X-4-S)]. The molecular structure of [ReO{eta(3)-OC(6)H(4)-2-CH=N-N=C(SCH(2)Ph)-S}(eta(1)-C(6)H(4)F-4-S)] (4) was determined by single-crystal X-ray analysis. Complex 4 consists of a central oxorhenium(V) core with phenolic oxygen, azomethine nitrogen and thiol sulfur donor from the thiosemicarbazone Schiff base ligand and one sulfur donor from monothiol ligand completing a distorted square pyramidal environment. Crystal data for 4, C(21)H(16)FN(2)O(2)S(3)Re: orthorhombic, P2(1)2(1)2(1), a=5.6682(3), b=11.6600(6), c=31.697(2) A, V=2094.9(2) A(3), Z=4.

Calix[4]arene rhenium(V) complexes as potential radiopharmaceuticals

The calix[4]arene platform was used for the syntheses of novel rhenium(V) complexes, that may have potential applications as radiopharmaceuticals. The reaction of ReO(PPh3)2Cl3 with tetradentate N2O2-calix[4]arene ligand 8 in ethanol gave the novel mixed-ligand rhenium complex 9 with the structure ReO(N2O2-calix)OEt. The configuration was elucidated by using a number of 1H NMR techniques. In 9, the ethoxy ligand could be easily and quantitatively exchanged for another monodentate ligand to give complex 12. Tetradentate N2S2-calix[4]arene ligand 15 formed the rhenium complex 16 either via reaction with ReO(PPh3)2Cl3 in an organic solvent or by reaction with rhenium gluconate in an aqueous solution. Complex 16 showed good stability in phosphate-buffered saline solution (37 degrees C, 5 d). The crystal structures of a mono- and a bimetallic complex were determined. The bimetallic N2O2-calixarene complex dimer 11 crystallized in the monoclinic space group C2/c, with a = 38.963(5) A, b = 23.140(6) A, c = 27.382(6) A, beta = 128.456(10) degrees, V = 19,333(7) A3, Z = 8, and final R = 0.0519. The monometallic N2S2 model complex 17 crystallized in the monoclinic space group Cc, with a = 15.715(2) A, b = 12.045(2) A, c = 20.022(3) A, beta = 94.863(12) degrees, V = 3776.3(10) A3, Z = 4, and final R = 0.0342.

Synthesis and characterization of oxorhenium(V)-'3+1' mixed thiolate [SNS]/[S] and [ONS]/[S] complexes. Crystal and molecular structures of [ReO(eta-SCH(2)C(5)H(3)NCH(2)S)(eta-C(6)H(4)Br-4-S)], [ReO(eta-SCH(2)C(5)H(3)NCH(2)O)(eta-C(6)H(4)X-4-S)] (X=Cl, OMe), [ReO(eta-SCH(2)C(5)H(3)NCH(2)O)(eta-C(6)H(4)OCH(3)-4-CH(2)S)] and [ReO(eta-SCH(2)C(5)H(3)NCH(2)S)(eta-C(5)H(4)NH-2-S)][Cl]

