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Izquierdo-Garcia D, Désogère P, Philip AL, Sosnovik DE, Catana C, Caravan P. Dosimetry of [ 64Cu]FBP8: a fibrin-binding PET probe. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.06.27.24309589. [PMID: 38978675 PMCID: PMC11230308 DOI: 10.1101/2024.06.27.24309589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
Purpose This study presents the biodistribution, clearance and dosimetry estimates of [64Cu]Fibrin Binding Probe #8 ([64Cu]FBP8) in healthy subjects. Procedures This prospective study included 8 healthy subjects to evaluate biodistribution, safety and dosimetry estimates of [64Cu]FBP8, a fibrin-binding positron emission tomography (PET) probe. All subjects underwent up to 3 sessions of PET/Magnetic Resonance Imaging (PET/MRI) 0-2 hours, 4h and 24h post injection. Dosimetry estimates were obtained using OLINDA 2.2 software. Results Subjects were injected with ~400 MBq of [64Cu]FBP8. Subjects did not experience adverse effects due to the injection of the probe. [64Cu]FBP8 PET images demonstrated fast blood clearance (half-life = 67 min) and renal excretion of the probe, showing low background signal across the body. The organs with the higher doses were: the urinary bladder (0.075 vs. 0.091 mGy/MBq for males and females, respectively); the kidneys (0.050 vs. 0.056 mGy/MBq respectively); and the liver (0.027 vs. 0.035 mGy/MBq respectively). The combined mean effective dose for males and females was 0.016 ± 0.0029 mSv/MBq, lower than the widely used [18F]fluorodeoxyglucose ([18F]FDG, 0.020mSv/MBq). Conclusions This study demonstrates the following properties of the [64Cu]FBP8 probe: low dosimetry estimates; fast blood clearance and renal excretion; low background signal; and whole-body acquisition within 20 minutes in a single session. These properties provide the basis for [64Cu]FBP8 to be an excellent candidate for whole-body non-invasive imaging of fibrin, an important driver/feature in many cardiovascular, oncological and neurological conditions.
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Affiliation(s)
- David Izquierdo-Garcia
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA
- Harvard Medical School, Boston, MA
- Harvard-MIT Division of Health Sciences and Technology, Cambridge, MA
- Bioengineering Department, Universidad Carlos III, Madrid, Spain
| | - Pauline Désogère
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA
- Institute for Innovation in Imaging, Massachusetts General Hospital, Boston, MA
| | - Anne L. Philip
- Cardiovascular Research Center, Cardiology Division, Dept. of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston MA
| | - David E. Sosnovik
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA
- Institute for Innovation in Imaging, Massachusetts General Hospital, Boston, MA
- Cardiovascular Research Center, Cardiology Division, Dept. of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston MA
- Cardiology Division, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Ciprian Catana
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA
- Harvard Medical School, Boston, MA
- Institute for Innovation in Imaging, Massachusetts General Hospital, Boston, MA
| | - Peter Caravan
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA
- Harvard Medical School, Boston, MA
- Institute for Innovation in Imaging, Massachusetts General Hospital, Boston, MA
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Baberwal P, Sonavane S, Vimalnath KV, Chakravarty R, Chakraborty S, Basu S. Normal physiological distribution and tumor localization of 64 CuCl 2 in different human malignancies along with semiquantitative scoring: a comparative evaluation with 18 Fluorodeoxyglucose ( 18 FDG) PET-CT. Nucl Med Commun 2024; 45:211-220. [PMID: 38165163 DOI: 10.1097/mnm.0000000000001804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
OBJECTIVE This study aimed to explore 64-Copper-Chloride ( 64 CuCl 2 ) PET-CT in various malignancies and demonstrate a head-to-head comparison of uptake on 64 CuCl 2 PET/computed tomography (CT) and 18 fluorodeoxyglucose ( 18 FDG)-PET/CT scans for different malignancies, with an emphasis on 18 FDG nonavid malignancies. METHODS Fifty-three patients diagnosed with various biopsy-proven malignancies (except prostate cancer) were recruited in this prospective study. All the patients underwent both 64 CuCl 2 PET/CT and 18 FDG-PET/CT. 64 CuCl 2 PET/CT was acquired at 1, 3 and 24 h time points. We studied the physiological biodistribution of 64 CuCl 2 in the various organs, corroborated the uptake of 64 CuCl 2 with various types of malignancies and comparison of their uptake with 18 FDG-PET/CT and their correlation with each other in various lesions. RESULTS The biodistribution study showed that the liver concentrated 64 CuCl 2 the most out of all the organs, followed by the pancreas and large intestine. Liver and intestinal activity increased subsequently with delayed imaging, and the washout of 64 CuCl 2 was noted in the pancreas in delayed images and followed a hepatobiliary excretion of tracer over a period of time. In lesion-wise analysis, it was noted that the primary neuroendocrine tumor, melanoma and renal/urothelial malignancy group showed more uptake of 64 CuCl 2 , than that in metastasis and vice-versa was noted in lung and soft tissue malignancies. Comparing it with 18 FDG, it was seen that FDG showed more uptake in lesions and showed no significant correlation (Kappa value: 0.089) with the uptake of 64 CuCl 2 in the lesion-wise comparison. CONCLUSION 64 CuCl 2 PET/CT did not show any added advantage over 18 FDG-PET/CT in the evaluation of the studied malignancies, both primary and their metastasis. Biodistribution studies showed the liver as the organ with maximum uptake, which implies it may hinder the detection of abdominal or hepatic involvement of the disease.
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Affiliation(s)
- Parth Baberwal
- Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Centre Annexe, Mumbai
- Homi Bhabha National Institute, Mumbai, India
| | - Sunita Sonavane
- Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Centre Annexe, Mumbai
- Homi Bhabha National Institute, Mumbai, India
| | - K V Vimalnath
- Homi Bhabha National Institute, Mumbai, India
- Radiopharmaceutical Division, Bhabha Atomic Research Centre, Mumbai, Maharashtra, India
| | - Rubel Chakravarty
- Homi Bhabha National Institute, Mumbai, India
- Radiopharmaceutical Division, Bhabha Atomic Research Centre, Mumbai, Maharashtra, India
| | - Sudipta Chakraborty
- Homi Bhabha National Institute, Mumbai, India
- Radiopharmaceutical Division, Bhabha Atomic Research Centre, Mumbai, Maharashtra, India
| | - Sandip Basu
- Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Centre Annexe, Mumbai
- Homi Bhabha National Institute, Mumbai, India
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Nazar AK, Kalshetty A, Chakravarty R, Chakraborty S, Basu S. Exploratory analysis of 64 CuCl 2 PET-CT imaging in carcinoma prostate and its comparison with 68 Ga-PSMA-11 and 18 F-FDG PET-CT. Nucl Med Commun 2023; 44:910-923. [PMID: 37578310 DOI: 10.1097/mnm.0000000000001744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
AIM Exploratory analysis of 64 CuCl 2 PET-CT imaging in patients of carcinoma prostate and its head-to-head comparison with 68 Ga-PSMA-11 and 18 F-FDG PET-CT. METHODS In this prospective study, 50 patients of biopsy-proven carcinoma prostate belonging to the entire spectrum of disease were evaluated, out of which 21 patients were for initial staging and 29 were for restaging/response evaluation. Both 64 CuCl 2 (early and delayed) and 68 Ga-PSMA-11 PET-CT were undertaken in all patients and 18 F-FDG PET-CT was done in patients whenever possible. All scans were done within a period of 2 weeks, without any interim therapeutic intervention. 64 CuCl 2 PET-CT was acquired at 1 and 3 h. We evaluated the physiological uptake of 64 CuCl 2 , correlated the uptake in primary with disease parameters like Gleason score and serum PSA levels, and compared the detection rates for primary and metastatic disease with 68 Ga-PSMA-11 and 18 F-FDG PET-CT. RESULTS The detection rates of primary disease were same for both 64 CuCl 2 and 68 Ga-PSMA-11 PET-CT and both agents performed similarly in detecting extra-prostatic disease. There was no statistically significant correlation observed between the uptake of 64 CuCl 2 in the primary lesion with disease parameters. With regard to the evaluation of metastatic disease, the detection rate of 64 CuCl 2 PET-CT was 86% for lymph nodes, 77.3% for skeletal metastases and 80.6% for soft tissue metastases while 68 Ga-PSMA-11 PET-CT performed better with detection rates were 98%, 99% and 85.4%, respectively. In 17 patients where 18 F-FDG PET-CT was available, 64 CuCl 2 PET-CT detected more metastatic disease than 18 F-FDG PET-CT. CONCLUSION 64 CuCl 2 PET-CT did not show any additional advantage over 68 Ga-PSMA-11 PET-CT in evaluation of local disease or for the assessment of metastatic disease. When compared to 68 Ga-PSMA-11 PET-CT, the absence of urinary bladder and ureteric activity allows better contrast for evaluating local disease, but it does not translate into increased disease detection.
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Affiliation(s)
- Aamir K Nazar
- Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Centre Annexe
- Homi Bhabha National Institute
| | - Ashwini Kalshetty
- Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Centre Annexe
- Homi Bhabha National Institute
| | - Rubel Chakravarty
- Homi Bhabha National Institute
- Radiopharmaceutical Division, Bhabha Atomic Research Centre, Mumbai, India
| | - Sudipta Chakraborty
- Homi Bhabha National Institute
- Radiopharmaceutical Division, Bhabha Atomic Research Centre, Mumbai, India
| | - Sandip Basu
- Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Centre Annexe
- Homi Bhabha National Institute
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Carrasco-Hernandez J, Ramos-Méndez J, Padilla-Rodal E, Avila-Rodriguez MA. Cellular lethal damage of 64Cu incorporated in mammalian genome evaluated with Monte Carlo methods. Front Med (Lausanne) 2023; 10:1253746. [PMID: 37841004 PMCID: PMC10575761 DOI: 10.3389/fmed.2023.1253746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 09/13/2023] [Indexed: 10/17/2023] Open
Abstract
Purpose Targeted Radionuclide Therapy (TRT) with Auger Emitters (AE) is a technique that allows targeting specific sites on tumor cells using radionuclides. The toxicity of AE is critically dependent on its proximity to the DNA. The aim of this study is to quantify the DNA damage and radiotherapeutic potential of the promising AE radionuclide copper-64 (64Cu) incorporated into the DNA of mammalian cells using Monte Carlo track-structure simulations. Methods A mammalian cell nucleus model with a diameter of 9.3 μm available in TOPAS-nBio was used. The cellular nucleus consisted of double-helix DNA geometrical model of 2.3 nm diameter surrounded by a hydration shell with a thickness of 0.16 nm, organized in 46 chromosomes giving a total of 6.08 giga base-pairs (DNA density of 14.4 Mbp/μm3). The cellular nucleus was irradiated with monoenergetic electrons and radiation emissions from several radionuclides including 111In, 125I, 123I, and 99mTc in addition to 64Cu. For monoenergetic electrons, isotropic point sources randomly distributed within the nucleus were modeled. The radionuclides were incorporated in randomly chosen DNA base pairs at two positions near to the central axis of the double-helix DNA model at (1) 0.25 nm off the central axis and (2) at the periphery of the DNA (1.15 nm off the central axis). For all the radionuclides except for 99mTc, the complete physical decay process was explicitly simulated. For 99mTc only total electron spectrum from published data was used. The DNA Double Strand Breaks (DSB) yield per decay from direct and indirect actions were quantified. Results obtained for monoenergetic electrons and radionuclides 111In, 125I, 123I, and 99mTc were compared with measured and calculated data from the literature for verification purposes. The DSB yields per decay incorporated in DNA for 64Cu are first reported in this work. The therapeutic effect of 64Cu (activity that led 37% cell survival after two cell divisions) was determined in terms of the number of atoms incorporated into the nucleus that would lead to the same DSBs that 100 decays of 125I. Simulations were run until a 2% statistical uncertainty (1 standard deviation) was achieved. Results The behavior of DSBs as a function of the energy for monoenergetic electrons was consistent with published data, the DSBs increased with the energy until it reached a maximum value near 500 eV followed by a continuous decrement. For 64Cu, when incorporated in the genome at evaluated positions (1) and (2), the DSB were 0.171 ± 0.003 and 0.190 ± 0.003 DSB/decay, respectively. The number of initial atoms incorporated into the genome (per cell) for 64Cu that would cause a therapeutic effect was estimated as 3,107 ± 28, that corresponds to an initial activity of 47.1 ± 0.4 × 10-3 Bq. Conclusion Our results showed that TRT with 64Cu has comparable therapeutic effects in cells as that of TRT with radionuclides currently used in clinical practice.
