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In this paper, the use of 123 I-Annexin V for the detection of farnesyltransferase inhibitor (FTI)-induced apoptosis in tumour-bearing athymic mice is described. In vitro binding assays on LoVo cells show time- and dosage-dependent 125 I-Annexin V binding upon treatment with Tipifarnib (Zarnestra, R115777), a selective and potent FTI. In vivo experiments using planar gamma scintigraphy on LoVo inoculated mice show a 40% increased 123 I-Annexin V uptake 8 h after a single oral administration of 100 mg/kg Tipifarnib in 20% β-cyclodextrin in 0.1 M HCl, as well as after 3 days of twice daily treatments with the same dose. Ex vivo TUNEL assays, detecting end-stage apoptotic cells, correlate significantly with both in vitro and in vivo results. The percentage of necrosis is also increased by Tipifarnib treatment, but is too low to interfere with the 123 I-Annexin V uptake. It can be concluded that 123 I-Annexin V can be used to monitor Tipifarnib-induced apoptosis in LoVo xenograft tumours in athymic mice. Future applications might include the early prediction of FTI response and the selection of FTI-sensitive patients very shortly after treatment initiation. Subsequently, such patients would greatly benefit from a noninvasive and fast therapy evaluation.

AIM: Radiopharmaceuticals can be used to exploit differences between microorganisms in order to distinguish fungal from bacterial infection. Chitin, abundant in the cell wall of fungi, is not present in mammalian or bacterial cells and therefore represents a highly specific target to localize fungal infection. In this study, we have examined the potential of chitin-binding protein (CBP21) from Serratia marcescens as a specific radiotracer for the detection of invasive fungal infections. METHODS: CBP21 was labeled with 99mTc via hydrazinonicotinamide (HYNIC) and its characteristics were analyzed. In vitro binding studies with polymorphic chitin forms and microorganisms (fungi as well as bacteria) were performed. In vivo biodistribution of the compound was studied in immunocompromised mice with bacterial and fungal infections in the left and right thigh muscle, respectively, using 99mTc-HYNIC-myoglobin as size-matched control and 67Ga-citrate as positive control. Scintigraphic images were acquired at 1 and 7 h postinjection of the tracer. RESULTS: 99mTc-HYNIC-CBP21 was labeled with a radiochemical yield of 61% and a specific activity of 22.3 MBq/nmol. Highest in vitro binding percentages were found with beta-chitin (86.8+/-2.4%). Binding interactions to fungi were higher than to bacteria (P

UNLABELLED: Earlier reports described the preferential uptake of d-amino acids in tumor-bearing mice. Moreover, it was shown that in tumor cells in vitro the L-amino acid transporter system seemed to lack stereospecificity. Because of the successful results with 123/125I-2-iodo-L-phenylalanine, 123/125I-2-iodo-D-phenylalanine was developed, and its tumor-detecting characteristics were evaluated in vivo. METHODS: 123I labeling of 2-iodo-D-phenylalanine was performed with a kit formulation by use of Cu1+-assisted nucleophilic exchange. 123I-2-Iodo-D-phenylalanine was evaluated in R1M tumor-bearing athymic mice by dynamic planar imaging (DPI) and dissection. The in vivo stability of the tracer was tested by high-performance liquid chromatography. Tumor tracer retention and tracer contrast were evaluated as a function of time. Two-compartment blood modeling from DPI results and dosimetric calculations from biodistribution results were carried out. Moreover, 125I-2-iodo-D-phenylalanine and 18F-FDG uptake in acute inflammation was investigated. RESULTS: 123I-2-Iodo-D-phenylalanine was metabolically stable. Fast, high, and specific tumor retention was observed. Two-compartment modeling confirmed the fast clearance of the tracer through the kidneys to the bladder, as observed by DPI and dissection. Moreover, compared with the L-isomer, 123I-2-iodo-D-phenylalanine demonstrated faster clearance and faster uptake in the peripheral compartment. No accumulation in the abdomen or in the brain was noted. Dosimetry revealed that 123I-2-iodo-D-phenylalanine demonstrated a low radiation burden comparable to those of 123I-2-iodo-L-phenylalanine and 123I-2-iodo-L-tyrosine. Although 123I-2-iodo-D-phenylalanine showed a tumor retention of only 4%, the tumor contrast was increased up to 350% at 19 h after injection. CONCLUSION: 123I-2-Iodo-D-phenylalanine is a promising tracer for diagnostic oncologic imaging because of its high, fast, and specific tumor uptake and fast clearance from blood.

