Tumor Imaging Using 1-(2'-deoxy-2'-18F- Fluoro- -D-Arabinofuranosyl)Thymine and PET

Abstract

The kinetics of 1-(29-deoxy-29-fluoro-b-D-arabinofuranosyl)thymine (FMAU) were studied using PET to determine the most appropriate and simplest approach to image acquisition and analysis. The concept of tumor retention ratio (TRR) is introduced and validated. Methods: Ten patients with brain (n 5 4) or prostate (n 5 6) tumors were imaged using 18 F-FMAU PET (mean dose, 369 MBq). Sixty-minute dynamic images were obtained; this was followed by whole-body images. Mean and maximum standardized uptake values (SUVmean and SUVmax, respectively) of each tumor were determined as the mean over 3 planes of each time interval. For kinetic analyses, blood activity was measured in 18 samples over 60 min. Samples were analyzed by high-performance liquid chromatography at 3 selected times to determine tracer metabolites. FMAU kinetics were measured using a 3-compartment model yielding the flux (K1 · k3/(k2 1 k3)) (K1, k2, and k3 are rate constants) and compared with TRR measurements. TRR was calculated as the tumor 18 F-FMAU uptake area under the curve divided by the product of blood 18 F-FMAU AUC and time. A similar analysis was performed using muscle to estimate 18 F-FMAU delivery. Results: SUVmean measurements obtained from 5 to 11 min correlated with those obtained from 30 to 60 min (r 2 5 0.92, P , 0.0001) and 50 to 60 min (r 2 5 0.92, P , 0.0001) due to the rapid clearance of 18 F-FMAU. Similar results were obtained using SUVmax measurements (r 2 5 0.93, P , 0.0001; r 2 5 0.88, P , 0.0001, respectively). The measurement of TRR using either blood or muscle activity over 11 min provided results comparable to those of 60-min dynamic imaging and a 3-compartment model. This analysis required only 5 blood samples drawn at 1, 2, 3, 5, and 11 min without metabolite correction to produce comparable results. Conclusion: Tissue retention ratio measurements obtained over 11 min can replace flux measurements in 18 F-FMAU imaging. The SUVmean and the SUVmax in 5-11 min images correlated well with those of images obtained at 50-60 min. The quality of the images and tissue kinetics in 11 min of imaging makes it a desirable and shorter tumor imaging option.

A novel radiochemical approach to 1‐(2'‐deoxy‐2'‐[18F]fluoro‐β‐d‐arabinofuranosyl)cytosine (18F‐FAC)

“…The synthesis of precursor (23) started with commercially available cytidine (17) which was first converted into the 3'-and 5'-protected nucleoside 18 using TIPDSCl 2 and pyridine at room temperature as previously described. [8] Subsequent TMS-protection furnished 19 which was followed by double N 4 -Boc protection using excess of Boc 2 O (5-6 eq.) and DMAP which gave compound 20 in good yield.…”

“…Table 1. Calculated electron density Ω of selected cytidine (4)(5)(6)(7)(8) and uridine derivatives (9-11).…”

“…In addition, serious dose-limiting toxicities are associated with this chemotherapy drug. [8] Prediction of patient response to gemcitabine chemotherapy would therefore be an important milestone towards personalised patient chemotherapy in the cancer clinic.…”

“…[6] Together, cytidine-based PET probes enable further conclusions towards personalised chemotherapy which, considering the low (≤ 20%) response rates and severe side effects, could lead to significantly improved treatment efficacy. [8] 2'-[ 18 F]arabinocytidines such as 18 F-FAC and 18 F-FIAC (3, Figure 1) have been synthesized in high purities using an early stage 18 F introduction strategy. [9] However, this synthetic approach limits reliable and reproducible production on commercially available synthesis modules for human application.…”

“…Calculated electron density Ω of selected cytidine (4)(5)(6)(7)(8) and uridine derivatives (9)(10)(11) [a] Quantum chemically calculated net charge at the 2-carbonyl oxygen. …”