Ce-141-labeled DOTMP: A theranostic option in management of pain due to skeletal metastases.

Owing to its favorable radioactive decay characteristics (T1/2  = 32.51 d, Eß [max] = 434.6 keV [70.5%] and 580.0 keV [29.5%], Eγ  = 145.4 keV [48.5%]), 141 Ce could be envisaged as a theranostic radionuclide for use in nuclear medicine. The present article reports synthesis and evaluation of 141 Ce complex of 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetramethylenephosphonic acid (DOTMP) as a potent theranostic agent targeting metastatic skeletal lesions. Ce-141 was produced with 314 ± 29 MBq/mg (n = 6) specific activity and >99.9% radionuclidic purity (n = 6). Around 185 MBq dose of [141 Ce]Ce-DOTMP was synthesized with 98.6 ± 0.5% (n = 4) radiochemical yield under optimized conditions of reaction, and the preparation showed adequately high in vitro stability. Biodistribution studies in normal Wistar rats demonstrated significant skeletal localization and retention of injected activity (2.73 ± 0.28% and 2.63 ± 0.22% of injected activity per gram in femur at 3 hours and 14 days post-injection, respectively) with rapid clearance from non-target organs. The results of biodistribution studies were corroborated by serial scintigraphic imaging studies. These results demonstrate the potential utility of 141 Ce-DOTMP as a theranostic molecule for personalized patient care of cancer patients suffering from painful metastatic skeletal lesions.

Preparation and preliminary in vivo evaluation of 166 Ho-labeled microspheres for possible use in radioembolic therapy of liver cancer.

Hepatocellular carcinoma (HCC) or liver cancer is an increasingly prevalent and highly morbid disease with critical significance in the Asian and African subcontinents. Among the various therapies currently used in the clinic to combat the global menace of HCC, radioembolization with suitable therapeutic isotopes is an effective targeted approach. In the Indian context, the significant cost and logistical disadvantage of imported radioembolic formulations for HCC therapy make it essential to develop more feasible indigenous alternatives-using locally available radioisotopes and microspheric carriers-that can serve the nuclear medicine community. With this aim Ho-166 was produced with good specific activity (>13 GBq mg-1 ) and purity (>99%) by reactor irradiation. Various commercially available microspheres were labeled with this therapeutic radioisotope, characterized for yield and stability of the radiolabeling, and tested for their in vivo retention and stability in Wistar rat model by viable surgery. Under the optimized reaction conditions, 166 Ho-labeled microspheres were prepared with high yield (>94%-99%) and in vitro stability (>95%) in saline and serum. Retention studies in animal model showed that 166 Ho-labeled microspheres remained stable in vivo and showed excellent retention in the site of interest (~95% at 72-hour p.i.). The study indicates good potential and warrants further investigation for application of these indigenous radiolabeled microspheres for HCC therapy. The successful application of this technology in the clinic would lead to logistically advantageous and cost-effective indigenous alternatives to expensive imported therapeutic solutions.

Barium titanate microparticles as potential carrier platform for lanthanide radionuclides for their use in the treatment of arthritis.

Since the inception of radiation synovectomy, a host of radioactive colloids and microparticles incorporating suitable therapeutic radionuclides have been proposed for the treatment of arthritis. The present article reports the synthesis and evaluation of barium titanate microparticles as an innovative and effective carrier platform for lanthanide radionuclides in the preparation of therapeutic agents for treatment of arthritis. The material was synthesized by mechanochemical route and characterized by X-ray diffraction, scanning electron microscopy, surface area, and particle size distribution analyses. Loading of lanthanide radionuclides (166 Ho, 153 Sm, 177 Lu, and 169 Er) on the microparticles was achieved in high yield (> 95%) resulting in the formulation of loaded particulates with excellent radiochemical purities (> 99%). Radiolanthanide-loaded microparticles exhibited excellent in vitro stability in human serum. In vitro diethylene triamine pentaacetic acid challenge study indicated fairly strong chemical association of lanthanides with barium titanate microparticles. Long-term biodistribution studies carried out after administration of 177 Lu-loaded microparticles into one of the knee joints of normal Wistar rats revealed near-complete retention of the formulation (> 96% of the administered radioactivity) within the joint cavity even 14 days post-administration. The excellent localization of the loaded microparticles was further confirmed by sequential whole-body radio-luminescence imaging studies carried out using 166 Ho-loaded microparticles.