The reaction of [ReOCl(3)(PPh(3))(2)] with the tridentate ligands 2,6-dithiomethylpyridine (4) or 6-thiomethyl-2-pyridinemethanol (5) and the appropriate monothiols, such as para-substituted benzenethiols (C(6)H(4)X-4-SH) (where X=F, Cl, Br and OCH(3)) and para-substituted benzylmercaptans (C(6)H(4)X-4-CH(2)SH) (where X=F, Cl and OCH(3)) in the presence of Et(3)N leads to the isolation of a series of integrated '3+1' oxorhenium(V) complexes. Similarly, reaction of [ReOCl(3)(PPh(3))(2)] with 2-mercaptopyridine and 4 afforded a cationic oxorhenium(V) complex, [ReO(eta(3)-SCH(2)C(5)H(3)NCH(2)S)(eta(1)-C(5)H(4)NH-2-S)][Cl] (22). Crystal data for 10, C(13)H(11)BrNOS(3)Re: triclinic, P1, a=7.2909(5), b=14.1978(9), c=15.991(1) A, alpha=77.184(1), beta=86.588(1), gamma=75.507(1) degrees , V=1562.69(18) A(3), Z=4. For 16, C(13)H(11)ClNO(2)S(2)Re: orthorhombic, P2(1)2(1)2(1), a=6.9728(6), b=13.477(1), c=15.761(1) A, V=1481.1(2) A(3), Z=4. For 18, C(14)H(14)NO(3)S(2)Re: monoclinic, P2(1)/c, a=15.6512(14), b=7.6678(7), c=13.732(1) A, beta=112.489(1) degrees , V=1522.7(2) A(3), Z=4. For 21, C(15)H(16)NO(3)S(2)Re: monoclinic, P2(1)/c, a=13.929(1), b=7.741(1), c=15.583(2) A, beta=103.600(2) degrees , V=1633.1(3) A(3), Z=4. For 22, C(12)H(11)ClN(2)OS(3)Re: monoclinic, C2(1)/(c), a=27.827(3), b=8.529(1), c=14.957(2) A, beta=119.314(2) degrees , V=3095.3(6) A(3), Z=8.

Synthesis and biological evaluation of the four isomers of technetium-99m labeled ethylenecysteamine cysteine ((99m)Tc-ECC), the mono-acid derivative of (99m)tc-L,L-ethylenedicysteine

A few years ago (99m)Tc-ethylenedicysteine ((99m)Tc-L,L-EC) had been proposed as an interesting substitute for technetium-99m labeled mercaptoacetyltriglycine (MAG3) as renal function tracer agent. It possesses in its structure two carboxylate functions and is in this respect different from other renal tracers such as (99m)Tc-N, N'-bis-(mercaptoacetyl)-2,3-diaminopropionate ((99m)Tc-CO(2)DADS), (99m)Tc-MAG3, and Hippuran, which have only one carboxylic group. To study whether both carboxylic acid groups of (99m)Tc-L,L-EC contribute to the efficient renal handling of this compound we synthesized and biologically evaluated the technetium-99m labeled isomers of L- and D-ethylenecysteamine cysteine (ECC), the mono-acid derivative of (99m)Tc-L,L-EC. Labeling of L-ECC or D-ECC with (99m)Tc using a direct or exchange labeling method yields for each of them two diastereomeric (99m)Tc complexes (A and B, in the order of elution during reversed phase high performance liquid chromatography) in relative amounts depending on the pH during labeling. In mice, all four isomers of (99m)Tc-ECC (LA, LB, DA, and DB) are cleared rapidly from the blood, mainly by the renal system. The isomers LB and DB show the most efficient renal handling, but none of the mono-acid derivatives has a urinary excretion rate as high as that of (99m)Tc-L,L-EC. The renal handling of the isomers of (99m)Tc-ECC is partly due to tubular secretion because the urinary excretion of these compounds is significantly lower in mice pretreated with probenecid. In the baboon, isomers DA and DB show a plasma clearance comparable to that of (99m)Tc-L,L-EC. The plasma clearance of isomers LA and LB is lower but still comparable to or higher than that of (99m)Tc-MAG3. In a human volunteer, isomer DB shows a plasma clearance rate only slightly lower than that of (99m)Tc-L,L-EC. Thus, it appears that the presence of one carboxylate in (99m)Tc-EC-like compounds can be sufficient for efficient renal handling. However, it is also evident that the configuration at the chiral carbon atom and the orientation of the oxotechnetium core determine in a significant way the biological characteristics.