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Affiliation(s)
- Jhonatan Carrasco-Hernandez
- Departamento de Estructura de la Materia, Instituto de Ciencias Nucleares, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - José Ramos-Méndez
- Department of Radiation Oncology, University of California, San Francisco, San Francisco, CA, United States
| | - Elizabeth Padilla-Rodal
- Departamento de Estructura de la Materia, Instituto de Ciencias Nucleares, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Miguel A. Avila-Rodriguez
- Unidad Radiofarmacia-Ciclotrón, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
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Dellepiane G, Casolaro P, Mateu I, Scampoli P, Braccini S. Alternative routes for 64Cu production using an 18 MeV medical cyclotron in view of theranostic applications. Appl Radiat Isot 2023; 191:110518. [DOI: 10.1016/j.apradiso.2022.110518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 10/13/2022] [Accepted: 10/14/2022] [Indexed: 11/28/2022]
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Tsymbal S, Li G, Agadzhanian N, Sun Y, Zhang J, Dukhinova M, Fedorov V, Shevtsov M. Recent Advances in Copper-Based Organic Complexes and Nanoparticles for Tumor Theranostics. Molecules 2022; 27:7066. [PMID: 36296659 PMCID: PMC9611640 DOI: 10.3390/molecules27207066] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/11/2022] [Accepted: 10/15/2022] [Indexed: 08/19/2023] Open
Abstract
Treatment of drug-resistant forms of cancer requires consideration of their hallmark features, such as abnormal cell death mechanisms or mutations in drug-responding molecular pathways. Malignant cells differ from their normal counterparts in numerous aspects, including copper metabolism. Intracellular copper levels are elevated in various cancer types, and this phenomenon could be employed for the development of novel oncotherapeutic approaches. Copper maintains the cell oxidation levels, regulates the protein activity and metabolism, and is involved in inflammation. Various copper-based compounds, such as nanoparticles or metal-based organic complexes, show specific activity against cancer cells according to preclinical studies. Herein, we summarize the major principles of copper metabolism in cancer cells and its potential in cancer theranostics.
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Affiliation(s)
- Sergey Tsymbal
- International Institute of Solution Chemistry of Advanced Materials and Technologies, ITMO University, 197101 Saint Petersburg, Russia
| | - Ge Li
- Cancer Center & Department of Breast and Thyroid Surgery, Xiang’an Hospital of Xiamen University, School of Medicine, Xiamen University, 2000 Xiang’an Road East, Xiamen 361101, China
- Xiamen Key Laboratory for Endocrine-Related Cancer Precision Medicine, Xiang’an Hospital of Xiamen University, Xiamen 361101, China
| | - Nikol Agadzhanian
- International Institute of Solution Chemistry of Advanced Materials and Technologies, ITMO University, 197101 Saint Petersburg, Russia
| | - Yuhao Sun
- Guangxi University of Chinese Medicine, Nanning 530200, China
| | - Jiazhennan Zhang
- Day-Care Department, Xinjiang Medical University, Urumqi 830011, China
| | - Marina Dukhinova
- International Institute of Solution Chemistry of Advanced Materials and Technologies, ITMO University, 197101 Saint Petersburg, Russia
| | - Viacheslav Fedorov
- Laboratory of Biomedical Nanotechnologies, Institute of Cytology of the Russian Academy of Sciences, 194064 Saint Petersburg, Russia
| | - Maxim Shevtsov
- Laboratory of Biomedical Nanotechnologies, Institute of Cytology of the Russian Academy of Sciences, 194064 Saint Petersburg, Russia
- Personalized Medicine Centre, Almazov National Medical Research Centre, 2 Akkuratova Str., 197341 Saint Petersburg, Russia
- Department of Radiation Oncology, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany
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Latgé A, Boisson F, Ouadi A, Averous G, Thomas L, Imperiale A, Brasse D. 64CuCl 2 PET Imaging of 4T1-Related Allograft of Triple-Negative Breast Cancer in Mice. Molecules 2022; 27:4869. [PMID: 35956819 PMCID: PMC9369569 DOI: 10.3390/molecules27154869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 07/27/2022] [Accepted: 07/28/2022] [Indexed: 11/29/2022] Open
Abstract
64CuCl2 is an economic radiotracer for oncologic PET investigations. In the present study, we characterized the uptake of 64CuCl2 in vivo by µPET/CT in an allograft 4T1-related mouse model (BALB/c) of advanced breast cancer. 18F-FDG was used as a comparator. Twenty-two animals were imaged 7-9 days following 4T1-cell implantation inside mammary glands. Dynamic 64CuCl2 µPET/CT acquisition or iterative static images up to 8 h p.i. were performed. Animal biodistribution and tumor uptake were first evaluated in vivo by µPET analysis and then assessed on tissue specimens. Concerning 18F-FDG µPET, a static acquisition was performed at 15 min and 60 min p.i. Tumor 64CuCl2 accumulation increased from 5 min to 4 h p.i., reaching a maximum value of 5.0 ± 0.20 %ID/g. Liver, brain, and muscle 64CuCl2 accumulation was stable over time. The tumor-to-muscle ratio remained stable from 1 to 8 h p.i., ranging from 3.0 to 3.7. Ex vivo data were consistent with in vivo estimations. The 18F-FDG tumor accumulation was 8.82 ± 1.03 %ID/g, and the tumor-to-muscle ratio was 4.54 ± 1.11. 64CuCl2 PET/CT provides good characterization of the 4T1-related breast cancer model and allows for exploration of non-glycolytic cellular pathways potentially of interest for theragnostic strategies.
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Affiliation(s)
- Adrien Latgé
- Nuclear Medicine and Molecular Imaging Department, Institut de Cancérologie de Strasbourg Europe (ICANS), 17 Rue Albert Calmette, 67200 Strasbourg, France;
| | - Frédéric Boisson
- Institut Pluridisciplinaire Hubert Curien, Université de Strasbourg, 23 Rue du Loess, 67037 Strasbourg, France; (F.B.); (A.O.); (L.T.); (D.B.)
- CNRS, UMR7178, 23 Rue du Loess, 67037 Strasbourg, France
| | - Ali Ouadi
- Institut Pluridisciplinaire Hubert Curien, Université de Strasbourg, 23 Rue du Loess, 67037 Strasbourg, France; (F.B.); (A.O.); (L.T.); (D.B.)
- CNRS, UMR7178, 23 Rue du Loess, 67037 Strasbourg, France
| | - Gerlinde Averous
- Department of Pathology, Hôpitaux Universitaires de Strasbourg, 1 Avenue Molière, 67200 Strasbourg, France;
| | - Lionel Thomas
- Institut Pluridisciplinaire Hubert Curien, Université de Strasbourg, 23 Rue du Loess, 67037 Strasbourg, France; (F.B.); (A.O.); (L.T.); (D.B.)
- CNRS, UMR7178, 23 Rue du Loess, 67037 Strasbourg, France
| | - Alessio Imperiale
- Nuclear Medicine and Molecular Imaging Department, Institut de Cancérologie de Strasbourg Europe (ICANS), 17 Rue Albert Calmette, 67200 Strasbourg, France;
- Institut Pluridisciplinaire Hubert Curien, Université de Strasbourg, 23 Rue du Loess, 67037 Strasbourg, France; (F.B.); (A.O.); (L.T.); (D.B.)
- CNRS, UMR7178, 23 Rue du Loess, 67037 Strasbourg, France
| | - David Brasse
- Institut Pluridisciplinaire Hubert Curien, Université de Strasbourg, 23 Rue du Loess, 67037 Strasbourg, France; (F.B.); (A.O.); (L.T.); (D.B.)
- CNRS, UMR7178, 23 Rue du Loess, 67037 Strasbourg, France
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Sandahl TD, Gormsen LC, Kjærgaard K, Vendelbo MH, Munk DE, Munk OL, Bender D, Keiding S, Vase KH, Frisch K, Vilstrup H, Ott P. The pathophysiology of Wilson's disease visualized: A human 64 Cu PET study. Hepatology 2022; 75:1461-1470. [PMID: 34773664 PMCID: PMC9305563 DOI: 10.1002/hep.32238] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 11/08/2021] [Accepted: 11/08/2021] [Indexed: 12/08/2022]
Abstract
BACKGROUND AND AIMS Wilson's disease (WD) is a genetic disease with systemic accumulation of copper that leads to symptoms from the liver and brain. However, the underlying defects in copper transport kinetics are only partly understood. We sought to quantify hepatic copper turnover in patients with WD compared with heterozygote and control subjects using PET with copper-64 (64 Cu) as a tracer. Furthermore, we assessed the diagnostic potential of the method. APPROACH AND RESULTS Nine patients with WD, 5 healthy heterozygote subjects, and 8 healthy controls were injected with an i.v. bolus of 64 Cu followed by a 90-min dynamic PET scan of the liver and static whole-body PET/CT scans after 1.5, 6, and 20 h. Blood 64 Cu concentrations were measured in parallel. Hepatic copper retention and redistribution were evaluated by standardized uptake values (SUVs). At 90 min, hepatic SUVs were similar in the three groups. In contrast, at 20 h postinjection, the SUV in WD patients (mean ± SEM, 31 ± 4) was higher than in heterozygotes (24 ± 3) and controls (21 ± 4; p < 0.001). An SUV-ratio of hepatic 64 Cu concentration at 20 and 1.5 h completely discriminated between WD patients and control groups (p < 0.0001; ANOVA). By Patlak analysis of the initial 90 min of the PET scan, the steady-state hepatic clearance of 64 Cu was estimated to be slightly lower in patients with WD than in controls (p = 0.04). CONCLUSIONS 64 Cu PET imaging enables visualization and quantification of the hepatic copper retention characteristic for WD patients. This method represents a valuable tool for future studies of WD pathophysiology, and may assist the development of therapies, and accurate diagnosis.
