This report describes synthesis of three new cyclic RGDfK peptide conjugates, HYNIC-PKM-SU016 (PKM = E, K and PEG4), and in vivo evaluation of the impact of PKM linkers on biodistribution characteristics of their ternary ligand complexes [ 99m Tc(HYNIC-PKM-SU016)(tricine)(TPPTS)] in athymic nude mice bearing the MDA-MB-435 human breast cancer xenografts. Results from biodistribution studies show that PKM linkers have minimal impact on the integrin α v β 3 binding capability of radiotracers. Even though they have different charges under physiological conditions, all three linkers (E, K and PEG4) are able to reduce the uptake of 99m Tc-labeled E[c(RGDfK)] 2 in blood, kidneys, liver and lungs, and increase target-to-background (T/B) ratios at >30 min postinjection. E and K may have advantages over PEG4 due to a combination of relatively low liver uptake, high tumor/liver and tumor/lung ratios of ternary ligand complexes [ 99m Tc(HYNIC-PKM-SU016)(tricine)(TPPTS)] (PKM = E and K).