Breast and endometrial cancers are the most common invasive malignancies in women, with more than 217,000 new diagnoses per year in the United States. These cancers are often classified into 2 subtypes based on the expression of the classical estrogen receptor. In this study, we describe a new structural class of neutral tridentate 99m Tc(I)-estradiol-pyridin-2-yl hydrazine derivatives for potential use in breast and endometrial cancer imaging. Methods: The 99m Tc(I)-estradiol-pyridin-2-yl hydrazine derivative was synthesized via the Sonogashira cross-coupling reaction and radiolabeled via the tricarbonyl approach. Radiochemical purity was assessed by high-performance liquid chromatography. Cell-binding studies were performed with human breast adenocarcinoma MCF-7 cells. The in vivo biodistribution of the 99m Tc(I) derivative was evaluated in virgin female C57BL/6 mice in defined phases of the estrous cycle. Biodistribution and SPECT/CT studies were performed with mice bearing MCF-7 and primary human endometrial tumors. Results: Radiochemical analysis demonstrated that the postpurification purity of the 99m Tc(I)-estradiol-pyridin-2-yl hydrazine derivative was $95%, with a specific activity of 99m Tc of 47.5 TBq/mmol. Cell-binding studies yielded a dissociation constant (mean 6 SEM) of 11 6 1.5 nM. In vivo studies revealed that receptor-mediated uptake was present in all phases of the estrous cycle in reproductive organs and mammary glands but was highest during the diestrous phase of the estrous cycle. Despite high nonspecific uptake in the liver, significant receptor-mediated uptake was observed in target tissues and estrogen receptor-expressing tumors (0.67% for MCF-7 tumors and 0.77% for endometrial tumors). Tumor uptake was reduced by approximately 50% on coinjection with 17b-estradiol. Conclusion: We have characterized a novel neutral tridentate 99m Tc(I)-estradiol-pyridin-2-yl hydrazine derivative for potential use in breast and endometrial cancer imaging. This study represents the first step on a path toward the design of estrogen-based Tc-labeled tracers with improved targeting and SPECT imaging characteristics. Over 250,000 new cases of breast, ovarian, and endometrial cancers were diagnosed in the United States in 2006 (1). Such cancers are often hormonally regulated and can be divided into 2 subtypes on the basis of whether or not tumor cells express the classical estrogen receptor (ER), ERa. Estrogen promotes cell proliferation and inhibits apoptosis through a complex signaling cascade resulting in transcriptional changes that may include the modulation of tumor suppressor function. The presence of ERa in approximately two thirds of breast cancers correlates with whether the tumors are estrogen dependent or independent (2) and represents one of the best prognostic factors in breast cancer because of the availability of antiestrogens such as tamoxifen and fulvestrant and, more recently, the aromatase inhibitors. With the recent characterization of a novel transmembrane ER, GPR30, in multiple cancer t...