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Affiliation(s)
| | - Lars C. Gormsen
- Department of Nuclear Medicine and PET‐CentreAarhus University HospitalAarhusDenmark
| | - Kristoffer Kjærgaard
- Department of Hepatology and GastroenterologyAarhus University HospitalAarhusDenmark
- Department of Nuclear Medicine and PET‐CentreAarhus University HospitalAarhusDenmark
| | - Mikkel Holm Vendelbo
- Department of Nuclear Medicine and PET‐CentreAarhus University HospitalAarhusDenmark
| | - Ditte Emilie Munk
- Department of Hepatology and GastroenterologyAarhus University HospitalAarhusDenmark
| | - Ole Lajord Munk
- Department of Nuclear Medicine and PET‐CentreAarhus University HospitalAarhusDenmark
| | - Dirk Bender
- Department of Nuclear Medicine and PET‐CentreAarhus University HospitalAarhusDenmark
| | - Susanne Keiding
- Department of Hepatology and GastroenterologyAarhus University HospitalAarhusDenmark
- Department of Nuclear Medicine and PET‐CentreAarhus University HospitalAarhusDenmark
| | - Karina H. Vase
- Department of Nuclear Medicine and PET‐CentreAarhus University HospitalAarhusDenmark
| | - Kim Frisch
- Department of Nuclear Medicine and PET‐CentreAarhus University HospitalAarhusDenmark
| | - Hendrik Vilstrup
- Department of Hepatology and GastroenterologyAarhus University HospitalAarhusDenmark
| | - Peter Ott
- Department of Hepatology and GastroenterologyAarhus University HospitalAarhusDenmark
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Copper Isotopes in Theranostics. Nucl Med Mol Imaging 2022. [DOI: 10.1016/b978-0-12-822960-6.00073-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Neels OC, Kopka K, Liolios C, Afshar-Oromieh A. Radiolabeled PSMA Inhibitors. Cancers (Basel) 2021; 13:6255. [PMID: 34944875 PMCID: PMC8699044 DOI: 10.3390/cancers13246255] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 12/10/2021] [Accepted: 12/11/2021] [Indexed: 12/16/2022] Open
Abstract
PSMA has shown to be a promising target for diagnosis and therapy (theranostics) of prostate cancer. We have reviewed developments in the field of radio- and fluorescence-guided surgery and targeted photodynamic therapy as well as multitargeting PSMA inhibitors also addressing albumin, GRPr and integrin αvβ3. An overview of the regulatory status of PSMA-targeting radiopharmaceuticals in the USA and Europe is also provided. Technical and quality aspects of PSMA-targeting radiopharmaceuticals are described and new emerging radiolabeling strategies are discussed. Furthermore, insights are given into the production, application and potential of alternatives beyond the commonly used radionuclides for radiolabeling PSMA inhibitors. An additional refinement of radiopharmaceuticals is required in order to further improve dose-limiting factors, such as nephrotoxicity and salivary gland uptake during endoradiotherapy. The improvement of patient treatment achieved by the advantageous combination of radionuclide therapy with alternative therapies is also a special focus of this review.
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Affiliation(s)
- Oliver C. Neels
- Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Bautzner Landstrasse 400, 01328 Dresden, Germany;
| | - Klaus Kopka
- Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Bautzner Landstrasse 400, 01328 Dresden, Germany;
- Faculty of Chemistry and Food Chemistry, School of Science, Technical University Dresden, Mommsenstrasse 4, 01062 Dresden, Germany
| | - Christos Liolios
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, National & Kapodistrian University of Athens, Zografou, 15771 Athens, Greece;
- INRASTES, Radiochemistry Laboratory, NCSR “Demokritos”, Ag. Paraskevi Attikis, 15310 Athens, Greece
| | - Ali Afshar-Oromieh
- Department of Nuclear Medicine, Bern University Hospital (Inselspital), Freiburgstrasse 18, 3010 Bern, Switzerland;
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Wang W, Hansen AE, Sun H, Fliedner FP, Kjaer A, Jensen AI, Andresen TL, Henriksen JR. Carbohydrate based biomarkers enable hybrid near infrared fluorescence and 64Cu based radio-guidance for improved surgical precision. Nanotheranostics 2021; 5:448-460. [PMID: 34055574 PMCID: PMC8156217 DOI: 10.7150/ntno.60295] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 05/04/2021] [Indexed: 01/15/2023] Open
Abstract
Increasing numbers of lung tumors are identified at early disease stages by diagnostic imaging in screening programs, but difficulties in locating these during surgical intervention has prevented an improved treatment outcome. Surgical biomarkers that are visible on diagnostic images, and that provide the surgeon with real-time image guidance during the intervention are thus highly warranted to bridge diagnostic precision into enhanced therapeutic outcome. In this paper, a liquid soft tissue marker for near infrared fluorescence and radio-guidance is presented. The biocompatible marker is based on the carbohydrate ester, sucrose acetate isobutyrate, ethanol, and a multifunctional naphthalocyanine dye, which enable near infrared fluorescence image-guided resection at short, medium and long tissue depths. Naphthalocyanine dyes have high quantum yields and may further act as chelators of radionuclides. Upon injection of the liquid marker, a gel-like depot is formed in situ at the site of injection, wherein the fluorescent dye and radionuclide is retained. The radiolabeled markers were optimized for minimal fluorescence quenching and high retention of the positron emission tomography radionuclide 64Cu. The performance of the radiolabeled marker was tested in vivo in mice, where it displayed high photostability over a period of 4 weeks, and high retention of 64Cu for 48 hours. The retention and biodistribution of 64Cu was quantified via PET/CT, and the fluorescence emission by an in vivo imaging system. The presented data demonstrate proof-of-concept for naphthalocyanine markers as multimodal imaging agents that can bridge the precision of diagnostic imaging into surgical interventions.
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Affiliation(s)
- Wenbo Wang
- Technical University of Denmark, Department of Health Technology, Building 423, 2800 Lyngby, Denmark.,Center for Nanomedicine and Theranostics, Technical University of Denmark, 2800 Lyngby, Denmark
| | - Anders E Hansen
- Technical University of Denmark, Department of Health Technology, Building 423, 2800 Lyngby, Denmark.,Center for Nanomedicine and Theranostics, Technical University of Denmark, 2800 Lyngby, Denmark
| | - Hongmei Sun
- School of Bioengineering and Food, Key Laboratory of Fermentation Engineering, (Ministry of Education), Key Laboratory of Industrial Microbiology in Hubei, National '111' Center for Cellular Regulation and Molecular Pharmaceutic, Hubei province Cooperative Innovation Center for Industrial Fermentation, Hubei University of Technology, Wuhan 430068, China
| | - Frederikke P Fliedner
- Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Department of Biomedical Sciences, Rigshospitalet and University of Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
| | - Andreas Kjaer
- Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Department of Biomedical Sciences, Rigshospitalet and University of Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
| | - Andreas I Jensen
- Technical University of Denmark, The Hevesy Laboratory, Department of Health Technology, 4000 Roskilde, Denmark.,Center for Nanomedicine and Theranostics, Technical University of Denmark, 2800 Lyngby, Denmark
| | - Thomas L Andresen
- Technical University of Denmark, Department of Health Technology, Building 423, 2800 Lyngby, Denmark.,Center for Nanomedicine and Theranostics, Technical University of Denmark, 2800 Lyngby, Denmark
| | - Jonas R Henriksen
- Technical University of Denmark, Department of Health Technology, Building 423, 2800 Lyngby, Denmark.,Center for Nanomedicine and Theranostics, Technical University of Denmark, 2800 Lyngby, Denmark
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12
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Tolvanen T, Kalliokoski K, Malaspina S, Kuisma A, Lahdenpohja S, Postema EJ, Miller MP, Scheinin M. Safety, Biodistribution, and Radiation Dosimetry of 18F-rhPSMA-7.3 in Healthy Adult Volunteers. J Nucl Med 2021; 62:679-684. [PMID: 33067338 PMCID: PMC8844263 DOI: 10.2967/jnumed.120.252114] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 09/16/2020] [Indexed: 12/12/2022] Open
Abstract
This first-in-humans study investigated the safety, biodistribution, and radiation dosimetry of a novel 18F-labeled radiohybrid prostate-specific membrane antigen (rhPSMA) PET imaging agent, 18F-rhPSMA-7.3. Methods: Six healthy volunteers (3 men, 3 women) underwent multiple whole-body PET acquisitions at scheduled time points up to 248 min after the administration of 18F-rhPSMA-7.3 (mean activity, 220; range, 210–228 MBq). PET scans were conducted in 3 separate sessions, and subjects were encouraged to void between sessions. Blood and urine samples were collected for up to 4 h after injection to assess metabolite-corrected radioactivity in whole blood, plasma, and urine. Quantitative measurements of 18F radioactivity in volumes of interest over target organs were determined directly from the PET images at 8 time points, and normalized time–activity concentration curves were generated. These normalized cumulated activities were then inputted into the OLINDA/EXM package to calculate the internal radiation dosimetry and the subjects’ effective dose. Results:18F-rhPSMA-7.3 was well tolerated. One adverse event (mild headache, not requiring medication) was considered possibly related to 18F-rhPSMA-7.3. The calculated effective dose was 0.0141 mSv/MBq when using a 3.5-h voiding interval. The organs with the highest mean absorbed dose per unit of administered radioactivity were the adrenals (0.1835 mSv/MBq), the kidneys (0.1722 mSv/MBq), the submandibular glands (0.1479 mSv), and the parotid glands (0.1137 mSv/MBq). At the end of the first scanning session (mean time, 111 min after injection), an average of 7.2% (range, 4.4%–9.0%) of the injected radioactivity of 18F-rhPSMA-7.3 was excreted into urine. Conclusion: The safety, biodistribution, and internal radiation dosimetry of 18F-rhPSMA-7.3 are considered favorable for PET imaging.