A "mix-and-use" approach for formulation of human clinical doses of 177 Lu-DOTMP at hospital radiopharmacy for management of pain arising from skeletal metastases.

Use of bone-seeking radiopharmaceuticals is an established modality in the palliative care of pain due to skeletal metastases. 177 Lu-DOTMP is a promising radiopharmaceutical for this application owing to the ideally suited decay properties of 177 Lu and excellent thermodynamic stability and kinetic rigidity of the macrocyclic complex. The aim of the present study is to develop a robust and easily adaptable protocol for formulation of clinical doses of 177 Lu-DOTMP at hospital radiopharmacy. After extensive radiochemical studies, an optimized strategy for formulation of clinical doses of 177 Lu-DOTMP was developed, which involves simple mixing of approximately 3.7 GBq of 177 Lu activity as 177 LuCl3 solution to an aqueous solution containing 5 mg of DOTMP and 8 mg of NaHCO3 . The proposed protocol yielded 177 Lu-DOTMP with >98% radiochemical purity, and the resultant formulation showed excellent in vitro stability and desired pharmacokinetic properties in animal model. Preliminary clinical investigations in 5 patients showed specific skeletal accumulation with preferential localization in the osteoblastic lesion sites and almost no uptake in soft tissue or any other major nontarget organ. The developed "mix-and-use" strategy would be useful for large number of nuclear medicine centers having access to 177 Lu activity and would thereby accelerate the clinical translation of 177 Lu-DOTMP.

Prospects of medium specific activity (177) Lu in targeted therapy of prostate cancer using (177) Lu-labeled PSMA inhibitor.

Targeted radionuclide therapy using (177) Lu-labeled peptidomimetic inhibitor of prostate specific membrane antigen (PSMA) viz. PSMA-617 is emerging as one the most effective strategies for management of metastatic prostate cancer, which is one of the leading causes of cancer related death. The aim of the present study is to develop a robust and easily adaptable protocol for formulation of therapeutic dose of (177) Lu-PSMA-617 at hospital radiopharmacy using moderate specific activity (177) Lu available at an affordable cost. Extensive radiochemical studies were performed to optimize the required [PSMA-617] / [Lu] ratio and other parameters to formulate 7.4 GBq dose of (177) Lu-PSMA-617. Based on these, 7.4 GBq therapeutic dose of (177) Lu-PSMA-617 was formulated by incubating 160 µg of PSMA-617 with indigenously produced (177) LuCl3 (555 GBq/µg specific activity of (177) Lu) at 90 °C for 30 min. The radiochemical purity of the formulation was 98.3 ± 0.6% (n = 7) which was retained to the extent of >95% after 7 d in normal saline at room temperature and >96% after 2 d in human serum at 37 °C. Preliminary clinical studies showed specific targeting of the agent in the lesion sites and similar physiological distribution as in diagnostic (68) Ga-PSMA-11 PET scans performed earlier. The developed optimized protocol for formulating therapeutic dose of (177) Lu-PSMA-617 could be useful for large number of nuclear medicine therapy clinics across the world having access to moderate specific activity (177) Lu at an affordable cost.

Preparation, evaluation, and first clinical use of 177Lu-labeled hydroxyapatite (HA) particles in the treatment of rheumatoid arthritis: utility of cold kits for convenient dose formulation at hospital radiopharmacy.

