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This paper describes the radiosynthesis, formulation, quality control of a new radiolabeled probe (i.e., 68Ga-labeled nanobody NM-02), and its use for small animal PET/CT imaging in a xenograft model.
Small animal Positron Emission Tomography (PET) and Single Photon Emission Computed Tomography (SPECT) imaging techniques are crucial in preclinical cancer research, necessitating meticulous attention to radiotracer synthesis, quality assurance, and in vivo injection protocols. This study presents a comprehensive workflow tailored to enhance the robustness and reproducibility of small animal PET experiments. The synthesis process in the radiochemistry laboratory using 68Ga is detailed, highlighting stringent quality control and assurance protocols for each radiotracer production. Parameters such as concentration, molar activity, pH, and purity are rigorously monitored, aligning with standards applicable to human studies. This methodology introduces streamlined syringe preparation and a custom-designed 30G cannula for precise intravenous injections into mice. Monitoring of animal health during scanning, including temperature and heart rate, ensures their well-being throughout the procedure. Dosages for PET and SPECT scans are predetermined to balance data acquisition with minimizing radiation exposure to animals and researchers. Similarly, CT scans employ pre-programmed settings to limit radiation exposure, especially pertinent in long-term studies assessing treatment effects. By optimizing these steps, the workflow aims to standardize procedures, reduce variability, and enhance the quality of small animal PET/SPECT/CT imaging. This resource provides valuable insights for researchers seeking to improve the accuracy and reliability of preclinical investigations in molecular imaging, ultimately advancing the field.
One topic that is of utmost relevance is research in the breast cancer field. Breast cancer remains a frequently occurring cancer, accounting for roughly 1/3rd of all cancers in women. The treatment is tailored to the biological and histological characteristics of the tumor and to the stage of the disease. The chance of survival is generally good unless the tumor has already metastasized, in which case the 5-year survival is only about 30%1. Other gynecologic cancers suffer from a similar fate, with, for example, ovarian cancer showing > 95% 5-year survival for stage 1 tumors but only 15% for metastasized stage 4 tumors2,3.
Non-invasive imaging, particularly positron emission tomography (PET), has been transforming cancer research as it offers unparalleled insights into tumor molecular aspects, such as metabolism, receptor expression, and therapeutic response4,5,6. It allows both visualization and quantification of specific metabolic areas - allowing not only to accurately diagnose, but also to monitor the effect of (new) therapies at very short time points. Indeed, PET allows evaluation of response versus non-response after 1-3 therapy cycles and does this better and faster compared to morphological changes as seen by classical computed tomography (CT) imaging7. The non-invasive nature of PET also enables longitudinal studies.
Any animal model requires maximal standardization in order to thoroughly assess the therapeutic capacity of new (radioactive) pharmaceuticals, so the emphasis has to be put on this - both in the generation of the tumor model and in the small animal PET imaging/data analysis. One could debate about the best tumor model in animals (subcutaneous inoculation or orthotopic implantation, mice, human, or syngeneic tumors, accompanied or not accompanied by routine clinical care), but that would be beyond the goal of this publication. Several models are used by us for cancer studies, and the one described here is a relatively simple subcutaneous model.
Quality control in radiochemistry is paramount for animal safety and treatment efficacy. This does not only affect the radiopharmaceutical itself but also the product formulation. There is extensive legislation on the production of radiopharmaceuticals for clinical applications8,9 (see 10 for an extensive overview of current legislation and guidelines), and several guidelines on the properties of radiopharmaceuticals for preclinical research (see 11 for an extensive overview). We produce radiopharmaceuticals both for clinical and preclinical applications, simplifying the translation from high-end quality control as found in syntheses for clinical applications into those for preclinical applications.
Our research focus is on directed theranostics, especially on human epidermal growth factor receptor 2 (HER2)-positive cancers. Hence, we develop new radiopharmaceuticals to diagnose and monitor cancer during treatment. Successful diagnostic radiopharmaceuticals are also evaluated as therapeutic compounds using different radioisotopes. The evaluation of these radiopharmaceuticals is performed at first in animal models, striving for clinical translation after promising preclinical results. In this article, we will present the protocols used, exemplified with one radiopharmaceutical, to ensure quality control and assurance, as well as standard practice for mouse intravenous injection and PET/CT scan, in order to improve the accuracy and reliability of preclinical investigations in molecular imaging. The protocol is divided into three different sections: radiochemistry (tracer synthesis and quality control), animal model generation (subcutaneous tumor model), and imaging.