UNLABELLED: The application of 123I-3-iodo-alpha-methyltyrosine is limited to diagnosis of brain tumors due to its marked long-term uptake in kidneys. In vitro evaluation of 125I-2-iodo-L-phenylalanine showed high uptake in R1M cells by L-type amino acid transport system 1 (LAT1). This study evaluates 123I-2-iodo-L-phenylalanine as a new specific tumor tracer for SPECT. METHODS: 123/125I-2-Iodo-L-phenylalanine is prepared as a one-pot kit using the Cu1+-assisted isotopic exchange method. The characteristics of 125I-2-iodo-L-phenylalanine were examined in vivo in R1M tumor-bearing athymic mice and in acute inflammation-bearing NMRI mice. The uptake of 123/125I-2-iodo-L-phenylalanine in tumor and other organs of interest was measured by dynamic planar imaging (DPI) and gamma-counting after dissection. Displacement of 123I-2-iodo-L-phenylalanine radioactivity by L-phenylalanine, L-methionine, and L-cysteine was measured. 123I-Iodo-human serum albumin planar imaging was performed to correct for blood-pool activity and MRI was performed to delineate the tumor in DPI. 18F-FDG uptake was measured with an animal PET scanner. 125I-2-Iodo-L-phenylalanine and 18F-FDG uptake in inflamed muscle were compared. RESULTS: 123/125I-2-Iodo-L-phenylalanine showed a high and fast tumor uptake and followed a reversible first-order pattern allowing calculation of the half-life and the time to reach equilibrium (t(R)). Net tumor-to-background ratios up to 6.7 at 60 min were obtained. This radioactivity was significantly displaced by L-phenylalanine, L-methionine, and L-cysteine, pointing to reversible LAT transport. When plotting t(R) of the tumor uptake as a function of tumor volume, a rectangular hyperbolic curve was obtained. The almost constant t(R) values at higher tumor volumes (>4 mL) could be linked to increased necrotic tissue. Fast blood clearance of the tracer through the kidneys to the bladder and low tracer activity in the abdomen and brain were observed. The inflamed muscle showed only a slight increase of 125I-2-iodo-L-phenylalanine uptake (inflammation-to-background ratio, RIB = 1.30 +/- 0.02), in contrast to the high 18F-FDG uptake (RIB = 11.1 +/- 1.7). The in vivo stability of 123/125I-2-iodo-L-phenylalanine was good: Only 7% of free radioiodide and no other labeled metabolites were observed after 90 min. CONCLUSION: 123/125I-2-Iodo-L-phenylalanine is quickly taken up by the overexpressed LAT1 system in R1M tumors with high tumor specificity. The availability of a kit and the specificity of the tracer make 123I-2-iodo-L-phenylalanine a promising tool for oncologic SPECT.

