Distribution volume as an alternative to the binding potential for sigma1 receptor imaging

PET Molecular Imaging in Drug Development: The Imaging and Chemistry Perspective

Positron emission tomography with selective radioligands advances the drug discovery and development process by revealing information about target engagement, proof of mechanism, pharmacokinetic and pharmacodynamic profiles. Positron emission tomography (PET) is an essential and highly significant tool to study therapeutic drug development, dose regimen, and the drug plasma concentrations of new drug candidates. Selective radioligands bring up target-specific information in several disease states including cancer, cardiovascular, and neurological conditions by quantifying various rates of biological processes with PET, which are associated with its physiological changes in living subjects, thus it reveals disease progression and also advances the clinical investigation. This study explores the major roles, applications, and advances of PET molecular imaging in drug discovery and development process with a wide range of radiochemistry as well as clinical outcomes of positron-emitting carbon-11 and fluorine-18 radiotracers.

N-[11C]Methyl-AMD3465 PET as a Tool for In Vivo Measurement of Chemokine Receptor 4 (CXCR4) Occupancy by Therapeutic Drugs

Purpose

Chemokine receptor 4 (CXCR4) is overexpressed in many cancers and a potential drug target. We have recently developed the tracer N-[¹¹C]methyl-AMD3465 for imaging of CXCR4 expression by positron emission tomography (PET). We investigated the pharmacokinetics of N-[¹¹C]methyl-AMD3465 in rats bearing a C6 tumor and assessed whether the CXCR4 occupancy by the drug Plerixafor® can be measured with this PET tracer.

Procedure

A subcutaneous C6 tumor was grown in Wistar rats. Dynamic N-[¹¹C]methyl-AMD3465 PET scans with arterial blood sampling was performed in control rats and rats pretreated with Plerixafor® (30 mg/kg, s.c). The distribution volume (V_T) of the tracer was estimated by compartment modeling with a two-tissue reversible compartment model (2TRCM) and by Logan graphical analysis. The non-displaceable binding potential (BP_ND) was estimated with the 2TRCM. Next, CXCR4 receptor occupancy of different doses of the drug Plerixafor® (0.5–60 mg/kg) was investigated.

Results

The tumor could be clearly visualized by PET in control animals. Pretreatment with 30 mg/kg Plerixafor® significantly reduced tumor uptake (SUV 0.65 ± 0.08 vs. 0.20 ± 0.01, p < 0.05). N-[¹¹C]Methyl-AMD3465 was slowly metabolized in vivo, with 70 ± 7% of the tracer in plasma still being intact after 60 min. The tracer showed reversible in vivo binding to its receptor. Both 2TRCM modeling and Logan graphical analysis could be used to estimate V_T. Pre-treatment with 30 mg/kg Plerixafor® resulted in a significant reduction in V_T (2TCRM 0.87 ± 0.10 vs. 0.23 ± 0.12, p < 0.05) and BP_ND (1.85 ± 0.14 vs. 0.87 ± 0.12, p < 0.01). Receptor occupancy by Plerixafor® was dose-dependent with an in vivo ED₅₀ of 12.7 ± 4.0 mg/kg. Logan analysis gave comparable results.

Conclusion

N-[¹¹C]Methyl-AMD3465 PET can be used to visualize CXCR4 expression and to calculate receptor occupancy. V_T determined by Logan graphical analysis is a suitable parameter to assess CXCR4 receptor occupancy. This approach can easily be translated to humans and used for early drug development and optimization of drug dosing schedules.

Sigma-1 Agonist Binding in the Aging Rat Brain: a MicroPET Study with [(11)C]SA4503

PURPOSE

Sigma-1 receptor ligands modulate the release of several neurotransmitters and intracellular calcium signaling. We examined the binding of a radiolabeled sigma-1 agonist in the aging rat brain with positron emission tomography (PET).

PROCEDURES

Time-dependent uptake of [(11)C]SA4503 was measured in the brain of young (1.5 to 3 months) and aged (18 to 32 months) Wistar Hannover rats, and tracer-kinetic models were fitted to this data, using metabolite-corrected plasma radioactivity as input function.

RESULTS

In aged animals, the injected probe was less rapidly metabolized and cleared. Logan graphical analysis and a 2-tissue compartment model (2-TCM) fit indicated changes of total distribution volume (V T) and binding potential (BP ND) of the tracer. BP ND was reduced particularly in the (hypo)thalamus, pons, and medulla.

CONCLUSIONS

Some areas showed reductions of ligand binding with aging whereas binding in other areas (cortex) was not significantly affected.

Development of PET radiopharmaceuticals and their clinical applications at the Positron Medical Center

The Positron Medical Center has developed a large number of radiopharmaceuticals and 36 radiopharmaceuticals have been approved for clinical use for studying aging and geriatric diseases, especially brain functions. Positron emission tomography (PET) has been used to provide a highly advanced PET-based diagnosis. The current status of the development of radiopharmaceuticals, and representative clinical and methodological results are reviewed.