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Affiliation(s)
- Tuula Tolvanen
- Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland
| | - Kari Kalliokoski
- Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland
| | - Simona Malaspina
- Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland
| | - Anna Kuisma
- Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland.,Department of Oncology and Radiotherapy, Turku University Hospital, Turku, Finland
| | - Salla Lahdenpohja
- Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland
| | | | | | - Mika Scheinin
- Clinical Research Services Turku-CRST Ltd., Turku, Finland
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13
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Volpe A, Pillarsetty NVK, Lewis JS, Ponomarev V. Applications of nuclear-based imaging in gene and cell therapy: probe considerations. MOLECULAR THERAPY-ONCOLYTICS 2021; 20:447-458. [PMID: 33718593 PMCID: PMC7907215 DOI: 10.1016/j.omto.2021.01.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 01/26/2021] [Indexed: 01/11/2023]
Abstract
Several types of gene- and cell-based therapeutics are now emerging in the cancer immunotherapy, transplantation, and regenerative medicine landscapes. Radionuclear-based imaging can be used as a molecular imaging tool for repetitive and non-invasive visualization as well as in vivo monitoring of therapy success. In this review, we discuss the principles of nuclear-based imaging and provide a comprehensive overview of its application in gene and cell therapy. This review aims to inform investigators in the biomedical field as well as clinicians on the state of the art of nuclear imaging, from probe design to available radiopharmaceuticals and advances of direct (probe-based) and indirect (transgene-based) strategies in both preclinical and clinical settings. Notably, as the nuclear-based imaging toolbox is continuously expanding, it will be increasingly incorporated into the clinical setting where the distribution, targeting, and persistence of a new generation of therapeutics can be imaged and ultimately guide therapeutic decisions.
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Affiliation(s)
- Alessia Volpe
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Naga Vara Kishore Pillarsetty
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Weill Cornell Medical College, New York, NY, USA
| | - Jason S Lewis
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Molecular Pharmacology Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Weill Cornell Medical College, New York, NY, USA
| | - Vladimir Ponomarev
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Molecular Pharmacology Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Weill Cornell Medical College, New York, NY, USA
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14
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Reactor produced [ 64Cu]CuCl 2 as a PET radiopharmaceutical for cancer imaging: from radiochemistry laboratory to nuclear medicine clinic. Ann Nucl Med 2020; 34:899-910. [PMID: 33048309 DOI: 10.1007/s12149-020-01522-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 09/07/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Copper-64 is a useful theranostic radioisotope that is attracting renewed interest from the nuclear medicine community in the recent times. This study aims to demonstrate the utility of research reactors to produce clinical-grade 64Cu via 63Cu(n,γ)64Cu reaction and use it in the form of [64Cu]CuCl2 as a radiopharmaceutical for PET imaging of cancer in human patients. METHODS Copper-64 was produced by irradiation of natural CuO target in a medium flux research reactor. The irradiated target was radiochemically processed and detailed quality control analyses were carried out. Sub-acute toxicity studies were carried out with different doses of Cu in Wistar rats. The biological efficacy of the radiopharmaceutical was established in preclinical setting by biodistribution studies in melanoma tumor bearing mice. After getting regulatory approvals, [64Cu]CuCl2 formulation was clinically used for PET imaging of prostate cancer and glioblastoma patients. RESULTS Large-scale (~ 30 GBq) production of 64Cu could be achieved in a typical batch and it was adequate for formulation of clinical doses for multiple patients. The radiopharmaceutical met all the purity requirements for administration in human subjects. Studies carried out in animal model showed that the toxicity due to "cold" Cu in clinical dose of [64Cu]CuCl2 for PET scans would be negligible. Clinical PET scans showed satisfactory uptake of the radiopharmaceutical in the primary cancer and its metastatic sites. CONCLUSIONS To the best of our knowledge, this is the first study on use of reactor produced [64Cu]CuCl2 for PET imaging of cancer in human patients. It is envisaged that this route of production of 64Cu would aid towards affordable availability of this radioisotope for widespread clinical use in countries with limited cyclotron facilities.
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15
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Bolzati C, Duatti A. The emerging value of 64Cu for molecular imaging and therapy. THE QUARTERLY JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING : OFFICIAL PUBLICATION OF THE ITALIAN ASSOCIATION OF NUCLEAR MEDICINE (AIMN) [AND] THE INTERNATIONAL ASSOCIATION OF RADIOPHARMACOLOGY (IAR), [AND] SECTION OF THE SOCIETY OF RADIOPHARMACEUTICAL CHEMISTRY AND BIOLOGY 2020; 64:329-337. [PMID: 33026210 DOI: 10.23736/s1824-4785.20.03292-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Along with other novel metallic radionuclides, copper-64 (64Cu) is currently being investigated as an alternative option to the gallium-68 (68Ga) and lutetium-177 (177Lu) radiopharmaceuticals widely used for targeting somatostatin receptors, expressed by neuroendocrine tumors (NETs), and recently prostate specific membrane antigen (PSMA), expressed by prostate cancer cells. This interest is mostly driven by the peculiar nuclear properties of 64Cu that make it an almost ideal example of theranostic radionuclide. In fact, 64Cu emits both low-energy positrons, β- particles and a swarm of Auger electrons. This combination of different emissions may allow to collect high-resolution PET images, but also to use the same radiopharmaceutical for eliciting a therapeutic effect. Another unique behavior of 64Cu originates from the fundamental biological role played in organisms by the ionic forms of the copper element, which is naturally involved in a multitude of cellular processes including cell replication. These intrinsic biological characteristics has led to the discovery that 64Cu, under its simplest dicationic form Cu2+, is able to specifically target a variety of cancerous cells and to detect the onset of a metastatic process in its initial stage. This short review reports an outline of the status of 64Cu radiopharmaceuticals and of the most relevant results that are constantly disclosed by preclinical and investigational clinical studies.
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Affiliation(s)
| | - Adriano Duatti
- Department of Chemical and Pharmaceutical Sciences, University of Ferrara, Ferrara, Italy -
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16
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Jalilian AR, Osso JA, Vera-Araujo J, Kumar V, Harris MJ, Gutfilen B, Guérin B, Li H, Zhuravlev F, Chakravarty R, Alirezapour B, Ávila-Rodríguez MA, Khan IU, Aljammaz I, Assaad T, Luurtsema G, Smith J, Duatti A. IAEA contribution to the development of 64Cu radiopharmaceuticals for theranostic applications. THE QUARTERLY JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING : OFFICIAL PUBLICATION OF THE ITALIAN ASSOCIATION OF NUCLEAR MEDICINE (AIMN) [AND] THE INTERNATIONAL ASSOCIATION OF RADIOPHARMACOLOGY (IAR), [AND] SECTION OF THE SOCIETY OF RADIOPHARMACEUTICAL CHEMISTRY AND BIOLOGY 2020; 64:338-345. [PMID: 33026211 DOI: 10.23736/s1824-4785.20.03302-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Copper-64 is a very attractive radioisotope with unique nuclear properties that allow using it as both a diagnostic and therapeutic agent, thus providing an almost ideal example of a theranostic radionuclide. A characteristic of Cu-64 stems from the intrinsic biological nature of copper ions that play a fundamental role in a large number of cellular processes. Cu-64 is a radionuclide that reflects the natural biochemical pathways of Cu-64 ions, therefore, can be exploited for the detection and therapy of certain malignancies and metabolic diseases. Beside these applications of Cu-64 ions, this radionuclide can be also used for radiolabelling bifunctional chelators carrying a variety of pharmacophores for targeting different biological substrates. These include peptide-based substrates and immunoconjugates as well as small-molecule bioactive moieties. Fueled by the growing interest of Member States (MS) belonging to the International Atomic Energy Agency (IAEA) community, a dedicated Coordinated Research Project (CRP) was initiated in 2016, which recruited thirteen participating MS from four continents. Research activities and collaborations between the participating countries allowed for collection of an impressive series of results, particularly on the production, preclinical evaluation and, in a few cases, clinical evaluation of various 64Cu-radiopharmaceuticals that may have potential impact on future development of the field. Since this CRP was finalized at the beginning of 2020, this short review summarizes outcomes, outputs and results of this project with the purpose to propagate to other MS and to the whole scientific community, some of the most recent achievements on this novel class of theranostic 64Cu-pharmaceuticals.
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Affiliation(s)
- Amir R Jalilian
- Department of Nuclear Sciences and Applications, International Atomic Energy Agency (IAEA), Vienna International Center, Vienna, Austria -
| | - Joao A Osso
- Department of Nuclear Sciences and Applications, International Atomic Energy Agency (IAEA), Vienna International Center, Vienna, Austria
| | - Julia Vera-Araujo
- Department of Nuclear Sciences and Applications, International Atomic Energy Agency (IAEA), Vienna International Center, Vienna, Austria
| | - Vijay Kumar
- Westmead Hospital, Westmead, Sydney, Australia
| | | | - Bianca Gutfilen
- Department of Radiology, Federal University of Rio de Janeiro, Laboratório de Marcação de Células e Moléculas (LMCM), Rio de Janeiro, Brazil
| | - Brigitte Guérin
- Department of Nuclear Medicine and Radiobiology, Centre de Recherche du CHUS (CRCHUS), Centre d'Excellence en Imagerie Médicale (CIMUS), University of Sherbrooke, Sherbrooke, Canada
| | - Hongyu Li
- China Isotope and Radiation Corporation, Beijing, China
| | - Fedor Zhuravlev
- Hevesy Laboratory, Technical University of Denmark (DTU HEALTH TECH), Roskilde, Denmark
| | - Rubel Chakravarty
- Division of Radiopharmaceuticals, Bhabha Atomic Research Center, Mumbai, India
| | - Behrouz Alirezapour
- Radiation Applications Research School, Nuclear Science and Technology Research Institute (NSTRI), Tehran, Iran
| | - Miguel A Ávila-Rodríguez
- Unit of Cyclotron and Radiopharmaceuticals, Division of Investigation, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Irfan U Khan
- Division of Cyclotron and Allied Radiopharmaceuticals, Institute of Nuclear Medicine and Oncology (INMOL), Lahore, Pakistan
| | - Ibrahim Aljammaz
- Department of Cyclotron and Radiopharmaceuticals, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Thaer Assaad
- Department of Radioisotope, Atomic Energy Commission of Syria (AECS), Damascus, Syria
| | - Gert Luurtsema
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen (UMCG), Groningen, the Netherlands
| | - Jeff Smith
- MU School of Medicine, University of Missouri, Columbia, MO, USA
| | - Adriano Duatti
- Department of Chemical and Pharmaceutical Sciences, University of Ferrara, Ferrara, Italy
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Carrasco-Hernández J, Ramos-Méndez J, Faddegon B, Jalilian AR, Moranchel M, Ávila-Rodríguez MA. Monte Carlo track-structure for the radionuclide Copper-64: characterization of S-values, nanodosimetry and quantification of direct damage to DNA. Phys Med Biol 2020; 65:155005. [PMID: 32303013 DOI: 10.1088/1361-6560/ab8aaa] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
TOPAS-nBio was used to simulate, collision-to-collision, the complete trajectories of electrons in water generated during the explicit simulation of 64Cu decay. S-values and direct damage to the DNA were calculated representing the cell (C) and the cell nucleus (N) with concentric spheres of 5 μm and 4 μm in radius, respectively. The considered 'target'←'source' configurations, including the cell surface (Cs) and cytoplasm (Cy), were: C←C, C←Cs, N←N, N←Cy and N←Cs. Ionization cluster size distributions were also calculated in a cylinder immersed in water corresponding to a DNA segment of 10 base-pairs in length (diameter 2.3 nm, length 3.4 nm), modeling a radioactive point source moving from the central axis to the edge of the cylinder. For that, the first moment (M1) and cumulative probability of having a cluster size of 2 or more ionizations in the cylindrical volume (F2) were obtained. Finally, the direct damage to the DNA was estimated by quantifying double-strand breaks (DSBs) using the clustering algorithm DBSCAN. The S-values obtained with TOPAS-nBio for 64Cu were 7.879 × 10-4 ± 5 × 10-7, 4.351 × 10-4 ± 6 × 10-7, 1.442 × 10-3 ± 1 × 10-6, 2.596 × 10-4 ± 8 × 10-7, 1.127 × 10-4 ± 4 × 10-7 Gy Bq-s-1 for the configurations C←C, C←Cs, N←N, N←Cy and N←Cs, respectively. The difference of these values, compared with previously reported S-values for 64Cu with the code MNCP and software MIRDCell, ranged from -4% to -25% for the configurations N←N and N←Cs, respectively. On the other hand, F2 was maximum with the source at the center of the cylinder 0.373 ± 0.001, and monotonically decreased until reaching a value of 0.058 ± 0.001 at 2.3 nm. The same behavior was observed for M1 with values ranging from 2.188 ± 0.004 to 0.242 ± 0.002. Finally, the DBSCAN algorithm showed that the mean number of DNA DSBs per decay were 0.187 ± 0.001, 0.0317 ± 0.0005, and 0.0125 ± 0.0002 DSB-(Bq-s)-1 for the configurations N←N, N←Cs, and N←Cy, respectively. In conclusion, the results of the S-values show that the absorbed dose strongly depends on the distribution of the radionuclide in the cell, the dose being higher when 64Cu is internalized in the cell nucleus, which is reinforced by the nanodosimetric study by the presence of DNA DSBs attributable to the Auger electrons emitted during the decay of 64Cu.