Experiments on a new phosphine-peptide chelator for labelling of peptides with Tc-99m

A phosphine-containing ligand providing a N-[N-[3-(diphenylphosphino)propionyl]glycyl]-L-S-benzyl-cystein (PNNS) donor atomset for the chelation of 99mTc was studied in labelling experiments with a model peptide (tetragastrin, cholecystokinin-fragment). The peptide was conjugated to the ligand chelator by active ester chemistry either before or after radiolabelling. Both the chelator-conjugate and the preformed chelate approaches resulted in the same radiolabelled isomers of the ligand peptide. Sequence and reaction conditions influence yield and purity.

Capillary electrophoresis of 99mtechnetium radiopharmaceuticals

Diagnostically used 99mTc kit radiopharmaceuticals were analyzed using capillary zone electrophoresis with radioactivity detection: 99mTc-bis(bis(2-ethyloxyethyl)phosphino)ethane (99mTc-Myoview, 99mTc-Tetrofosmin), 99mTc-trans(1,2-bis(dehydro-2,2,5,5,-tetramethyl-3-furanone-4-methylene- amino)ethane)-tris(3-methoxy-1-propyl)phosphine) (99mTc-Technescan Q12, 99mTc-Furifosmin), 99mTc-methoxyisobutylisonitrile (99mTc-MIBI), 99mTc-L,L-ethylenecysteine diethylester dimer (99mTc-ECD), 99mTc-d,1-hexamethylene propyleneamine oxime (99mTc-HMPAO), 99mTc-diethylenetriaminepentaacetic acid (99mTc-DTPA), 99mTc-ethylene hepatobiliary iminodiacetic acid (99mTc-EHIDA), 99mTc-L,L-ethylenecysteine dimer (99mTc-EC), 99mTc-mercaptoacetylglycylglycylglycine (99mTc-MAG3), 99mTc-dimercaptosuccinic acid (99mTc-DMSA), 99mTc-methylene diphosphonate (99mTc-MDP) and 99mNaTcO4. A pressure-driven capillary zone electrophoresis was employed to detect small anions of high electrophoretic mobility and cations within one run. Effective 99mTc complex charges could be determined by a neutral internal standard. All complexes showed the expected electrophoretic behaviours in view of their charges. Pure products were obtained for the majority of the studied complexes. In the case of 99mTc-Q12, 99mTc-EHIDA and 99mTc-MDP, complex mixtures were detected. The high potential of CE for the analysis of 99mTc radiopharmaceuticals could be shown.

Determination of dissociation constants of 99mTechnetium radiopharmaceuticals by capillary electrophoresis

Capillary electrophoresis was applied to investigate pKa values of 99mTc radiotracers used in nuclear medicine. Therefore, the protonation equilibria of the carboxyl groups of 99mTc-mercaptoacetylglycylglycylglycine (99mTc-MAG3) and 99mTc-ethylenecysteine dimer (99mTc-EC) were studied by pH-dependent determination of electrophoretical velocities. 99mTc-ethylenecysteine dimer diethyl ester (99mTc-ECD) was used as a non-protonable standard. The capillary electrophoresis system was equipped with a radioactivity detector. Measurements were performed using a pressure-driven capillary zone electrophoresis which allowed runs even in the low pH range. For the determination of pKa values, the electrophoretical velocities of the analytes were referred to the electrophoretical velocities of tetraphenyle arsonium chloride as a positively charged marker. Calculation of pKa values was accomplished by non-linear curve fitting of both structure-based equilibria equations and sigmoidal decay functions to the experimental data. 99mTc-MAG3 was shown to have a carboxyl group pKa value of 4.22. The value for the carboxyl groups of 99mTc-EC is 2.90 (determined by structure-based equilibria equations), which represents a common value for both carboxyl groups. By the use of sigmoidal functions, similar values were elucidated. As expected, 99mTc-ECD shows no protonation step.

