Conspectus
Future medicine
is primarily aiming at the development of novel
approaches for an early diagnosis of diseases and a personalized therapy
for patients. For achieving these objectives, a key role is played
by medical imaging. Among available noninvasive imaging techniques,
Fluorine-19 (19F) Magnetic Resonance Imaging (MRI) is emerging
as a powerful quantitative detection modality for clinical use both
for molecular imaging and for cell tracking.
The strength of
using 19F-MRI is mainly related to the
lack of endogenous organic fluorine in tissues, with no background,
enabling the visualization of fluorinated tracers as hot-spot images, adding secondary independent information to the anatomical
features provided by the grayscale 1H-MRI. The main challenge
for 19F-MRI clinical application is the intrinsic reduced
sensitivity of MRI. To improve sensitivity, undoubtedly the use of
a high field MRI scanner and cryogenic radiofrequency probes is advantageous,
but there is a clear need of developing increasingly effective fluorinated
tracers.
The ideal tracer should bear as many as possible magnetically
equivalent
fluorine atoms and show optimal magnetic resonance relaxivity properties
(i.e., T
1 and T
2), which enable reduced acquisition time with the possibility to
apply fast imaging methods. Moreover, it should be biocompatible with
reduced tendency to bioaccumulate in tissues, which is one of the
main drawbacks in using perfluorocarbons (PFCs), together with their
difficulty to be chemically modified with functional groups. In fact,
PFCs such as perfluorooctyl bromide (PFOB), perfluoro-15-crown-5-ether
(PFCE), and linear perfluoropolyethers (PFPE) are currently the most
used tracers in 19F-MRI preclinical and clinical studies,
with the above-mentioned limitations. In this regard, molecules bearing
short branched fluorinated chains gained a lot of attention for their
high number of equivalent fluorines and expected capability of reducing
bioaccumulation concerns. A valuable building block for branched fluorinated
tracers is perfluoro-tert-butanol (PFTB), with nine
magnetically equivalent fluorines and easy availability and modification.
In this Account we will discuss the main challenges that 19F-MRI has to overcome for increasing its clinical use, highlighting
on one hand the need of developing customized fluorinated materials
for increasing sensitivity and enabling multimodal properties, and
on the other hand, the importance of the ultrastructure of the final
formulation for the final biological response (i.e., clearance). In
this context, our group has been focusing on the synthesis and development
of branched fluorinated tracers, for which the originator is a molecule called PERFECTA (from suPERFluorinatEdContrasT Agent),
bearing 36 equiv 19F atoms, which showed not only optimal
relaxometry properties but also a very specific and intense Raman
signal. Thus, PERFECTA and its derivatives represent a new family
of multimodal tracers enabling multiscale analysis, from whole body
imaging (19F-MRI) to microsco...