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Affiliation(s)
- J Carrasco-Hernández
- Escuela Superior de Física y Matemáticas, Instituto Politécnico Nacional, Ciudad de México 07738, México
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Bordes J, Incerti S, Mora-Ramirez E, Tranel J, Rossi C, Bezombes C, Bordenave J, Bardiès M, Brown R, Bordage MC. Monte Carlo dosimetry of a realistic multicellular model of follicular lymphoma in a context of radioimmunotherapy. Med Phys 2020; 47:5222-5234. [PMID: 32623743 DOI: 10.1002/mp.14370] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 04/20/2020] [Accepted: 06/15/2020] [Indexed: 12/31/2022] Open
Abstract
PURPOSE Small-scale dosimetry studies generally consider an artificial environment where the tumors are spherical and the radionuclides are homogeneously biodistributed. However, tumor shapes are irregular and radiopharmaceutical biodistributions are heterogeneous, impacting the energy deposition in targeted radionuclide therapy. To bring realism, we developed a dosimetric methodology based on a three-dimensional in vitro model of follicular lymphoma incubated with rituximab, an anti-CD20 monoclonal antibody used in the treatment of non-Hodgkin lymphomas, which might be combined with a radionuclide. The effects of the realistic geometry and biodistribution on the absorbed dose were highlighted by comparison with literature data. Additionally, to illustrate the possibilities of this methodology, the effect of different radionuclides on the absorbed dose distribution delivered to the in vitro tumor were compared. METHODS The starting point was a model named multicellular aggregates of lymphoma cells (MALC). Three MALCs of different dimensions and their rituximab biodistribution were considered. Geometry, antibody location and concentration were extracted from selective plane illumination microscopy. Assuming antibody radiolabeling with Auger electron (125 I and 111 In) and β- particle emitters (177 Lu, 131 I and 90 Y), we simulated energy deposition in MALCs using two Monte Carlo codes: Geant4-DNA with "CPA100" physics models for Auger electron emitters and Geant4 with "Livermore" physics models for β- particle emitters. RESULTS MALCs had ellipsoid-like shapes with major radii, r, of ~0.25, ~0.5 and ~1.3 mm. Rituximab was concentrated in the periphery of the MALCs. The absorbed doses delivered by 177 Lu, 131 I and 90 Y in MALCs were compared with literature data for spheres with two types of homogeneous biodistributions (on the surface or throughout the volume). Compared to the MALCs, the mean absorbed doses delivered in spheres with surface biodistributions were between 18% and 38% lower, while with volume biodistribution they were between 15% and 29% higher. Regarding the radionuclides comparison, the relationship between MALC dimensions, rituximab biodistribution and energy released per decay impacted the absorbed doses. Despite releasing less energy, 125 I delivered a greater absorbed dose per decay than 111 In in the r ~ 0.25 mm MALC (6.78·10-2 vs 6.26·10-2 µGy·Bq-1 ·s-1 ). Similarly, the absorbed doses per decay in the r ~ 0.5 mm MALC for 177 Lu (2.41·10-2 µGy·Bq-1 ·s-1 ) and 131 I (2.46·10-2 µGy·Bq-1 ·s-1 ) are higher than for 90 Y (1.98·10-2 µGy·Bq-1 ·s-1 ). Furthermore, radionuclides releasing more energy per decay delivered absorbed dose more uniformly through the MALCs. Finally, when considering the radiopharmaceutical effective half-life, due to the biological half-life of rituximab being best matched by the physical half-life of 177 Lu and 131 I compared to 90 Y, the first two radionuclides delivered higher absorbed doses. CONCLUSION In the simulated configurations, β- emitters delivered higher and more uniform absorbed dose than Auger electron emitters. When considering radiopharmaceutical half-lives, 177 Lu and 131 I delivered absorbed doses higher than 90 Y. In view of real irradiation of MALCs, such a work may be useful to select suited radionuclides and to help explain the biological effects.
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Affiliation(s)
- Julien Bordes
- CRCT, UMR 1037 INSERM, Université Paul Sabatier, Toulouse, F-31037, France.,UMR 1037, CRCT, Université Toulouse III-Paul Sabatier, Toulouse, F-31037, France
| | - Sébastien Incerti
- Université de Bordeaux, CENBG, UMR 5797, Gradignan, F-33170, France.,CNRS, IN2P3, CENBG, UMR 5797, Gradignan, F-33170, France
| | - Erick Mora-Ramirez
- CRCT, UMR 1037 INSERM, Université Paul Sabatier, Toulouse, F-31037, France.,UMR 1037, CRCT, Université Toulouse III-Paul Sabatier, Toulouse, F-31037, France.,Escuela de Física, CICANUM, Universidad de Costa Rica, San José, 11501-2060, Costa Rica
| | - Jonathan Tranel
- CRCT, UMR 1037 INSERM, Université Paul Sabatier, Toulouse, F-31037, France.,UMR 1037, CRCT, Université Toulouse III-Paul Sabatier, Toulouse, F-31037, France.,Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, 94143, USA
| | - Cédric Rossi
- CRCT, UMR 1037 INSERM, Université Paul Sabatier, Toulouse, F-31037, France.,UMR 1037, CRCT, Université Toulouse III-Paul Sabatier, Toulouse, F-31037, France.,CHU Dijon, Hématologie Clinique, Hôpital François Mitterand, Dijon, 21000, France
| | - Christine Bezombes
- CRCT, UMR 1037 INSERM, Université Paul Sabatier, Toulouse, F-31037, France.,UMR 1037, CRCT, Université Toulouse III-Paul Sabatier, Toulouse, F-31037, France
| | - Julie Bordenave
- CRCT, UMR 1037 INSERM, Université Paul Sabatier, Toulouse, F-31037, France.,UMR 1037, CRCT, Université Toulouse III-Paul Sabatier, Toulouse, F-31037, France
| | - Manuel Bardiès
- CRCT, UMR 1037 INSERM, Université Paul Sabatier, Toulouse, F-31037, France.,UMR 1037, CRCT, Université Toulouse III-Paul Sabatier, Toulouse, F-31037, France
| | - Richard Brown
- Institute of Nuclear Medicine, University College London, 235 Euston Road, London, NW1 2BU, UK
| | - Marie-Claude Bordage
- CRCT, UMR 1037 INSERM, Université Paul Sabatier, Toulouse, F-31037, France.,UMR 1037, CRCT, Université Toulouse III-Paul Sabatier, Toulouse, F-31037, France
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Preclinical PET imaging study of lung cancer with 64CuCl 2. Ann Nucl Med 2020; 34:653-662. [PMID: 32567008 DOI: 10.1007/s12149-020-01491-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 06/15/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Human copper transporter 1 (CTR1) has been proven to be overexpressed in many types of cancer cells, and copper (II)-64 chloride (64CuCl2) has been used as an effective tracer for positron emission tomography (PET) imaging in tumor-bearing animal models. Thus, this study aimed to investigate the potential application of 64CuCl2 in PET imaging of lung cancer through targeting CTR1. METHODS The expression of CTR1 in a series of lung cancer cell lines was identified by quantitative real-time polymerase chain reaction (Q-PCR), western blot, enzyme-linked immunosorbnent assay (ELISA), and immunofluorescent staining. Then in vitro cell uptake assay of 64CuCl2 was investigated in human lung cancer cell lines with different levels of CTR1 expression. Small animal PET imaging and quantitative analysis were performed in human lung cancer tumor-bearing mice after intravenous injection of 64CuCl2, respectively. RESULTS The CTR1 expression in multiple human lung cancer cells was identified and confirmed, and H1299 cell lines with high CTR1 expression, H460 with moderate CTR1, and H1703 with low CTR1 were selected for further experiments. In vitro cellular uptake assay displayed that the 64CuCl2 uptake by these three kinds of cells was positively correlated with their CTR1 expressed levels. The blocking experiments testified the specificity of 64CuCl2 to target CTR1. Moreover, small animal PET imaging and quantitative results showed that 64CuCl2 accumulation in H1299, H460, and H1703 tumor-bearing mice were consistent with CTR1 levels and cell uptake experiments. CONCLUSIONS The expression of CTR1 in human lung cancer xenograft model could be successfully visualized by 64CuCl2 PET examination. With the expected growth of PET/CT examination to be an essential strategy in clinical lung cancer management, 64CuCl2 has the potential to be a promising PET imaging agent of lung cancer.