While radiation synovectomy (RSV) constitutes a successful paradigm for the treatment of arthritis, a major cornerstone of its success resides in the selection of appropriate radiolabeled agent. Among the radionuclide used for RSV, the scope of using (177)Lu [T1/2 = 6.65 d, Eß(max) = 497 keV, Eγ = 113 KeV (6.4%), 208 KeV (11%)] seemed to be attractive owing to its suitable decay characteristics, easy availability, and cost-effective production route. The present article describes a formulation of (177)Lu-labeled hydroxyapatite (HA) using ready-to-use kits of HA particles of 1-10 µm size range. The developed kits enable convenient one-step preparation of (177)Lu-HA (400 ± 30 MBq doses) in high radiochemical purity (>99%) and stability at hospital radiopharmacy. The preparation showed promising results in pre-clinical studies carried out in Wistar rats bearing arthritis in knee joints. In preliminary clinical investigation, significant improvement in the disease conditions was reported in 10 patients with rheumatoid arthritis of knee joints treated with 333 ± 46 MBq doses of (177)Lu-HA. The studies reveal that while (177)Lu labeled HA particles holds considerable promise as a cost-effective agent for RSV, the adopted strategy of using HA kits could be a potential step toward wider clinical utilization of radiolanthanide-labeled HA particles.

[64Cu]Copper chloride PET-CT: a comparative evaluation of fasting and non-fasting states in patients of prostate carcinoma.

Altered copper metabolism in cancer has been linked to increased intracellular copper uptake mediated by human copper transporter 1, with [64Cu]Cu2+ as a potential biomarker for cancer theranostics. [64Cu]CuCl2 PET-CT though explored in various malignancies, a lack of standardized protocol exists, particularly regarding fasting status before imaging. This analysis aimed to evaluate the requirement of fasting for [64Cu]CuCl2 PET-CT along with temporal changes in physiological organ uptake in delayed scans. A total of 26 patients of prostate carcinoma who underwent [64Cu]CuCl2 PET-CT imaging were divided into two groups: (1) nonfasting (n = 12) and (2) fasting (n = 14). The nonfasting group received an average dose of 350 MBq, while the fasting group received 300 MBq of [64Cu]CuCl2, and PET-CT images acquired approximately 60-90 min (1 h image) and 3-3.5 h (delayed image) after intravenous injection of the tracer. An experienced nuclear medicine physician evaluated the images for qualitative assessment between the groups. Multiple spherical regions of interest were placed at sites of physiological organ uptake of the tracer and over the diseased lesions to measure the mean SUVmax. No significant difference was observed in the qualitative assessment of the images between the two groups (except for a slight predilection towards more hepatic tracer retention observed in the fasting group), including in the delayed images. The liver demonstrated the highest tracer uptake in all patients, with a mean SUVmax of 21.5 in the fasting group and 19.7 in the nonfasting group, showing no significant difference (P = 0.32). The kidneys, intestines, and salivary glands also showed similar trends of tracer uptake in both groups. The study illustrated that the fasting or nonfasting status did not affect image quality or semiquantitative measurements significantly in physiological organs and diseased lesions in patients with carcinoma prostate.

Normal physiological distribution and tumor localization of 64 CuCl 2 in different human malignancies along with semiquantitative scoring: a comparative evaluation with 18 Fluorodeoxyglucose ( 18 FDG) PET-CT.