Contains fulltext : 57171.pdf (Publisher’s version ) (Closed access) The use of (99m)Tc-ciprofloxacin as a tracer for infection and inflammation has been examined and discussed in the literature extensively. Its alleged ability to discriminate between sterile inflammation and bacterial versus nonbacterial infections has led to an intense debate. Other labeled fluoroquinolones might offer better characteristics or may add to a better understanding of the working mechanism of (99m)Tc-ciprofloxacin. The rationale of this work was to determine possible differences in the use of 2 labeled quinolones--that is, (99m)Tc-ciprofloxacin and (99m)Tc-enrofloxacin--as tracers for infection and inflammation in animals. METHODS: Ciprofloxacin and enrofloxacin were labeled with (99m)Tc and characterized. The stability of both preparations was evaluated in serum and in the presence of an excess of cysteine. In vitro binding studies were performed to determine the interaction of the labeled quinolones with bacteria and other cells. Rats with sterile and infectious intramuscular lesions were used to study the scintigraphic properties of the 2 compounds. To assess the specificity of binding to living bacteria, infectious intramuscular lesions of heat-killed Staphylococcus aureus and Candida albicans were used as controls. Imaging was performed with a gamma-camera at 0, 3, 5, and 22 h after injection. RESULTS: The radiochemical purity of both radiolabeled fluoroquinolones exceeded 95% as determined by instant thin-layer chromatography. Both compounds were moderately stable in serum. Binding assays did not show any saturable binding to S. aureus, heat-killed S. aureus, as well as C. albicans. None of the tracers showed specific binding to bacteria. Scintigraphy showed uptake in the infectious lesion at 1 h after injection, which washed out during the next 4 h. Abscess-to-muscle ratios for both preparations were not significantly different for the various infectious or inflammatory lesions studied and did not exceed an average of 4.25 +/- 0.62. CONCLUSION: The study demonstrated that (99m)Tc-ciprofloxacin and (99m)Tc-enrofloxacin do not show preferential binding to living bacteria. In vivo (99m)Tc-enrofloxacin has similar characteristics as (99m)Tc-ciprofloxacin except for differences in uptake in a few normal tissues.

Activated microglia are involved in the immune response of multiple sclerosis (MS). The peripheral benzodiazepine receptor (PBR) is expressed on microglia and up-regulated after neuronal injury. [(11) C]PK11195 is a positron emission tomography (PET) radioligand for the PBR. The objective of the present study was to investigate [(11) C]PK11195 imaging in MS patients and its additional value over magnetic resonance imaging (MRI) concerning the immuno-pathophysiological process. Seven healthy and 22 MS subjects were included. Semiquantitative [(11) C]PK11195 uptake values were assessed with normalization on cortical grey matter. Uptake in Gadolinium-lesions was significantly increased compared with normal white matter. Uptake in T2-lesions was generally decreased, suggesting a PBR down-regulation. However, uptake values increased whenever a clinical or MR-relapse was present, suggestive for a dynamic process with a transient PBR up-regulation. During disease progression, an increase of normal-appearing white matter (NAWM) uptake was found, propagating NAWM as the possible real burden of disease. In conclusion, [(11) C]PK11195 and PET are able to demonstrate inflammatory processes with microglial involvement in MS.

Objectives : [C-11]PK11195 is a peripheral-benzo-diazepine-receptor radioligand used for detection of microglial inflammation. Normal uptake by means of semiquantification was measured in order to establish reference data. The applicability of this semiquantitative approach was tested in three multiple sclerosis patients. Materials and methods : Seven controls and three patients underwent MR and PET scanning. Coregistered static scans 40 minutes postinjection of [C-11]PK11195 were used for assessment of relative ligand uptake by comparison to whole-brain uptake. Results : For static scans acquired in near steady-state, the relative ligand uptake was significantly higher in gray matter structures as compared to the whole brain (ratio : 1.041 +/- 0.06, p = 0.036) whereas it was comparable in white matter (1.010 +/- 0.035). Intersubject reproducibility was 11.4% and 12.9% for white and grey matter Intrasubject reproducibility was of the same order: 14.0% and 14.5% respectively. In two clinically active patients with Gadolinium-positive T1-weighted lesions on MRI the focal ligand uptake was significantly increased (1.36 and 1.14, p = 0.001). In one clinically stable patient, the uptake value corresponding with a T2-weighted MR lesion was not different from normal brain measurements. Conclusion : The current investigations show that normal brain uptake of [C-11]PK11195 is very low and shows the feasibility of a semiquantitative method which can be applied to larger cohorts of patients subgroups.