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Kjærgaard K, Sandahl TD, Frisch K, Vase KH, Keiding S, Vilstrup H, Ott P, Gormsen LC, Munk OL. Intravenous and oral copper kinetics, biodistribution and dosimetry in healthy humans studied by [ 64Cu]copper PET/CT. EJNMMI Radiopharm Chem 2020; 5:15. [PMID: 32556736 PMCID: PMC7303253 DOI: 10.1186/s41181-020-00100-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 06/04/2020] [Indexed: 12/16/2022] Open
Abstract
Purpose Copper is essential for enzymatic processes throughout the body. [64Cu]copper (64Cu) positron emission tomography (PET) has been investigated as a diagnostic tool for certain malignancies, but has not yet been used to study copper homeostasis in humans. In this study, we determined the hepatic removal kinetics, biodistribution and radiation dosimetry of 64Cu in healthy humans by both intravenous and oral administration. Methods Six healthy participants underwent PET/CT studies with intravenous or oral administration of 64Cu. A 90 min dynamic PET/CT scan of the liver was followed by three whole-body PET/CT scans at 1.5, 6, and 20 h after tracer administration. PET data were used for estimation of hepatic kinetics, biodistribution, effective doses, and absorbed doses for critical organs. Results After intravenous administration, 64Cu uptake was highest in the liver, intestinal walls and pancreas; the gender-averaged effective dose was 62 ± 5 μSv/MBq (mean ± SD). After oral administration, 64Cu was almost exclusively taken up by the liver while leaving a significant amount of radiotracer in the gastrointestinal lumen, resulting in an effective dose of 113 ± 1 μSv/MBq. Excretion of 64Cu in urine and faeces after intravenous administration was negligible. Hepatic removal kinetics showed that the clearance of 64Cu from blood was 0.10 ± 0.02 mL blood/min/mL liver tissue, and the rate constant for excretion into bile or blood was 0.003 ± 0.002 min− 1. Conclusion 64Cu biodistribution and radiation dosimetry are influenced by the manner of tracer administration with high uptake by the liver, intestinal walls, and pancreas after intravenous administration, while after oral administration, 64Cu is rapidly absorbed from the gastrointestinal tract and deposited primarily in the liver. Administration of 50 MBq 64Cu yielded images of high quality for both administration forms with radiation doses of approximately 3.1 and 5.7 mSv, respectively, allowing for sequential studies in humans. Trial registration number EudraCT no. 2016–001975-59. Registration date: 19/09/2016.
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Affiliation(s)
- Kristoffer Kjærgaard
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark. .,Department of Nuclear Medicine & PET Centre, Aarhus University Hospital, Aarhus, Denmark.
| | | | - Kim Frisch
- Department of Nuclear Medicine & PET Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Karina Højrup Vase
- Department of Nuclear Medicine & PET Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Susanne Keiding
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.,Department of Nuclear Medicine & PET Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Hendrik Vilstrup
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
| | - Peter Ott
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
| | - Lars Christian Gormsen
- Department of Nuclear Medicine & PET Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Ole Lajord Munk
- Department of Nuclear Medicine & PET Centre, Aarhus University Hospital, Aarhus, Denmark
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21
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García-Pérez FO, Medina-Ornelas SS, Barron-Barron F, Arrieta-Rodriguez O. Evaluation of non-small cell lung cancer by PET/CT with 64CuCl 2: initial experience in humans. AMERICAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING 2020; 10:143-150. [PMID: 32704405 PMCID: PMC7364381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 03/07/2020] [Indexed: 06/11/2023]
Abstract
Human copper transporter 1 (hCtr1) is the main transporter of copper which has been involved as an essential cofactor in biological processes and mechanisms of action for cisplatin and its analogues. Although expression of hCtr1 is present in all tissues that require copper, several studies have showed that levels of expression are highly variable between normal and neoplastic tissues. We evaluated the potential diagnostic of the 64CuCl2-PET/CT in patients with wild type non-small cell lung cancer (NSCLC). Eleven patients were included. Baseline 18F-FDG-PET/CT and 64CuCl2-PET/CT performed before to initiate treatment with platinum-based chemotherapy. 18F-FDG-PET/CT detected a total of 68 lesions in different corporal sites: lung (24), regional lymph node (30), distant non-bone metastases (17) and bone metastases (14). Of total, 73% demonstrated high focal uptake of 64CuCl2-PET/CT: 36% in primary tumor and 27% in lymph-nodes metastases. The detection-rates (DRs) was lower with 64CuCl2 PET/CT compared to 18F-FDG-PET/CT, however, these was not statistically significant (P = 0.108). A complete match was found in 2 patients. All patients were treated with platinum-based chemotherapy. According to RECIST 1.1 and PERCIST 1.0 criteria, most patients with highest uptake 64CuCl2-PET/CT presented partial response (mean 3 cycles) corroborated with 18F-FDG PET/CT. On the other hand, patients with very low uptake or faint uptake have progressive disease (3/16 patients). To our knowledge, this is the first study with 64CuCl2-PET/CT in-human in patients with NSCLC chemo-naïve. Our results may represent that 64CuCl2-PET/CT had a good ability for detect lesions. In addition, the 64CuCl2 uptake is based on the expression of Ctr1 transporters seeking to differentiate between those patients who may benefit from platinum-based therapy. More studies are necessary for confirm these findings.
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Affiliation(s)
- Francisco Osvaldo García-Pérez
- Departament of Nuclear Medicine and Molecular Imaging, Instituto Nacional de Cancerología (INCan)Av. San Fernando No. 22, Col. Sección XVI, Tlalpan, C.P. 14080, Ciudad de México, México
| | - Sevastian Salvador Medina-Ornelas
- Departament of Nuclear Medicine and Molecular Imaging, Instituto Nacional de Cancerología (INCan)Av. San Fernando No. 22, Col. Sección XVI, Tlalpan, C.P. 14080, Ciudad de México, México
| | - Feliciano Barron-Barron
- Functional Unit of Thoracic Oncology and Laboratory of Personalized Medicine, Instituto Nacional de Cancerología (INCan)Av. San Fernando No. 22, Col. Sección XVI, Tlalpan, C.P. 14080, Ciudad de México, México
| | - Oscar Arrieta-Rodriguez
- Functional Unit of Thoracic Oncology and Laboratory of Personalized Medicine, Instituto Nacional de Cancerología (INCan)Av. San Fernando No. 22, Col. Sección XVI, Tlalpan, C.P. 14080, Ciudad de México, México
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22
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Kelly JM, Ponnala S, Amor-Coarasa A, Zia NA, Nikolopoulou A, Williams C, Schlyer DJ, DiMagno SG, Donnelly PS, Babich JW. Preclinical Evaluation of a High-Affinity Sarcophagine-Containing PSMA Ligand for 64Cu/ 67Cu-Based Theranostics in Prostate Cancer. Mol Pharm 2020; 17:1954-1962. [PMID: 32286841 DOI: 10.1021/acs.molpharmaceut.0c00060] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The application of small molecules targeting prostate-specific membrane antigen (PSMA) has emerged as a highly promising clinical strategy for visualization and treatment of prostate cancer. Ligands that integrate the ability to both quantify the distribution of radioactivity and treat disease through the use of a matched pair of radionuclides have particular value in clinical and regulatory settings. In this study, we describe the development and preclinical evaluation of RPS-085, a ligand that binds PSMA and serum albumin and exploits the 64/67Cu radionuclide pair for prostate cancer theranostics. RPS-085 was synthesized by conjugation of a PSMA-targeting moiety, an Nε-(2-(4-iodophenyl)acetyl)lysine albumin binding group, and a bifunctionalized MeCOSar chelator. The IC50 of the metal-free RPS-085 was determined in a competitive binding assay. The affinity for human serum albumin of the radiolabeled compound was determined by high-performance affinity chromatography. Radiolabeling was performed in NH4OAc buffer at 25 °C. The stability of the radiolabeled compounds was assessed in vitro and in vivo. The biodistribution of [64/67Cu]Cu-RPS-085 was determined following intravenous administration to male BALB/c mice bearing LNCaP tumor xenografts. The radiochemical yields of [64/67Cu]Cu-RPS-085 were nearly quantitative after 20 min. The metal-free complex is a potent inhibitor of PSMA (IC50 = 29 ± 2 nM), and the radiolabeled compound has moderate affinity for human serum albumin (Kd = 9.9 ± 1.7 μM). Accumulation of the tracer in mice was primarily evident in tumor and kidneys. Activity in all other tissues, including blood, was negligible, and the radiolabeled compounds demonstrated high stability in vitro and in vivo. Tumor activity reached a maximum at 4 h post injection (p.i.) and cleared gradually over a period of 96 h. By contrast, activity in the kidney cleared rapidly from 4 to 24 h p.i. As a consequence, by 24 h p.i., the tumor-to-kidney ratio exceeds 2, and the predicted dose to tumors is significantly greater than the dose to kidneys. [64Cu]Cu-RPS-085 combines rapid tissue distribution and clearance with prolonged retention in LNCaP tumor xenografts. The pharmacokinetics should enable radioligand therapy using [67Cu]Cu-RPS-085. By virtue of its rapid kidney clearance, the therapeutic index of [67Cu]Cu-RPS-085 likely compares favorably to its parent structure, [177Lu]Lu-RPS-063, a highly avid PSMA-targeting compound. On this basis, [64/67Cu]Cu-RPS-085 show great promise as PSMA-targeting theranostic ligands for prostate cancer imaging and therapy.
