Synthesis and quality control of 68Ga citrate for routine clinical PET

Rizzello, Anna; Pierro, Donato Di; Lodi, Filippo; Trespidi, Silvia; Cicoria, Gianfranco; Pancaldi, D.; Nanni, Cristina; Marengo, Mario; Marzola, Maria Cristina; Al-Nahhas, Adil; Rubello, Domenico; Boschi, Stefano

doi:10.1097/mnm.0b013e32832b9ac8

Cited by 37 publications

(30 citation statements)

References 5 publications

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“…The bio-distribution of 68 Ga-citrate demonstrated pronounced blood pool activity, which is different from the bio-distribution seen with 67 Ga-citrate and which has also been confirmed by other authors [14,17]. Compared to 67 Ga-citrate, 68 Ga-citrate has a much shorter half-life (68 min vs. 78 h) and the ideal uptake time for imaging with 68 Ga-citrate has not yet clearly been established, due to (as yet) limited patient data.…”

Section: Discussionsupporting

confidence: 75%

“…From our initial experience, the labeling method is relatively simple, the image quality is good and dual-point imaging up to 2 h post-injection is possible. Also, the dosimetry compares favorably to that of 18 F-FDG [17] and normal bio-distribution does not include any lung uptake, which may provide good lesion to background ratios.…”

Section: Discussionmentioning

confidence: 95%

“…68 Ga-citrate preparation and QC A SnO 2 -based 68 Ge/ 68 Ga generator (iThemba LABS, Somerset West, South Africa) [15] was fractionally eluted with 10 ml of 0.6 N HCl for 68 Ga-citrate synthesis. This was performed manually in a one-step-aseptic procedure, which was based on a combination of the protocols used by Kumar et al [16] and Rizzello et al [17] and made use of ACD-A. All solvents used were of a pharmacological grade.…”

Section: Patient Populationmentioning

confidence: 99%

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Evaluating the possible role of 68Ga-citrate PET/CT in the characterization of indeterminate lung lesions

et al. 2014

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We sought to determine whether PET/CT imaging with 68 Ga-citrate could be of value in distinguishing benign from malignant lung pathology in a setting with a high prevalence of granulomatous diseases. Methods Thirty-six consecutive patients with indeterminate lung lesions prospectively underwent dual time point (60 and 120 min) 68 Ga-citrate PET/CT study prior to lung biopsy. Qualitative and semi-quantitative measures of tracer uptake in the lung lesions (SUVmax) were compared to the histopathology in order to establish an imaging pattern to distinguish benign from malignant lesions.Results Fourteen patients (38.9 %) were diagnosed with a malignant lesion, 12 (33.3 %) with tuberculosis (TB), and 10 participants (27.8 %) with other benign lung lesions. At 60-min post-injection, patients who were diagnosed with a malignant lesion (n = 14) demonstrated a mean SUVmax of 3.36 ± 1.14, with a median value of 3.04 (min = 1.56, max = 4.65).Those with TB (n = 12) demonstrated a SUVmax of 3.99 ± 2.28, and a median value of 3.71 (pct 25 = 2.19, pct 75 = 4.95). In patients with other benign lesions (n = 10), the following values were observed: a SUVmax of 2.70 ± 1.31, a median value of 2.50 (pct 25 = 1.76, pct 75 = 3.59). The mean values of these three types of pathology were not statistically significant (p = 0.1919), and therefore the SUVmax could not be used to accurately distinguish between these lesions using both early and delayed imaging. Conclusion This study, as the first 68 Ga-citrate PET/CT in humans for the in vivo imaging of lung pathology, demonstrated its potential for the detection of both malignancy and TB. However, 68 Ga-citrate seemed incapable of providing a clear distinction between malignant and benign lung lesions in a setting with a high prevalence of granulomatous diseases such as TB.

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Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 95%

Section: Patient Populationmentioning

confidence: 99%

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Evaluating the possible role of 68Ga-citrate PET/CT in the characterization of indeterminate lung lesions

et al. 2014

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“…68 Ga-Citrate Synthesis 68 Ga-citrate was synthesized according to the method described in a previous publication (4). Briefly, a 68 Ge/ 68 Ga generator was produced by Eckert & Ziegler Isotope Products GmbH, and 68 Gacitrate syntheses were performed on a commercial adapted module used for the routine labeling of 68 Ga-DOTANOC (3).…”

Section: Patient Populationmentioning

confidence: 99%

⁶⁸Ga-Citrate PET/CT for Evaluating Patients with Infections of the Bone: Preliminary Results