UNLABELLED: Assessing tumor uptake and retention of (123)I-labeled tamoxifen (TX) could increase our understanding of TX's action and the mechanisms involved in resistance to the drug. METHODS: Nine untreated primary breast carcinoma patients underwent whole-body planar and tomographic (SPECT) imaging 30 min and 4-5 h after injection of 185 MBq (123)I-TX. Tumor-to-normal tissue uptake ratios (T/N) derived from SPECT images were related to estrogen receptor (ER) and progesterone receptor (PR) status. RESULTS: In 4 of 9 patients, all of whom were ER+/PR+, (123)I-TX tumor uptake was clearly depicted. In 2 of them, involved axillary lymph nodes were also visualized. T/N consistently increased over time. All ER+/PR- and ER-/PR- tumors as well as 2 ER+/PR+ tumors were (123)I-TX-. CONCLUSION: These preliminary findings suggest that (123)I-TX is preferentially taken up in alpha-ER+/PR+ breast tumors known to be more likely to respond to endocrine treatment.

The highest concentrations of the peripheral benzodiazepine receptor (PBR) are found in the kidneys and heart. In addition, the PER has been reported to reflect neuro-inflammatory damage by co-localisation with activated microglia. PK 11195 is a high-affinity ligand for the PER. The aim of this study was to investigate in humans the biodistribution and dosimetry of [I-123]iodo-PK 11195, a potential single-photon emission tomography tracer for the PER. Five healthy volunteers were injected with 112 MBq of [I-123]iodo-PK 11195. Sequential whole-body scans were performed up to 72 h post injection. Multiple blood samples were taken, and urine was collected to measure the fraction voided by the renal system. Decay-corrected regions of interest of the whole-body images were analysed, and geometric mean count rates were used to determine organ activity. Organ absorbed doses and effective dose were calculated using the MIRD method. [I-123]iodo-PK 11195 was rapidly cleared from the blood, mainly by the hepatobiliary system. Approximately 22% was voided in urine after 48 h. Average organ residence times were 0.74, 0.44 and 0.29 h for the liver, upper large intestine and lower large intestine, respectively. The testes received the highest dose. 109.4 mu Gy/MBq. All other organs investigated received doses of less than 50 mu Gy/MBq. The effective dose was 40.3 mu Sv/MBq. In conclusion, [I-123]iodo-PK 11195 is a suitable agent for the visualisation of the PER and indirectly for the imaging of neuro-inflammatory lesions. Taking into account the radiation burden of 7.46 mSv following an administration of 185 MBq, a [I-123]iodo-PK 11195 investigation has to be considered an ICRP risk category IIb investigation.

The main aim of the EANM Task Group on Quality Assurance and Standardisation is to develop harmonised clinical procedures that are accepted within Europe. In order to achieve an evidence-based analysis of guidelines in the 27 EANM member societies, a survey was conducted. A questionnaire in mid 1999 investigated three major questions: (1) current status of national guidelines in EANM member societies, (2) specification of the cover and level of these national guidelines, and (3) future desires for national, EANM and SNM guidelines. The complete response rate was 96% (26/27). Guidelines are required by 19 of 27 member societies and have been initiated by 16 member societies. Guidelines are provided by 13 member societies, generally in the national language. In ten societies, specialists other than nuclear medicine physicians, mostly physicists and radiopharmacists, take the lead on some guidelines. Moreover, in some national societies there is active collaboration with other medical societies when writing guidelines, particularly cardiology societies. Currently, only 18% of the necessary procedure guidelines are covered. Compared with a survey conducted in 1993 by the EANM Committee on Quality Assurance and Standardisation, slow progress has been made in this regard, but compared with a survey conducted by the same committee in 1996 in 23 EANM member societies, the number of member societies providing guidelines has approximately doubled. Moreover, 26 of 27 member societies share a commitment for future development of guidelines and 21 of 27 prefer EANM guidelines to national guidelines. The results of this questionnaire justify the need for close co-operation between EANM, EANM member societies, the EANM Task Group on "Quality Assurance and Standardisation" and the Guideline Committee of the SNM. The clinical priorities are considered to be cardiac, renal and brain procedures