The Application of 18F-FES PET in Clinical Cancer Care: A Systematic Review

Ya-Ting Huang, PhD , RN, NP,* Tom Wei-Wu Chen, MD, PhD , Li-Yu Chen, MS , Ya-Yao Huang, PhD , and Yen-Shen Lu, MD, PhD

Published by Clinical Nuclear Medicine 48(2):p 132-142, February 2023

Abstract

Background: [C-11] Pittsburgh Compound-B (PiB) is now almost routinely used to perform clinical studies for patients in the neurological department at Taipei Veterans General Hospital positron emission tomography (PET) center. It is important to have high molar activity of [C-11] PiB when it is injected into the patients. The aim of this work was to modify an Eckert-Ziegler (EZ) modular system for the routine synthesis of [C-11] PiB to meet the demand of clinical studies. Some modifications of [C-11] PiB routine production procedures are described in detail.

Methods: The fully automated synthesis of [C-11] PiB starting from [C-11] CO_2 is reported. [C-11] methyl triflate was produced in the semi-preparative HPLC loop in EZ modular system. Methylation reactions and the final formulation were performed using the EZ modular system.

Results: The radiochemical yield of [C-11] PiB was 9.66 ± 2.02% (based on [C-11] CO_2 decay uncorrected, n = 22) and the molar activity was 156.71 ± 4.56 GBq/μmol (end of synthesis) (n = 22). The radiochemical purity exceeded 99%.

Conclusions: We adopted the “loop” method and modified some procedures in the modular system. The molar activity of [C-11] PiB was getting stable and so was the total radioactivity of [C-11] PiB. Sufficient radioactivity of [C-11] PiB with high molar activity could be achieved by EZ modular system for clinical studies. The C-11-methylation reaction could be applied to other radiosynthesis of the C-11-tracer via the loop method.