OBJECTIVE: This study aimed to explore 64-Copper-Chloride ( 64 CuCl 2 ) PET-CT in various malignancies and demonstrate a head-to-head comparison of uptake on 64 CuCl 2 PET/computed tomography (CT) and 18 fluorodeoxyglucose ( 18 FDG)-PET/CT scans for different malignancies, with an emphasis on 18 FDG nonavid malignancies. METHODS: Fifty-three patients diagnosed with various biopsy-proven malignancies (except prostate cancer) were recruited in this prospective study. All the patients underwent both 64 CuCl 2 PET/CT and 18 FDG-PET/CT. 64 CuCl 2 PET/CT was acquired at 1, 3 and 24 h time points. We studied the physiological biodistribution of 64 CuCl 2 in the various organs, corroborated the uptake of 64 CuCl 2 with various types of malignancies and comparison of their uptake with 18 FDG-PET/CT and their correlation with each other in various lesions. RESULTS: The biodistribution study showed that the liver concentrated 64 CuCl 2 the most out of all the organs, followed by the pancreas and large intestine. Liver and intestinal activity increased subsequently with delayed imaging, and the washout of 64 CuCl 2 was noted in the pancreas in delayed images and followed a hepatobiliary excretion of tracer over a period of time. In lesion-wise analysis, it was noted that the primary neuroendocrine tumor, melanoma and renal/urothelial malignancy group showed more uptake of 64 CuCl 2 , than that in metastasis and vice-versa was noted in lung and soft tissue malignancies. Comparing it with 18 FDG, it was seen that FDG showed more uptake in lesions and showed no significant correlation (Kappa value: 0.089) with the uptake of 64 CuCl 2 in the lesion-wise comparison. CONCLUSION: 64 CuCl 2 PET/CT did not show any added advantage over 18 FDG-PET/CT in the evaluation of the studied malignancies, both primary and their metastasis. Biodistribution studies showed the liver as the organ with maximum uptake, which implies it may hinder the detection of abdominal or hepatic involvement of the disease.

[90Y]Yttria Alumino Silicate Glass Microspheres: A Biosimilar Formulation to "TheraSphere" for Cost-Effective Treatment of Liver Cancer.

Background: Selective internal radiation therapy (SIRT) using a suitable ß--emitting radionuclide is a promising treatment modality for unresectable liver carcinoma. Yttrium-90 (90Y) [T1/2 = 64.2 h, Eß(max) = 2.28 MeV, no detectable γ-photon] is the most preferred radioisotope for SIRT owing to its favorable decay characteristics. Objective: The present study describes indigenous development and evaluation of intrinsically radiolabeled [90Y]yttria alumino silicate ([90Y]YAS) glass microsphere, a formulation biosimilar to "TheraSphere" (commercially available, U.S. FDA-approved formulation), for SIRT of unresectable liver carcinoma in human patients. Methods: YAS glass microspheres of composition 40Y2O3-20Al2O3-40SiO2 (w/w) and diameter ranging between 20 and 36 µm were synthesized with almost 100% conversion efficiency and >99% sphericity. Intrinsically labeled [90Y]YAS glass microspheres were produced by thermal neutron irradiation of cold YAS glass microspheres in a research reactor. Subsequent to in vitro evaluations and in vivo studies in healthy Wistar rats, customized doses of [90Y]YAS glass microspheres were administered in human patients. Results: [90Y]YAS glass microspheres were produced with 137.7 ± 8.6 MBq/mg YAS glass (∼6800 Bq per microsphere) specific activity and 99.94% ± 0.02% radionuclidic purity at the end of irradiation. The formulation exhibited excellent in vitro stability in human serum and showed >97% retention in the liver up to 7 d post-administration when biodistribution studies were carried out in healthy Wistar rats. Yttrium-90 positron emission tomography scans recorded at different time points post-administration of customized dose of [90Y]YAS glass microspheres in human patients showed near-quantitative retention of the formulation in the injected lobe. Conclusions: The study confirmed the suitability of indigenously prepared [90Y]YAS glass microspheres for clinical use in the treatment of unresectable hepatocellular carcinoma.

Facile Synthesis of a Pt(IV) Prodrug of Cisplatin and Its Intrinsically 195mPt Labeled Analog: A Step Closer to Cancer Theranostic.