High occupancy of sigma1 receptors in the human brain after single oral administration of donepezil: a positron emission tomography study using [11C]SA4503

The acetylcholinesterase (AChE) inhibitor donepezil is also a sigma1 receptor agonist. We examined whether donepezil binds to sigma1 receptors in the living human brain after a single oral administration. Dynamic positron emission tomography (PET) data acquisition using the selective sigma1 receptor ligand [11C]SA4503 was performed to evaluate quantitatively the binding of [11C]SA4503 to sigma1 receptors in eight healthy male volunteers. Each subject had a PET scan before and after receiving a single dose of donepezil (5 or 10 mg). The binding potential of [11C]SA4503 was calculated. Doses of 5 mg and 10 mg donepezil bound to sigma1 receptors in the human brain with occupancies of approximately 60% and approximately 75%, respectively, in a dose-dependent manner. This study demonstrated that donepezil binds to sigma1 receptors in the living human brain at therapeutic doses. Therefore, sigma1 receptors may be implicated in the pharmacological mechanism of donepezil in the human brain.

Improvement of likelihood estimation in Logan graphical analysis using maximum a posteriori for neuroreceptor PET imaging

OBJECTIVE

To reduce variance of the total volume of distribution (V (T)) image, we improved likelihood estimation in graphical analysis (LEGA) for dynamic positron emission tomography (PET) images using maximum a posteriori (MAP).

METHODS

In our proposed MAP estimation in graphical analysis (MEGA), a set of time-activity curves (TACs) was formed with V (T) varying in physiological range as a template, and then the most similar TAC was sought out for a given measured TAC in a feature space. In simulation, MEGA was compared with other three methods, Logan graphical analysis (GA), multilinear analysis (MA1), and LEGA using 500 noisy TACs, under each of seven physiological conditions (from 9.9 to 61.5 of V (T)). PET studies of [(11)C]SA4503 were performed in three healthy volunteers. In clinical studies, the V (T) images estimated from MEGA were compared with region of interest (ROI) estimates from a nonlinear least square (NLS) fitting over four brain regions.

RESULTS

In the simulation study, the estimated V (T) by GA had a large underestimation (y = 0.27x + 8.72, r (2) = 0.87). Applying the other methods (MA1, LEGA, and MEGA), these noise-induced biases were improved (y = 0.80x + 4.04, r (2) = 0.98; y = 0.85x + 3.05, r (2) = 0.99; y = 0.96x + 1.21, r (2) = 0.99, respectively). MA1 and LEGA produced increased variance of the estimated V (T) in clinical studies. However, MEGA improved signal-to-noise ratio (SNR) in V (T) images with linear correlations between ROI estimates with NLS (y = 0.87x + 5.1, r (2) = 0.96).

CONCLUSIONS

MEGA was validated as an alternative strategy of LEGA to improve estimates of V (T) in clinical PET imaging.

Successive positron emission tomography measurement of cerebral blood flow and neuroreceptors in the human brain: an 11C-SA4503 study

For evaluating a newly developed radioligand for positron emission tomography (PET), successive measurements of regional cerebral blood flow (rCBF) and the kinetics of the radioligand in the same subject are preferable in the first clinical trial. In this study, we demonstrate an example for the study of (11)C-labeled 1-(3,4-dimethoxyphenethyl)-4-(3-phenylprophyl) piperazine ((11)C-SA4503) for mapping sigma(1) receptors in the human brain. Five healthy male subjects underwent two successive PET scans with (15)O-H(2)O to measure the rCBF and with (11)C-SA4503 (dynamic 60-min scan). The brain kinetics of (11)C-SA4503 was evaluated using the time-activity curve (TAC) of tissue in each of the 11 regions of the brain and the metabolite-corrected TAC of plasma on the basis of a two-tissue compartment fourparameter model. The estimated parameters were four rate constants: K (1), influx from plasma to brain tissue; k (2), efflux from tissue to plasma; k (3), association between tracer and receptors; and k (4), dissociation of tracer-receptor complex, and the binding potential (BP), k (3)/k (4). (11)CSA4503 was distributed all over the brain, and the TACs exhibited an accumulation pattern in all the 11 regions. K (1) of (11)C-SA4503 correlated with rCBF, but the other three rate constant parameters and BP did not. The regional difference in the BP of (11)C-SA4503 is compatible with those of sigma(1) receptors. In conclusion, successive PET measurements of rCBF and the brain kinetics of radioligand-neuroreceptor binding are useful for the first clinical trial of a newly developed radioligand for mapping neuroreceptors, and the protocol is applicable to pathophysiological studies of brain disorders.

Shortened protocol in practical [11C]SA4503-PET studies for sigma1 receptor quantification

In practical positron emission tomography (PET) diagnosis, a shortened protocol is preferred for patients with brain disorders. In this study, the applicability of a shortened protocol as an alternative to the 90-min PET scan with [(11)C]SA4503 for quantitative sigma(1) receptor measurement was investigated. Tissue time-activity curves of 288 regions of interest in the brain from 32 [(11)C]SA4503-PET scans of 16 healthy subjects prior to and following administration of a selective serotonin reuptake inhibitor (fluvoxamine or paroxetine) were applied to two algorithms of quantitative analysis; binding potential (BP) was derived from compartmental analysis based on nonlinear estimation, and total distribution volume (tDV) was derived from Logan plot analysis. As a result, although both BP and tDV tended to be underestimated by the shortened method, the estimates from the shortened protocol had good linear relationships with those of the full-length protocol. In conclusion, if approximately 10% differences in the estimated results are acceptable for a specific purpose, then a 60-min measurement protocol is capable of providing reliable results.