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Affiliation(s)
- James M Kelly
- Division of Radiopharmaceutical Sciences and MI3 Institute, Department of Radiology, Weill Cornell Medicine, New York, New York 10021, United States
| | - Shashikanth Ponnala
- Division of Radiopharmaceutical Sciences and MI3 Institute, Department of Radiology, Weill Cornell Medicine, New York, New York 10021, United States
| | - Alejandro Amor-Coarasa
- Division of Radiopharmaceutical Sciences and MI3 Institute, Department of Radiology, Weill Cornell Medicine, New York, New York 10021, United States
| | - Nicholas A Zia
- School of Chemistry and Bio21 Molecular Science and Biotechnology Institute, University of Melbourne, Melbourne, Victoria 3010, Australia
| | - Anastasia Nikolopoulou
- Division of Radiopharmaceutical Sciences and MI3 Institute, Department of Radiology, Weill Cornell Medicine, New York, New York 10021, United States.,Citigroup Biomedical Imaging Center, Weill Cornell Medicine, New York, New York 10021, United States
| | - Clarence Williams
- Division of Radiopharmaceutical Sciences and MI3 Institute, Department of Radiology, Weill Cornell Medicine, New York, New York 10021, United States
| | - David J Schlyer
- Brookhaven National Laboratory, Upton, New York 11973, United States.,Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York 11794, United States
| | - Stephen G DiMagno
- College of Pharmacy, University of Illinois-Chicago, Chicago, Illinois 60612, United States
| | - Paul S Donnelly
- School of Chemistry and Bio21 Molecular Science and Biotechnology Institute, University of Melbourne, Melbourne, Victoria 3010, Australia
| | - John W Babich
- Division of Radiopharmaceutical Sciences and MI3 Institute, Department of Radiology, Weill Cornell Medicine, New York, New York 10021, United States.,Citigroup Biomedical Imaging Center, Weill Cornell Medicine, New York, New York 10021, United States.,Sandra and Edward Meyer Cancer Center, Weill Cornell Medicine, New York, New York 10065, United States
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23
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Liu T, Karlsen M, Karlberg AM, Redalen KR. Hypoxia imaging and theranostic potential of [ 64Cu][Cu(ATSM)] and ionic Cu(II) salts: a review of current evidence and discussion of the retention mechanisms. EJNMMI Res 2020; 10:33. [PMID: 32274601 PMCID: PMC7145880 DOI: 10.1186/s13550-020-00621-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Accepted: 03/19/2020] [Indexed: 02/07/2023] Open
Abstract
Background Tumor hypoxia (low tissue oxygenation) is an adverse condition of the solid tumor environment, associated with malignant progression, radiotherapy resistance, and poor prognosis. One method to detect tumor hypoxia is by positron emission tomography (PET) with the tracer [64Cu][Cu-diacetyl-bis(N(4)-methylthiosemicarbazone)] ([64Cu][Cu(ATSM)]), as demonstrated in both preclinical and clinical studies. In addition, emerging studies suggest using [64Cu][Cu(ATSM)] for molecular radiotherapy, mainly due to the release of therapeutic Auger electrons from copper-64, making [64Cu][Cu(ATSM)] a “theranostic” agent. However, the radiocopper retention based on a metal-ligand dissociation mechanism under hypoxia has long been controversial. Recent studies using ionic Cu(II) salts as tracers have raised further questions on the original mechanism and proposed a potential role of copper itself in the tracer uptake. We have reviewed the evidence of using the copper radiopharmaceuticals [60/61/62/64Cu][Cu(ATSM)]/ionic copper salts for PET imaging of tumor hypoxia, their possible therapeutic applications, issues related to the metal-ligand dissociation mechanism, and possible explanations of copper trapping based on studies of the copper metabolism under hypoxia. Results We found that hypoxia selectivity of [64Cu][Cu(ATSM)] has been clearly demonstrated in both preclinical and clinical studies. Preclinical therapeutic studies in mice have also demonstrated promising results, recently reporting significant tumor volume reductions and improved survival in a dose-dependent manner. Cu(II)-[Cu(ATSM)] appears to be accumulated in regions with substantially higher CD133+ expression, a marker for cancer stem cells. This, combined with the reported requirement of copper for activation of the hypoxia inducible factor 1 (HIF-1), provides a possible explanation for the therapeutic effects of [64Cu][Cu(ATSM)]. Comparisons between [64Cu][Cu(ATSM)] and ionic Cu(II) salts have showed similar results in both imaging and therapeutic studies, supporting the argument for the central role of copper itself in the retention mechanism. Conclusions We found promising evidence of using copper-64 radiopharmaceuticals for both PET imaging and treatment of hypoxic tumors. The Cu(II)-[Cu(ATSM)] retention mechanism remains controversial and future mechanistic studies should be focused on understanding the role of copper itself in the hypoxic tumor metabolism.
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Affiliation(s)
- Tengzhi Liu
- Department of Physics, Norwegian University of Science and Technology, Høgskoleringen 5, 7491, Trondheim, Norway.,Department of Radiology and Nuclear Medicine, St. Olavs hospital, Trondheim University Hospital, Trondheim, Norway
| | - Morten Karlsen
- Department of Radiology and Nuclear Medicine, St. Olavs hospital, Trondheim University Hospital, Trondheim, Norway
| | - Anna Maria Karlberg
- Department of Radiology and Nuclear Medicine, St. Olavs hospital, Trondheim University Hospital, Trondheim, Norway.,Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kathrine Røe Redalen
- Department of Physics, Norwegian University of Science and Technology, Høgskoleringen 5, 7491, Trondheim, Norway.
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24
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Gul-e-Raana, Shah SQ. Targeting 5α-reductase with 99mTc labeled dutasteride derivatives for prostate imaging. RADIOCHIM ACTA 2019. [DOI: 10.1515/ract-2019-3156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
To assess the suitability of 99mTc labeled 5α-reductase (5α-Rds) inhibitors for non-invasive targeting of prostate cancer (PCa) using Male Sprague Dawely Rat (MSDR) model. In this work, dutasteride (Cpd-1) a 5α-Rds inhibitor was derivatized to its dithiocarbamate analogue (Cpd-2) for subsequent synthesis of 99mTc(CO)3-dutasteride dithiocarbamate (Cpd-3) using tricarbonyl technique. To determine the structure of Cpd-3, for the first time a reference Re(CO)3-dutasteride dithiocarbamate (Cpd-4) was synthesized and characterized with NMR, ESIMS, HPLC and elemental analysis. HPLC was used to establish the identity of Cpd-3 using Cpd-4 as a reference standard. The suitability of Cpd-3 as a new 5α-Rds targeting agent was investigated, both in vitro and vivo. The Cpd-3 has shown ≥98 % in vitro stability at room temperature and was remained ≥90 % stable up to 6 h. In serum Cpd-3 has revealed an analogous behavior with a small decrease in stability after 16 h. High uptake (26.25 ± 1.10 %, after 4 h of i.v.) of Cpd-3 was observed in the prostate (target tissue) of MSDR model with reasonably good target to non-target ratio. Blocking the target site with excess Cpd-2 considerably decreased the uptake of Cpd-3 to 4.10 ± 0.75 % in PCa. High in vitro stability in saline and serum and in vivo uptake in prostate of MSDR model plausibly attracts the opportunity of using Cpd-3 as a novel radiopharmaceutical for non invasive targeting of prostate.
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Affiliation(s)
- Gul-e-Raana
- Biochemistry and Nuclear Medicine Research Laboratory (NMRL), Institute of Chemical Sciences (ICS) , University of Peshawar , Peshawar, 25120, KPK , Pakistan , Tel.: 00 92 91 9216701-20, Cell: 0333 9254009, Fax: 00 92 91 9216447
| | - Syed Qaiser Shah
- Biochemistry and Nuclear Medicine Research Laboratory (NMRL), Institute of Chemical Sciences (ICS) , University of Peshawar , Peshawar, 25120, KPK , Pakistan
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25
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26
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Zhou Y, Li J, Xu X, Zhao M, Zhang B, Deng S, Wu Y. 64Cu-based Radiopharmaceuticals in Molecular Imaging. Technol Cancer Res Treat 2019; 18:1533033819830758. [PMID: 30764737 PMCID: PMC6378420 DOI: 10.1177/1533033819830758] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Copper-64 (T1/2 = 12.7 hours; β+: 19%, β-: 38%) has a unique decay profile and can be used for positron emission tomography imaging and radionuclide therapy. The well-established coordination chemistry of copper allows for its reaction with different types of chelator systems. It can be linked to antibodies, proteins, peptides, and other biologically relevant small molecules. Two potential ways to produce copper-64 radioisotopes concern the use of the cyclotron or the reactor. This review summarized several commonly used biomarkers of copper-64 radionuclide.
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Affiliation(s)
- Yeye Zhou
- 1 Department of Nuclear Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jihui Li
- 1 Department of Nuclear Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xin Xu
- 1 Department of Nuclear Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Man Zhao
- 1 Department of Nuclear Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Bin Zhang
- 1 Department of Nuclear Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Shengming Deng
- 1 Department of Nuclear Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yiwei Wu
- 1 Department of Nuclear Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China
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27
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Radiobiological Characterization of 64CuCl₂ as a Simple Tool for Prostate Cancer Theranostics. Molecules 2018; 23:molecules23112944. [PMID: 30423862 PMCID: PMC6278521 DOI: 10.3390/molecules23112944] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 11/07/2018] [Accepted: 11/09/2018] [Indexed: 12/11/2022] Open
Abstract
64CuCl2 has recently been proposed as a promising agent for prostate cancer (PCa) theranostics, based on preclinical studies in cellular and animal models, and on the increasing number of human studies documenting its use for PCa diagnosis. Nevertheless, the use of 64CuCl2 raises important radiobiological questions that have yet to be addressed. In this work, using a panel of PCa cell lines in comparison with a non-tumoral prostate cell line, we combined cytogenetic approaches with radiocytotoxicity assays to obtain significant insights into the cellular consequences of exposure to 64CuCl2. PCa cells were found to exhibit increased 64CuCl2 uptake, which could not be attributed to increased expression of the main copper cellular importer, hCtr1, as had been previously suggested. Early DNA damage and genomic instability were also higher in PCa cells, with the tumoral cell lines exhibiting deficient DNA-damage repair upon exposure to 64CuCl2. This was corroborated by the observation that 64CuCl2 was more cytotoxic in PCa cells than in non-tumoral cells. Overall, we showed for the first time that PCa cells had a higher sensitivity to 64CuCl2 than healthy cells, supporting the idea that this compound deserved to be further evaluated as a theranostic agent in PCa.
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28
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Umbricht CA, Benešová M, Hasler R, Schibli R, van der Meulen NP, Müller C. Design and Preclinical Evaluation of an Albumin-Binding PSMA Ligand for 64Cu-Based PET Imaging. Mol Pharm 2018; 15:5556-5564. [DOI: 10.1021/acs.molpharmaceut.8b00712] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
| | - Martina Benešová
- Department of Chemistry and Applied Biosciences, ETH Zurich, 8093 Zurich, Switzerland
| | | | - Roger Schibli
- Department of Chemistry and Applied Biosciences, ETH Zurich, 8093 Zurich, Switzerland
| | | | - Cristina Müller
- Department of Chemistry and Applied Biosciences, ETH Zurich, 8093 Zurich, Switzerland
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29
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Gutfilen B, Souza SA, Valentini G. Copper-64: a real theranostic agent. DRUG DESIGN DEVELOPMENT AND THERAPY 2018; 12:3235-3245. [PMID: 30323557 PMCID: PMC6173185 DOI: 10.2147/dddt.s170879] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Ongoing studies of physiological and pathological processes have led to a corresponding need for new radiopharmaceuticals, especially when studies are limited by the absence of a particular radiolabeled target. Thus, the development of new radioactive tracers is highly relevant and can represent a significant contribution to efforts to elucidate important phenomena in biology. Currently, theranostics represents a new frontier in the fields of medicine and nuclear medicine, with the same compound being used for both diagnosis and treatment. In the human body, copper (Cu) is the third most abundant metal and it plays a crucial role in many biological functions. Correspondingly, in various acquired and inherited pathological conditions, such as cancer and Alzheimer’s disease, alterations in Cu levels have been found. Moreover, a wide spectrum of neurodegenerative disorders are associated with higher or lower levels of Cu, as well as inappropriately bound or distributed levels of Cu in the brain. In human cells, the membrane protein, hCtr1, binds Cu in its Cu(I) oxidation state in an energy-dependent manner. Copper-64 (64Cu) is a cyclotron-produced radionuclide that has exhibited physical properties that are complementary for diagnosis and/or therapeutic purposes. To date, very few reports have described the clinical development of 64Cu as a radiotracer for cancer imaging. In this review, we highlight recent insights in our understanding and use of 64CuCl2 as a theranostic agent for various types of tumors. To the best of our knowledge, no adverse effects or clinically observable pharmacological effects have been described for 64CuCl2 in the literature. Thus, 64Cu represents a revolutionary radiopharmaceutical for positron emission tomography imaging and opens a new era in the theranostic field.