Design of metal-binding green fluorescent protein variants

Diglycylcysteine motifs bind reduced oxo-compounds of technetium-99m, an important isotope in nuclear imaging. We suggested a system for detecting gene expression employing the effect of oxo[99mTc]technetate (Tc(V)O3+) transchelation and coordination with redox amino acid motifs. DNA fragments encoding diglycylcysteine (GGC) binding motifs were prepared by PCR and positioned downstream from the green fluorescent protein (GFP) cDNA insert. Using a Bluescript (+) vector with the fusion protein positioned under the control of a lac promoter, we obtained several E. coli clones expressing the following GFP fusion peptides: (1) GFP-P1 bearing a 'hydrophilic' C-terminal peptide (LEGGGCEGGC) containing two residues of glutamic acid and C-terminal cysteine (2) GFP-P2 carrying a 'hydrophobic' (LGGGGCGGGCGI) peptide (3) a control GFP fusion peptide with deleted C-terminal portion. Bacterial lysates obtained from the corresponding clones were tested for oxo[99mTc] technetate transchelation from a glucoheptonate complex. We found, using a solid phase assay, that radioactivity associated with protein lysates obtained from clones expressing GFP-P2 fusions were 3-4 fold higher than lysates prepared from a clone expressing a truncated GFP fusion protein lacking the C-terminal GGC motifs. High expression of GFP fusions (5-21% of total protein) was demonstrated by electrophoresis and verified by immunoblotting. Specific association of the isotope with GFP-P2 fusion proteins was detected upon incubation of gels in the presence of [99mTc]glucoheptonate, while no binding of oxo[99mTc]technetate to GFP-P1 was revealed. We demonstrated, by using semi-quantitative autoradiography, that there is a 10-fold higher binding of oxotechnetate to GFP-P2 than to a control GFP fusion protein. The implications of the study for in vivo gene expression imaging are discussed.

Technetium-99m-labeled receptor-specific small-molecule radiopharmaceuticals: recent developments and encouraging results

The development of technetium-99m-labeled small-molecule radiopharmaceuticals directed at specific high-affinity binding sites, as are found in receptors for hormones and neurotransmitters, transport systems, and certain enzymes, is a natural outgrowth from the successful development of technetium radiopharmaceuticals for imaging flow and metabolism. Although many receptor-specific radiopharmaceuticals labeled with PET and other SPECT isotopes already exist, the low cost and widespread availability of technetium-99m would make their 99mTc-labeled counterparts much more accessible to the medical community. This review has four goals: (a) To survey and analyze critically the results of a flurry of research activity in this area in recent years, which has led to the preparation of a number of novel technetium-labeled radiopharmaceuticals targeted at high-affinity sites, a few of which appear to be very promising; (b) to provide a conceptual analysis of how these agents are being designed; (c) to provide a context in terms of binding and uptake behavior by which these agents should be judged; and (d) to highlight emerging knowledge on the structure of receptors and related high-affinity binding biomolecules and their distribution, which may serve as reference points for understanding the results that have been obtained so far, and may be useful guides for future design.

Influence of a 99mTcN core on the biological and physicochemical behavior of 99mTc complexes of L,L-EC and L,L-ECD

99mTc-nitrido complexes of L,L-ethylene dicysteine (99mTcN-L,L-EC) and 99mTcN-L,L-ethylene dicysteine diethylester (99mTcN-L,L-ECD) were prepared and their characteristics compared to those of the respective 99mTc-oxo complexes. 99mTcN-L,L-EC and 99mTcO-L,L-EC migrate to similar extents during electrophoresis at pH 12, but, at pH6, 99mTcN-L,L-EC migrates further than 99mTcO-L,L-EC. Renal excretion of 99mTcN-L,L-EC is inferior to that of 99mTcO-L,L-EC, indicating that the TcN-glycine sequence has lower affinity for the renal tubular system. Both 99mTcO-L,L-ECD and 99mTcN-L,L-ECD are neutral, but 99mTcN-L,L-ECD is hydrophilic and shows minimal brain uptake in both mice and the baboon.