Nanni¹,

Errani²,

Boriani³

et al. 2010

J Nucl Med

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119

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The aim of this work was to preliminarily evaluate the sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy of 68 Ga-citrate PET/CT in a population of patients with suspected bone infections. Methods: We enrolled 31 patients with suspected osteomyelitis or diskitis who underwent a total of forty 68 Ga-citrate PET/CT scans. The results were compared with different combinations of diagnostic procedures (MRI, radiography, CT, or white blood cell scintigraphy), biopsy (when diagnostic), and follow-up data (at least 1 y) to determine the performance of 68 Ga-citrate PET/CT. Results: We found a sensitivity of 100%, a specificity of 76%, a positive predictive value of 85%, a negative predictive value of 100%, and an overall accuracy of 90%. Conclusion: Although preliminary, these data confirm a possible role for 68 Ga-citrate in the diagnosis of bone infections, especially in consideration of its favorable characteristics.

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“…Generally, this radiopharmaceutical is used for work-up of chronic osteomyelitis, in detection of opportunistic respiratory tract infections [26], and for fever of unknown origin (FUO) [27]. More recently, 68 Ga-citrate has been developed for PET scanning that exploits the same biologic basis for scanning described above, but with the advantage of an earlier optimal scanning time and better anatomic detail [28].…”

Section: Ady and Fongmentioning

confidence: 99%

Imaging for Infection: From Visualization of Inflammation to Visualization of Microbes

Ady

Fong²

2014

Surgical Infections

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Background: With the development of high-resolution cross-sectional imaging, anatomic identification of most areas of infection has become routine. Imaging a site of infection allows for diagnosis and treatment. In the past, molecular imaging for infection involved mainly the use of radiolabeled leukocytes for functional targeting at infection sites. With the recent development of functional nuclear imaging, bacterial and viral metabolism can also be imaged directly for potential identification of early infection. Methods: Review of pertinent English-language literature. Results: Cross-sectional imaging is used routinely to identify and treat sources of infection in patients with fever, leukocytosis, or unexplained hemodynamic instability. Although ultrasound is preferred for the identification of biliary or hepatic sepsis, computed tomography (CT) has proved to be accurate for the identification and treatment of intra-abdominal fluid collections and abscesses. Biologic imaging is a non-invasive technique that identifies sites of infection in cases in which no definite abnormality is identified via cross-sectional imaging. This is made possible by imaging the accumulation of radioisotopes that have been attached to white blood cells or glucose. Biologic imaging is useful for the identification of anatomic sites where there is inflammation or high metabolic demand. However, a drawback of biologic imaging is that it is not specific for infection. Techniques that image microbes directly increase the specificity of imaging results significantly and can be used to quantify and track infectious processes. For example, radiolabeling of antimicrobial proteins and antibiotics is one technique that has been demonstrated to identify areas of infection accurately in animals but is not currently being used clinically in humans. With the advent of gene therapy, many researchers are inserting the herpes viral thymidine kinase gene into both viruses and bacteria. This allows for tracking of the infectious process by imaging the accumulation of radiolabeled thymidine analogues. Conclusion: This review summarizes standard imaging for infection as it is currently practiced clinically. We will also explore the promising new methods of microbial imaging that are likely to become standards in clinical care in the near future.

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Synthesis and quality control of 68Ga citrate for routine clinical PET

Abstract: The high radiochemical yield and purity showed that this method is a reliable tool for the production of 68Ga citrate to be used in the detection of inflammatory and infectious diseases using high resolution and qualitative PET.

Cited by 37 publications

References 5 publications

Evaluating the possible role of 68Ga-citrate PET/CT in the characterization of indeterminate lung lesions

Evaluating the possible role of 68Ga-citrate PET/CT in the characterization of indeterminate lung lesions

⁶⁸Ga-Citrate PET/CT for Evaluating Patients with Infections of the Bone: Preliminary Results

Imaging for Infection: From Visualization of Inflammation to Visualization of Microbes

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Synthesis and quality control of 68Ga citrate for routine clinical PET

Abstract: The high radiochemical yield and purity showed that this method is a reliable tool for the production of 68Ga citrate to be used in the detection of inflammatory and infectious diseases using high resolution and qualitative PET.

Cited by 37 publications

References 5 publications

Evaluating the possible role of 68Ga-citrate PET/CT in the characterization of indeterminate lung lesions

Evaluating the possible role of 68Ga-citrate PET/CT in the characterization of indeterminate lung lesions

68Ga-Citrate PET/CT for Evaluating Patients with Infections of the Bone: Preliminary Results

Imaging for Infection: From Visualization of Inflammation to Visualization of Microbes

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Product

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⁶⁸Ga-Citrate PET/CT for Evaluating Patients with Infections of the Bone: Preliminary Results