Evaluation of the enantiomer specific biokinetics and radiation doses of [18-F]-fluspidine – a new tracer in clinical translation for imaging of σ1 receptors


Evaluation of the enantiomer specific biokinetics and radiation doses of [18-F]-fluspidine – a new tracer in clinical translation for imaging of σ1 receptors

Kranz, M.; Sattler, B.; Wüst, N.; Deuther-Conrad, W.; Patt, M.; Meyer, P. M.; Fischer, S.; Donat, C. K.; Wünsch, B.; Hesse, S.; Steinbach, J.; Brust, P.; Sabri, O.

The enantiomers of [18F]-fluspidine, recently developed for imaging of σ1 receptors, exhibit promising and distinct pharmacokinetics which makes them attractive for different clinical questions. To support their clinical translation, human radiation dosimetry of (S)-(-)-[18F]-fluspidine and (R)-(+)-[18F]-fluspidine was estimated from ex vivo biodistribution and PET/MR imaging in mice after extrapolation to human scale. The results were validated by a first-in-human study where time-dependent activity data of (S)-(-)-[18F]-fluspidine was obtained by PET/CT. The time-activity curves were exponentially fitted and the integral used in OLINDA to calculate organ doses (ODs) and the effective dose (ED). According to different biokinetics of (S)-(-)-[18F]-fluspidine and (R)-(+)-[18F]-fluspidine, the EDs differ significantly with values of 12.9 µSv/MBq and 14.0 µSv/MBq (p<0.025, image-derived data of mice), respectively, as observed by ex vivo biodistribution too. In the human study, the ED was calculated to be 21.0 µSv/MBq. The preclinical dosimetry reveals the ED for [18F]-fluspidine comparable with other 18F-labeled PET imaging agents, despite differences of the EDs due to enantiomer specific kinetics. The first-in-human study confirmed that the radiation risk of (S)-(-)-[18F]-fluspidine imaging is within accepted limits. However, the ED in humans is underestimated when using preclinical imaging for dosimetry which needs to be considered when applying for first-in-human studies.

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Publ.-Id: 23965