An Rh-105 complex of tetrathiacyclohexadecane diol with potential for formulating bifunctional chelates

1,5,9,13-Tetrathiacyclohexane-3,11-diol (16S4-diol), a sulfur crown ether analog, was studied as a potential chelating agent to complex no-carrier-added (NCA) grade 105Rh(III) in high yield at low ligand concentrations. trans-[RhCl2(16S4-diol)]chi (chi = Cl, PF6) was prepared using nonradioactive RhCl3.3H2O and characterized by UV-Vis, nuclear magnetic resonance (NMR) and X-ray crystallography. It was shown to have a +1 charge with the Rh(III) metal center coordinated to the four S atoms equatorially and two Cl atoms in trans axial positions. The 105Rh-16S4-diol complex prepared with NCA 105Rh(III)-chloride reagent was found to exhibit identical chromatographic properties as trans-[Rh(III)Cl2(16S4-diol)]+ (including silica and C-18 thin-layer chromatography [TLC] and electrophoresis). The preparation of 105Rh-16S4-diol complex formation optimized for conditions of pH, temperature, time, % ethanol and quantity of 16S4-diol resulted in yields > 90%. Very low quantities of 16S4-diol (3 nmol) complex NCA 105Rh(III) under relatively mild reaction conditions (heating at 64 degrees C for 90 min) in the presence of ethanol (10%), yielded the high specific activity 105Rh-16S4-diol complex as a single cationic species. The 105Rh-16S4-diol complex was shown to be stable for > or = 4 days in physiological buffers at room temperature and in human serum at 37 degrees C.

Complexes of technetium-99m with tetrapeptides containing one alanyl and three glycyl moieties

Recently, we have shown that tetrapeptides can be efficiently labelled with technetium-99m by direct labelling at alkaline pH. Tetrapeptides can be considered derivatives of mercaptoacetyltriglycine (MAG3) in which the mercaptoacetyl moiety is replaced by an amino acid residue. In view of the interesting biological properties of some C-methyl substituted derivatives of 99mTc-MAG3, we have now synthesised and evaluated the complexes of 99mTc with tetrapeptides containing three glycyl (G) moieties and one D- or L-alanyl (A) moiety. In mice, 99mTc-L-GAGG, 99mTc-D-GGAG and 99mTc-L-GGAG showed a rapid and high renal excretion, comparable to that of 99mTc-MAG3. Renal handling was somewhat reduced for isomers d and l of 99mTc-AGGG and 99mTc-D-GAGG and markedly inferior for 99mTc-L-GGGA and 99mTc-D-GGGA. In the baboon, 99mTc-L-AGGG, 99mTc-D-AGGG and 99mTc-L-GAGG showed a comparable or even higher 1-h plasma clearance than 99mTc-MAG3. 99mTc-D-GAGG, 99mTc-L-GGAG and 99mTc-D-GGAG were characterised by a lower plasma clearance and the clearance of 99mTc-L-GGGA and 99mTc-D-GGGA was remarkably low. The three 99mTc-labelled tetrapeptides with the highest plasma clearance in a baboon were compared with 99mTc-MAG3 in a human volunteer. 99mTc-L-AGGG and 99mTc-L-GAGG had a roughly similar plasma clearance as 99mTc-MAG3. The clearance of 99mTc-D-AGGG was significantly lower and liver uptake was clearly visible with this compound. Left kidney renograms of 99mTc-L-AGGG and 99mTc-D-AGGG indicated moderate kidney accumulation. On the other hand, the renogram obtained after injection of 99mTc-L-GAGG had an excellent shape and the maximum kidney concentration was slightly higher than for 99mTc-MAG3. These results show the importance of the position of the methyl substituent on the 99mTc-tetrapeptide with respect to its biological behaviour.