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Affiliation(s)
- Bianca Gutfilen
- Department of Radiology, School of Medicine, Laboratório de Marcação de Células e Moléculas (LMCM), Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil,
| | - Sergio Al Souza
- Department of Radiology, School of Medicine, Laboratório de Marcação de Células e Moléculas (LMCM), Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil,
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Abstract
Imaging plays a key role in the preclinical evaluation of nanomedicine-based drug delivery systems and it has provided important insights into their mechanism of action and therapeutic effect. Its role in supporting the clinical development of nanomedicine products, however, has been less explored. In this review, we summarize clinical studies in which imaging has provided valuable information on the pharmacokinetics, biodistribution, and target site accumulation of nanomedicine-based drug delivery systems. Importantly, these studies provide convincing evidence on the uptake of nanomedicines in tumors, confirming that the enhanced permeability and retention (EPR) effect is a real phenomenon in patients, albeit with fairly high levels of inter- and intraindividual variability. It is gradually becoming clear that imaging is critically important to help address this high heterogeneity. In support of this notion, a decent correlation between nanomedicine uptake in tumors and antitumor efficacy has recently been obtained in two independent studies in patients, exemplifying that image-guided drug delivery can help to pave the way towards individualized and improved nanomedicine therapies.
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Affiliation(s)
- Francis Man
- School of Biomedical Engineering & Imaging Sciences, King's College London, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK
| | - Twan Lammers
- Department of Nanomedicine and Theranostics, Institute for Experimental Molecular Imaging (ExMI), University Clinic and Helmholtz Institute for Biomedical Engineering, RWTH Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany
- Department of Targeted Therapeutics, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, P.O. Box 217, 7500 AE, Enschede, The Netherlands
- Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Universiteitsweg 99, 3584 CG, Utrecht, The Netherlands
| | - Rafael T M de Rosales
- School of Biomedical Engineering & Imaging Sciences, King's College London, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK.
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Aguilar-Ortíz E, Jalilian AR, Ávila-Rodríguez MA. Porphyrins as ligands for 64copper: background and trends. MEDCHEMCOMM 2018; 9:1577-1588. [PMID: 30429966 PMCID: PMC6194497 DOI: 10.1039/c8md00263k] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 08/17/2018] [Indexed: 12/13/2022]
Abstract
Porphyrins and 64Cu have emerged as a novel synergic option for applications in PET molecular imaging. Both the characteristics and photophysical properties of macrocyclic porphyrins and the relatively long half-life of the copper isotope, in addition to the increased tumor-specific uptake of porphyrins compared to normal cells, make this complex an attractive option not only for diagnosis but also for therapeutic applications. Herein, we present an overview of the latest results on the development of PET agents based on porphyrins and 64Cu, including methods used to improve the selectivity of these macrocycles when conjugated with biological units such as monoclonal antibodies, peptides or proteins.
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Affiliation(s)
- Edgar Aguilar-Ortíz
- Unidad Radiofarmacia-Ciclotrón , División de Investigación , Facultad de Medicina , Universidad Nacional Autónoma de México , 04510 Cd. Mx. , Mexico . ;
| | - Amir R Jalilian
- Department of Nuclear Sciences and Applications , International Atomic Energy Agency (IAEA) , Vienna , Austria
| | - Miguel A Ávila-Rodríguez
- Unidad Radiofarmacia-Ciclotrón , División de Investigación , Facultad de Medicina , Universidad Nacional Autónoma de México , 04510 Cd. Mx. , Mexico . ;
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32
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The emerging role of copper-64 radiopharmaceuticals as cancer theranostics. Drug Discov Today 2018; 23:1489-1501. [DOI: 10.1016/j.drudis.2018.04.002] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 03/02/2018] [Accepted: 04/03/2018] [Indexed: 12/12/2022]
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Righi S, Ugolini M, Bottoni G, Puntoni M, Iacozzi M, Paparo F, Cabria M, Ceriani L, Gambaro M, Giovanella L, Piccardo A. Biokinetic and dosimetric aspects of 64CuCl 2 in human prostate cancer: possible theranostic implications. EJNMMI Res 2018; 8:18. [PMID: 29492782 PMCID: PMC5833894 DOI: 10.1186/s13550-018-0373-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 02/20/2018] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The aim of the present study is to evaluate the kinetics and dosimetry of 64CuCl2 in human prostate cancer (PCa) lesions. We prospectively evaluated 50 PCa patients with biochemical relapse after surgery or external beam radiation therapy. All patients underwent 64CuCl2-PET/CT to detect PCa recurrence/metastases. Volumes of interest were manually drawn for each 64CuCl2 avid PCa lesion with a diameter > 1 cm on mpMRI in each patient. Time-activity curves for all lesions were obtained. The effective and biological half-life and the standard uptake values (SUVs) were calculated. Tumour/background ratio (TBR) curves as a function of time were considered. Finally, the absorbed dose per lesion was estimated. RESULTS The mean effective half-life of 64CuCl2 calculated in the lymph nodes (10.2 ± 1.7 h) was significantly higher than in local relapses (8.8 ± 1.1 h) and similar to that seen in bone metastases (9.0 ± 0.4 h). The mean 64CuCl2 SUVmax calculated 1 h after tracer injection was significantly higher in the lymph nodes (6.8 ± 4.3) and bone metastases (6.8 ± 2.9) than in local relapses (4.7 ± 2.4). TBR mean curve of 64CuCl2 revealed that the calculated TBRmax value was 5.0, 7.0, and 6.2 in local relapse and lymph node and bone metastases, respectively, and it was achieved about 1 h after 64CuCl2 injection. The mean absorbed dose of the PCa lesions per administrated activity was 6.00E-2 ± 4.74E-2mGy/MBq. Indeed, for an administered activity of 3.7 GBq, the mean dose absorbed by the lesion would be 0.22 Gy. CONCLUSIONS Dosimetry showed that the dose absorbed by PCa recurrences/metastases per administrated activity was low. The dosimetric study performed does not take into account the possible therapeutic effect of the Auger electrons. Clinical trials are needed to evaluate 64Cu internalization in the cell nucleus that seems related to the therapeutic effectiveness reported in preclinical studies.
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Affiliation(s)
- Sergio Righi
- Medical Physics Department, E.O. Galliera Hospital, Genoa, Italy
| | - Martina Ugolini
- Medical Physics Department, E.O. Galliera Hospital, Genoa, Italy
| | - Gianluca Bottoni
- Department of Nuclear Medicine, Galliera Hospital, Mura delle Cappuccine 14, 16128, Genoa, Italy
| | - Matteo Puntoni
- Clinical Trial Unit, Office of the Scientific Director, Galliera Hospital, Genoa, Italy
| | - Massimiliano Iacozzi
- Department of Nuclear Medicine, Galliera Hospital, Mura delle Cappuccine 14, 16128, Genoa, Italy
| | | | - Manlio Cabria
- Department of Nuclear Medicine, Galliera Hospital, Mura delle Cappuccine 14, 16128, Genoa, Italy
| | - Luca Ceriani
- Department of Nuclear Medicine, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Monica Gambaro
- Medical Physics Department, E.O. Galliera Hospital, Genoa, Italy
| | - Luca Giovanella
- Department of Nuclear Medicine, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Arnoldo Piccardo
- Department of Nuclear Medicine, Galliera Hospital, Mura delle Cappuccine 14, 16128, Genoa, Italy.
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Jiang L, Song D, Chen H, Zhang A, Wang H, Cheng Z. Pilot Study of 64CuCl₂ for PET Imaging of Inflammation. Molecules 2018; 23:molecules23020502. [PMID: 29495260 PMCID: PMC6017813 DOI: 10.3390/molecules23020502] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Revised: 02/18/2018] [Accepted: 02/20/2018] [Indexed: 11/16/2022] Open
Abstract
Copper(II) ion (Cu2+) is the essential element for numerous pathophysiological processes in vivo. Copper transporter 1 (CTR1) is mainly responsible for maintaining Cu2+ accumulation in cells, which has been found to be over-expressed in inflammatory tissues. Therefore, we explored the potential application of 64CuCl₂ for PET imaging of inflammation through targeting CTR1. The animal models of H₂O₂ induced muscle inflammation and lipopolysaccaharide induced lung inflammation were successfully established, then imaged by small animal PET (PET/CT) post-injection of 64CuCl₂, and PET images were quantitatively analyzed. H&E and immunohistochemical (IHC) staining and western blot experiments were performed for evaluating CTR1 levels in the inflammatory and control tissues. Both inflammatory muscle and lungs can be clearly imaged by PET. PET image quantitative analysis revealed that the inflammatory muscle and lungs showed significantly higher 64Cu accumulation than the controls, respectively (p < 0.05). Furthermore, IHC staining and western blot analysis demonstrated that compared with the controls, CTR1 expression was increased in both the inflammatory muscle and lungs, which was consistent with the levels of 64Cu2+ accumulation in these tissues. 64CuCl₂ can be used as a novel, simple, and highly promising PET tracer for CTR1 targeted imaging of inflammation.
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Affiliation(s)
- Lei Jiang
- Department of Nuclear Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China.
- Molecular Imaging Program at Stanford (MIPS), Department of Radiology and Bio-X Program, Canary Center at Stanford for Cancer Early Detection, Stanford University, Stanford, CA 94305-5484, USA.
| | - Dongli Song
- Institute of Clinical Science, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
| | - Hao Chen
- Molecular Imaging Program at Stanford (MIPS), Department of Radiology and Bio-X Program, Canary Center at Stanford for Cancer Early Detection, Stanford University, Stanford, CA 94305-5484, USA.
| | - Ao Zhang
- CAS Key Laboratory of Receptor Research, Synthetic Organic & Medicinal Chemistry Laboratory (SOMCL), Shanghai Institute of Materia Medica, Chinese Academy of Sciences, No. 555 Zuchong Road, Pudong New Area, Shanghai 201203, China.
| | - Huoqiang Wang
- Department of Nuclear Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China.
| | - Zhen Cheng
- Molecular Imaging Program at Stanford (MIPS), Department of Radiology and Bio-X Program, Canary Center at Stanford for Cancer Early Detection, Stanford University, Stanford, CA 94305-5484, USA.
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