BACKGROUND AIMS AND OBJECTIVES: Cisplatin is extensively used in chemotherapy for treatment of a broad range of cancers. But its undesired side reactions with biomolecules that lead to severe side effects especially on kidney and nervous system, are limiting its clinical utility. To reduce its side effects, the kinetically inert Pt(IV) prodrug was recognized as an alternative approach from satisfactory results of preliminary experiments. But, its approval as anticancer drug for clinical use requires detailed investigations of its anticancer action and pharmacological pathways by employing its analogue which can be traced by a suitable technique. As a step closer towards translation of Pt(IV)-based prodrug from research to clinical level, a protocol for efficient synthesis of 195mPt-radiolabeled Pt(IV) prodrug was devised. MATERIALS AND METHODS: In order to achieve the aim, we started synthesis from elemental platinum avoiding lengthy steps. The synthesis protocol was standardized on its cold analogue, as [PtCl2(NH3)2(OCOCH2CH2COOH)2] which has been characterized with nuclear magnetic resonance (1H, 13C{1H} and 195Pt{1H}) spectroscopy, microanalyses and cyclic voltammetry. Also, cytotoxicity of [PtCl2(OCOCH2CH2COOH)2(NH3)2] was evaluated against MCF-7 human breast cancer cell lines using cisplatin as test control. RESULTS: Intrinsically, 195mPt-labeled analogue of prodrug was obtained with high radionuclidic and radiochemical purity. It was confirmed by chromatography and γ-ray spectrometry. CONCLUSION: The 195mPt-radiolabeled prodrug was synthesized in a facile manner. It can be utilized in evaluating the mechanism of anticancer action and pharmacokinetics by enabling synergistic use of molecular imaging and targeted drug delivery.

One decade of 'Bench-to-Bedside' peptide receptor radionuclide therapy with indigenous [177Lu]Lu-DOTATATE obtained through 'Direct' neutron activation route: lessons learnt including practice evolution in an Indian setting.

The present treatise chronicles one decade of experience pertaining to clinical PRRT services in a large-volume tertiary cancer care centre in India delivering over 4,000 therapies, an exemplar of successful PRRT programme employing indigenous 177Lutetium production and resources. For the purpose of systematic discussion, we have sub-divided the communication into 3 specific parts: (a) Radiopharmaceutical aspects that describes 177Lutetium production through 'Direct' Neutron Activation Route and the subsequent radiolabeling procedures, (b) The specific clinical nuances and finer learning points (apart from the routine standard procedure) based upon clinical experience and how it has undergone practice evolution in our setting and (c) Dosimetry results with this indigenous product and radiation safety/health physics aspects involved in PRRT services. Initiated in 2010 at our centre, the PRRT programme is a perfect example of affordable quality health care delivery, with indigenous production of the radionuclide (177Lu) in the reactor and subsequent radiolabeling of the radiopharmaceutical ([177Lu]Lu-DOTATATE) at the hospital radiopharmacy unit of the centre, which enabled catering to the needs of a large number of patients of progressive, metastatic and advanced Neuroendocrine Neoplasms (NENs) and related malignancies.

Preparation and evaluation of a new radiopharmaceutical for radiosynovectomy, 111Ag-labelled hydroxyapatite (HA) particles.

Many radionuclides, namely, 166Ho, 90Y, 165Dy, 32P, 198Au, 186Re, etc. have been used for radio-synovectomy. Silver-111 (T 1/2 7.45 d) can be produced in a nuclear reactor and is a potential therapeutic radionuclide decaying by beta(-) emission (92% E beta max=1.037MeV and 8% by beta(-) decay associated with emission of gamma-rays (E gamma=245.4keV, I gamma=1.33%; E gamma=342.1keV, I gamma=6.7%)). Because of the production feasibility and favourable nuclear properties, 111Ag may find use as a suitable radionuclide for radio-synovectomy. Hydroxyapatite (HA), Ca10(PO4)6(OH)2 is one of the preferred particulates for this application. In this work, [111Ag]Ag-HA particulates were successfully prepared with high-labelling yield ( approximately 97%) at various pH values. The radiochemical purity of the [111Ag]Ag-HA particles was 99.9%. Stability studies for 7 days showed that the [111Ag]Ag-HA particles retained their stability. gamma camera images at 15 min, 24h and 5 d after injection of the particles into rabbits revealed the retention of the activity in the synovial joints of the knee, thereby indicating excellent in vivo stability of [111Ag]Ag-HA particles. Therefore, [111Ag]Ag-HA particles would be a potential therapeutic agent in the management of arthritis.