The research protocol adheres to the highest standards of animal welfare and is in strict accordance with the Animal Care Guidelines of University Hospital RWTH Aachen. We are committed to ensuring the ethical and humane treatment of all animals involved in the studies, and the procedures are reviewed and approved by the local animal ethics committee. All animal experiments were approved by a German competent authority (Landesamt für Natur, Umwelt und Verbraucherschutz Nordrhein-Westfalen, LANUV) for compliance with the Animal Protection Act, in conjunction with the regulation for the protection of animals used for experimental and other scientific purposes.
NOTE: A complete list of the equipment, materials, and reagents used throughout this study is provided in the Table of Materials. It is important to note that the handling of 68Ga should be done by pipette whenever possible and certainly avoid any metal, as the iron can vastly reduce the labeling yield. This means that needles have to be avoided until the radiochemistry procedures are completed.
1. Radiochemistry
2. Animal model generation
3. Imaging
4. Post imaging animal care
5. PET/CT reconstruction
6. Image processing and analysis
NOTE: The co-registered PET/CT images are further used for quantification within the database server of an image analysis software, where each hybrid scan is saved as a subject.
One of the most important aspects of quality control of a radiopharmaceutical is by means of HPLC, as this shows not only the chemical and radiochemical purity (98.2% in this case) but also allows to prove the identity of the radiopharmaceutical by comparing the elution time and peak shape to that of a non-radioactive reference compound. This reference compound is, in this case, an unlabeled nanobody, proven to be the correct compound by classical techniques such as mass spectrometry or nuclear magnetic resonance. These ...
Radiosynthesis
The radiosynthesis described here is typical for a new 68Ga-labeled compound - short synthesis time, with emphasis on suitable pH and avoiding metals whenever possible. For this, it is important to strictly follow the order in which the components are added. In any case, the pH value of the 68Ga solution must first be adjusted to pH 4 with 3 M NH4OAc; otherwise, the nanobody may degrade if the pH is too acidic. The general concepts of 68Ga-...
FMM is a medical advisor for NanoMab Technology Ltd. and Advanced Accelerator Applications (AAA) GmbH. He has recently received institutional grants from NanoMab Technology Ltd., Siemens, and GE Precision Healthcare LLC. Furthermore, he has an interventional research contract with CURIUM.
The authors are grateful to Susanne Allekotte for her technical support.
Name | Company | Catalog Number | Comments |
Equipment | |||
Activity meter ISOMED 2010 | Nuviatech Healthcare | - | |
Centrifuge MIKRO 185 | Andreas Hettich GmbH & Co. KG | 1203 | |
Endotoxin testing Endosafe nexgen-PTS | Charles River | - | |
Heating block NANOCOLOR VARIO C2 | Macherey-Nagel | 919350 | |
HPLC system, including radio detector | Knauer & Raytest | - | |
Image analysis software Pmod 4.4 | PMOD Technologies LLC | - | |
Small animal PET/CT system β-CUBE and X-CUBE | Molecubes NV | - | |
TLC MiniGITA* | Elysia-Raytest | - | |
Materials | |||
0.3 mm diameter PE10 tube | fisher scientific | 22-204008 | |
30G needle | B|Braun | 4656300 | |
Centrifugal filter; 10 kDa MWCO, 0.5 mL | Millipore | UFC501008 | |
Chromatography paper strip iTLC-SG | Agilent Technologies | SGI0001 | |
Endotoxin Cartridge, 0.05 EU/ml sensitivity | Charles River | PTS-2005 | |
HPLC Column Biosep SEC-s2000 | Phenomenex | - | |
Microcentrifuge tube (1.5 mL) | Eppendorf | 0030125150 | |
pH strip 0.0 - 6.0 | Merck KGaA | 109531 | |
pH strip 0-14 | Merck KGaA | 109535 | |
PS-H+ SPE cartridge | Macherey Nagel GmbH & Co. KG | 731861 | |
Sterile vial 10 mL | ALK Life Science Solutions | SEV100 | |
Reagents | |||
68Ge/68Ga-Generator | NRF-iThembaLABS | - | |
Ammoniumacetate | Merck KGaA | 101116 | |
Citric acid | Merck KGaA | 100241 | |
Hydrochloric acid | Merck KGaA | 320331 | |
NaCl | Merck KGaA | S9888 | |
Nanobody NM-02 | Radiopharm Theranostics | - | |
P-SCN-Bz-DOTA-GA | CheMatech | C115 | |
Trifluoracetic acid | Merck KGaA | T6508 | |
Ultrapure water | Merck KGaA | 101262 |
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