Sources of radiochemical impurities in the 99mTc/S-unprotected MAG3 system

With the aim of obtaining a general insight into the technetium/S-unprotected MAG3 system, the reactions of technetium with the unprotected MAG3 ligand, both at c.a.- and n.c.a.-level, were investigated. Based on a profound knowledge of the reaction route and the TcMAG3 complexes, sources of by-products were identified and eliminated as far as possible. Only a small percentage (< 5%) of intermediate Tc-MAG3 complexes occurs, but this may increase by improper handling of the kit, such as insufficient reaction time. In conclusion, two kinds of impurity may occur in the Tc/MAG3 kit: One is derived from impurities in the ligand (MAG3 disulphide), which can be excluded by careful preparation and storage. The other is caused by insufficient reaction time according to the scheme (Fig. 3) during the labelling procedure. Its content can be minimized by optimization of the reaction time. A reaction time of at least 10 minutes gives about 98% of the renal agent.

Experience with the iodine-123 and technetium-99m labelled anti-granulocyte antibody MAb47: a comparison of labelling methods

Four different methods of radiolabelling the anti-granulocyte monoclonal antibody MAb47 were compared and their influence on diagnostic value studied. The best clinical images were obtained following labelling with iodine-123 by the Iodogen method and direct labelling with technetium-99m after tris-(carboxyethyl)-phosphine treatment of MAb47 to achieve disulphide bridge reduction. 99mTc labelling using a specific ligand (MAb47-mtp), or a second method involving direct reduction with mercaptoethanol, led to an increased background activity in clinical studies, thus impeding the diagnosis of chronic disease. Fresh infections were clearly localized by all four preparations. The elimination of the activity from the blood was slower in the case of the iodinated MAb47, while the collected urine samples showed an excretion of about 10% of the injected activity per day independent of the labelling method. The results in terms of sensitivity and specificity were rather similar for all labelling methods and ranged from 90% to 99%.

Complexes of technetium-99m with tetrapeptides, a new class of 99mTc-labelled agents

Tetrapeptides are a class of N4-tetraligands that can efficiently bind 99mTc. In fact, tetrapeptides can be considered as derivatives of mercaptoacetyltriglycine (MAG3) in which the mercaptoacetyl moiety is replaced by a more stable and easier to handle aminoacyl group. Direct labelling of tetrapeptides with 99mTc in alkaline medium (pH > or = 11) in the presence of stannous ions gave a high yield (> 95%) of one or two (probably isomeric) radiochemical species. Exchange labelling at different pH values in the presence of stannous tartrate resulted in lower yields of the same 99mTc-labelled products as those formed during direct labelling. In addition, other radiochemical species were formed of which one was characterized as an oxotechnetium-complex with the cyclisized tetrapeptide. Tetrapeptides with a chiral centre in the first amino acid yield upon labelling with 99mTc two radiochemical species, probably the two diastereomers with an oxotechnetium core respectively syn and anti with respect to the substituent on the amino acid. Only one diastereomer was observed when the chiral carbon atom is located in the second or third amino acid. Electrophoresis indicated that these new 99mTc-labelled complexes are neutral in acidic medium and negatively charged in neutral and alkaline conditions. This correlates with a complex in which an oxotechnetium(V) group is bound to the ligand through three deprotonated nitrogen atoms of the amide functions and the free electron pair of the amine nitrogen atom. Biodistribution in mice showed for all studied 99mTc-labelled tetrapeptides a rapid clearance from the blood mainly by the renal system. The presence of a methyl substituent in the tetrapeptide increased the urinary excretion. 99mTc-labelled L-glycylalanylglycylglycine showed in mice a urinary excretion comparable to that of 99mTc-MAG3. Further rise of lipophilicity by introduction of a dimethyl, isopropyl or isobutyryl group leads to increased hepatobiliary handling. It is concluded that tetrapeptides are an interesting group of technetium complexing agents which can easily be labelled with 99mTc at room temperature in alkaline medium. This class offers the possibility of a wide variety of derivatives, just by substituting one or more amino acids. This group of ligands thus opens a new research field of 99mTc-complexes with potential usefulness in several areas.