Multidose formulation of ready-to-use 177Lu-PSMA-617 in a centralized radiopharmacy set-up.

Lutetium-177-labeled PSMA inhibitor has emerged as a promising modality for targeted therapy of prostate carcinoma. A protocol for regular multidose formulation of ready-to-use 177Lu-PSMA-617 has been developed based on detailed and systematic radiochemical investigations. The formulation meets the requirements of clinical use and can be shipped to nuclear medicine centres for administration up to 4 days from the date of formulation. The reported protocol would be useful toward facilitating widespread clinical utilization of 177Lu-PSMA-617 in the management of prostate cancer.

A versatile technique for radiochemical separation of medically useful no-carrier-added (nca) radioarsenic from irradiated germanium oxide targets.

A method for the separation of no-carrier-added (nca) arsenic radionuclides from bulk amounts of irradiated germanium oxide (GeO2) target was developed in view of their potentialities in different biological and nuclear medicine applications. The beta- emitting 77As radionuclide, produced by the decay of 77Ge through the natGe(n,gamma)77Ge nuclear reaction, was used for standardization of the radiochemical separation procedure. The radiochemical separation was performed by precipitation followed by solvent extraction. About 99% post-irradiation recovery of the GeO2 target material, in a form suitable for reuse in future irradiation, was achieved. The developed method was suitable for the production of nca arsenic radionuclides either as trivalent or pentavalent arsenic in various vehicles which provided flexibility of formulations of different kinds of compound. The overall radiochemical yield for the complete separation of 77As was 90%. The separated nca 77As was of high radionuclidic purity and did not contain detectable amounts of the target material. This method can be adopted for the radiochemical separation of other different arsenic radionuclides produced from GeO2 through cyclotron as well as reactor irradiation.

Bulk Scale Formulation of Therapeutic Doses of Clinical Grade Ready-to-Use 177Lu-DOTA-TATE: The Intricate Radiochemistry Aspects.

INTRODUCTION: 177Lu-DOTA-TATE is a clinically useful and promising therapeutic radiopharmaceutical for peptide receptor radionuclide therapy of neuroendocrine tumors (NETs) overexpressing somatostatin receptors. Currently, the radiopharmaceutical is prepared in-house at nuclear medicine centers, thereby restricting its use to limited centers only. In this article, the authors describe systematic studies toward bulk scale formulation of "ready-to-use" 177Lu-DOTA-TATE using medium specific activity 177Lu (740-1110 GBq/mg) at a centralized radiopharmacy facility. METHODS: In an optimized protocol, 177Lu-DOTA-TATE synthesis was carried out by direct heating of 177LuCl3 (Sp. act. 740-1110 GBq/mg) with DOTA-TATE peptide (1.5-3.0 equivalents) in ammonium acetate buffer (0.2 M) containing 2,5-dihydroxy benzoic acid (gentisic acid). Thereafter, the crude labeled product was purified using a Sep-Pak® C18 column and diluted with acetate buffer-gentisic acid (1.5% w/v) solution to final radioactive concentration of 740 MBq/mL. This was further sterilized and dispensed as 7.4 GBq patient dose/vial with 2 days postformulation calibration. RESULTS: A peptide/metal ratio of 1.5-3.0 is essential for complexation wherein radiolabeling yields >90% are obtained minimizing free 177Lu waste. For formulation of 7.4 GBq patient dose (2 days postproduction), even specific activity of about 555 GBq/mg was found to be adequate for the radiometal. The ready-to-use 740 MBq/mL 177Lu-DOTA-TATE formulation with gentisic acid (1.5% w/v) is observed to be safe for human use for more than 1 week (radiochemical purity >98%) from the day of production when stored at -70°C. However, the target specificity may get affected beyond 2 days as the total peptide content for 7.4 GBq dose may exceed the critical peptide limit of 300 µg. Patient treatment carried with several batches of present formulation in diseased NET patients exhibited desired distribution at the tumor and its metastatic site. CONCLUSIONS: A ready-to-use formulation of 177Lu-DOTA-TATE was successfully prepared and optimized for regular bulk scale production and supply to distant nuclear medicine centers.

Evaluation of (177)Lu-CHX-A''-DTPA-Bevacizumab as a radioimmunotherapy agent targeting VEGF expressing cancers.

This study aimed at the preparation and evaluation of (177)Lu-CHX-A''-DTPA-Bevacizumab for targeting VEGF over-expressing cancers. Bevacizumab conjugated to p-NCS-Bn-CHX-A''-DTPA was radiolabeled with (177)Lu. The radioimmunoconjugate characterized by SE-HPLC exhibited radiochemical purity of 98.0±0.6%. In vitro stability was retained upto 4 days at 37°C. In vitro cell binding studies showed good uptake by VEGF expressing U937 tumor cells. Biodistribution studies in melanoma model showed significant uptake and retention of (177)Lu-CHX-A''-DTPA-Bevacizumab in tumor with reduction in uptake in presence of cold Bevacizumab confirming its specificity to VEGF.

Hydroxyapatite (HA) microparticles labeled with (32)P - A promising option in the radiation synovectomy for inflamed joints.

In the present article we describe a systematic approach pursued for the synthesis of (32)P-labeled hydroxyapatite (HA) microparticles (1-10µm size range) using no carrier added (NCA) (32)P produced in a nuclear reactor and animal evaluation of its utility as an expected viable radiopharmaceutical for the treatment of pain intensive arthrosis. NCA (32)P was produced via the (32)S(n,p)(32)P route in nuclear reactor with high radionuclidic purity (99.95±0.01%, n=5). Phosphorus-32-labeled hydroxyapatite microparticles (1-10µm size range) were synthesized with high radiochemical purity (99.0±0.3% n=12) under optimized conditions and the formulation showed excellent in vitro stability in saline as well as in rat serum. Intra-articular administration of the radiolabeled particles in the knee joints of normal Wistar rats showed near-complete retention of activity within the synovial cavity upto 1 month post-administration. The radiochemical formulation thus demonstrated promising features as a radiopharmaceutical for treatment of arthritis with excellent logistic advantage for shipment to sites distant from the production facility thanks to the suitable nuclear decay properties of (32)P.

Facile access to 154Eu, a new reference source for calibration in gamma ray spectrometry.

Europium-154 can be obtained as a by-product from the large-scale production of Samarium-153 and possesses attractive features (t1/2 8.592 yr; Egamma 0.12-1.6 MeV) for use as a reference source similar to 152Eu (t1/2 13.516 yr; Egamma 0.12-1.4 MeV), which is the gold standard for calibration in gamma ray spectrometry. Thermal neutron irradiation of 5mg of 98% enriched 153Sm2O3 target in the reactor led to approximately 200 GBq 153Sm and 1.26 MBq 154Eu. A typical batch control sample of 153SmCl3 solution and final radiopharmaceutical product formulation of 153Sm-phosphonate (153Sm-EDTMP) pooled together contained about 20% of total yield, requiring post decay disposal of 153Sm as radioactive waste. Such spent solutions pooled on quarterly basis led to availing 756 kBq of 154Eu. The radioactivity content and radionuclide purity (approximately 82%) of the recovered 154Eu sample were envisaged as adequate to prepare reference sources for calibration of gamma ray spectrometers. At present, one batch of 153Sm is handled per month at our institution, with the possibility for weekly processing in future. Access to approximately 3.5 MBq of 154Eu on quarterly basis is envisaged, apart from obviating the need for instituting steps to tackle disposal of the long-lived 154Eu in the spent solution. Up to 60-120 units of 20-100 kBq of 154Eu reference sources per year could thus be available by the proposed strategy.

Radiochemistry, pre-clinical studies and first clinical investigation of 90Y-labeled hydroxyapatite (HA) particles prepared utilizing 90Y produced by (n,γ) route.