Renal elimination of some 99mTc-labelled cysteamine derivatives

It is generally believed that -CO-NH-(CH2)n-COOH moiety promotes tubular excretion of organic anions. Recently it was reported that newly developed renal agents, containing the oxotechnetium(V) glycine group, may mimic the carbonyl amide sequence of [131]I-o-iodohippuric acid. In this study the renal excretion of certain carboxy-cysteamine derivatives is investigated in mice, in the presence of renal tubular transport inhibitor. A similar pattern of renal depression was observed for complexes containing the oxotechnetium glycine sequence, suggesting that this group may satisfy structural parameters for tubular secretion of anionic technetium complexes.

The labeling of proteins and LDL with 99mTc: a new direct method employing KBH4 and stannous chloride

A new direct labeling technique for proteins with technetium-99m (99mTc) has been developed and makes use of borohydride and stannous chloride. The method is simple and reproducible and gives a high labeling efficiency and high retention of biological activity for proteins, including polyclonal immunoglobulin (Ig), antifibrin monoclonal antibody, tissue type plasminogen activator, fibrinogen and low density lipoprotein (LDL). This method can be used in kit-format and takes about 20 min preparation time at room temperature. Both in vitro and in vivo studies indicate good stability of the label. In vivo, mice and rabbit images show significant accumulation of 99mTc-Ig at an inflammation area, 99mTc-antifibrin at a thrombus site and 99mTc-LDL in atherosclerotic lesions. The method is attractive for routine research and clinical purposes.

99mTc-citrate versus 67Ga-citrate for the scintigraphic visualization of inflammatory lesions

Citric acid was labeled with 99mTc with an efficiency of > 99%. The biodistribution of 99mTc-citrate was studied in mice with turpentine-induced abscesses in comparison to 67Ga-citrate. The max. abscess/muscle concentration ratios were 4.61 +/- 1.92 (3 h) for 99mTc-citrate and 4.76 +/- 2.04 (4 h) for 67Ga-citrate. Arthritis was induced in 10 rabbits by intra-articular injection of ovalbumin Scintigrams obtained 4 days later and at 3 h post-injection of 99mTc-citrate showed increased activity involving the synovium. The max. arthritic/contralateral knee ratio was 3.19 +/- 1.29 (3 h) and 6.47 +/- 3.71 (24 h) for 99mTc- and 67Ga-citrate, respectively. The blood clearance curve of 99mTc-citrate in rabbits was biexponential with a fast (T1/2 = 36 min) and a slow (T1/2 = 18 h) component, compared to mono-exponential clearance of 67Ga-citrate (T1/2 = 23 h). In 10 patients with rheumatoid arthritis whole-body scintigrams and spot images of involved joints indicated localization of the tracer in inflamed tissues. The mean target-to-soft tissue ratios were 3.04 +/- 0.81 and 4.95 +/- 2.56 for 99mTc-citrate and 99mTc-MDP, respectively. Renal clearance of radioactivity was evident from the scintigrams. Our results demonstrated that 99mTc-citrate is effective as a radiopharmaceutical for the visualization of inflammatory lesions and may be preferred to 67Ga-citrate due to the ideal physical characteristics of the radionuclide, easy preparation, low cost, early accumulation and the preference for the renal route of excretion.

A new method of technetium-99m labeling of monoclonal antibodies through sugar residues. A study with TAG-72 specific CC-49 antibody

We have developed a very efficient labeling technique for monoclonal antibodies with technetium-99m. Oxidation of sugar residues on the IgG class of antibodies leads to the generation of aldehyde groups which are further reacted with two newly developed hydrazide compounds. This methodology introduces sulfhydryl groups on the antibody through sugar residues which can be labeled with technetium-99m. We have studied the TAG-72 specific second generation antibody CC-49. The specific activity of the labeled antibody was high without loss of its immunoreactivity.