INTRODUCTION: The scope of using no carrier added (NCA) (90)Y [T(1/2) = 64.1 h, Eß(max) = 2.28 MeV] obtained from (90)Sr/(90)Y generator in radiation synovectomy (RSV) is widely accepted. In the present study, the prospect of using (90)Y produced by (n,γ) route in a medium flux research reactor for use in RSV was explored. METHODS: Yttrium-90 was produced by thermal neutron irradiation of Y(2)O(3) target at a neutron flux of ~1×10(14) n/cm(2).s for 14 d. The influence of various experimental parameters were systematically investigated and optimized to arrive at the most favorable conditions for the formulation of (90)Y labeled hydroxyapatite (HA) using HA particles of 1-10 µm size range. An optimized kit formulation strategy was developed for convenient one-step compounding of (90)Y-HA, which is easily adaptable at hospital radiopharmacy. The pre-clinical biological evaluation of (90)Y-HA particles was studied by carrying out biodistribution and bioluminiscence imaging studies in Wistar rats. The first clinical investigation using the radiolabeled preparation was performed on a patient suffering from chronic arthritis in knee joint by administering 185 MBq (90)Y-HA formulated at the hospital radiopharmacy deploying the proposed strategy. RESULTS: Yttrium-90 was produced with a specific activity of 851 ± 111 MBq/mg and radionuclidic purity of 99.95 ± 0.02%. (90)Y-labeled HA particles (185 ± 10 MBq doses) were formulated in high radiochemical purity (>99%) and excellent in vitro stability. The preparation showed promising results in pre-clinical studies carried out in Wistar rats. The preliminary results of the first clinical investigation of (90)Y-HA preparation in a patient with rheumatoid arthritis in knee joints demonstrated the effectiveness of the formulation prepared using (90)Y produced via (n,γ) route in the management of the disease. CONCLUSION: The studies revealed that effective utilization of (90)Y produced via (n,γ) route in a medium flux research reactor coupled with the developed strategy of using HA kits for convenient formulation of (90)Y-HA at the hospital radiopharmacy can contribute to sustainable growth in the clinical utilization of (90)Y in RSV in the foreseeable future.

Synthesis and Preclinical Evaluation of (177)Lu-CHX-A"-DTPA-Rituximab as a Radioimmunotherapeutic Agent for Non-Hodgkin's Lymphoma.

INTRODUCTION: Radioimmunotherapy is a feasible treatment modality for B-cell lymphomas expressing CD20 antigen. Tagging of anti-CD20 monoclonal antibody with a ß(-) emitter will deliver radiation to the tumor preferentially, thereby causing its destruction. This work explores the utility of (177)Lu-CHX-A"-DTPA-Rituximab as a radioimmunotherapeutic agent for non-Hodgkin's lymphoma (NHL). METHODS: Rituximab was conjugated with p-NCS-Bn-CHX-A"-DTPA and radiolabeled with (177)Lu. (177)Lu-CHX-A"-DTPA-Rituximab was characterized by SE-HPLC. In vitro cell binding and inhibition studies were carried out in Raji cells which express CD20 antigen. Biodistribution studies were performed in SCID mice bearing lymphoma at various time intervals. RESULTS: The CHX-A"-DTPA-Rituximab conjugate prepared had three molecules of DTPA per Rituximab molecule. Radiochemical purity of (177)Lu-CHX-A"-DTPA-Rituximab was >95%. In the HPLC system, (177)Lu-CHX-A"-DTPA-Rituximab showed a single peak (Rt ∼15.5 minutes). In vitro cell binding studies showed 38.9%±1.1% binding of (177)Lu-CHX-A"-DTPA-Rituximab (∼6.7 nM of radioimmunoconjugate) with Raji cells which reduced to 17.7%±0.5% with the addition of 67 nM of cold antibody. Biodistribution studies showed good tumor uptake at all the time points studied. CONCLUSIONS: In vitro and in vivo studies showed good specificity of (177)Lu-CHX-A"-DTPA-Rituximab toward CD20 antigen. It can be concluded that (177)Lu-CHX-A"-DTPA-Rituximab could be a promising agent in the treatment of NHL.