Radioiodinated tracers for myocardial imaging

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Recent advances in the efficient production of high purity radioiodine (123I) and new efficient radiolabeling techniques have allowed the development of new classes of cardiovascular radiopharmaceuticals. These include 123I-labeled fatty acids to assess myocardial metabolism, 123I-metaiodobenzylguanidine (MIBG) for myocardial neuronal activity, labeled monoclonal antibodies for myocardial necrosis, and labeled lipoproteins for receptor concentration. 123I-labeled fatty acids and MIBG are under clinical investigation with encouraging results. 123I-and 111In-labeled fragments of monoclonal antibodies to myosin have been used for imaging myocardial necrosis in humans. The development of radiotracers for imaging of cholinergic and adrenergic receptors is still in the experimental stage. Recent advances in imaging instrumentation and radiopharmaceuticals have resulted in cardiac imaging applications beyond blood pool ventriculography, perfusion, and infarctavid imaging. Developments of radioiodine (123I)-labeled agents promise to play an important role in the assessment of myocardial metabolism, neuronal activity, and receptor concentration. The chemistry activity, and receptor concentration. The chemistry of iodine is well defined compared with that of 99mTc; therefore, iodine isotopes are well suited for labeling biologically important molecules. Among the iodine isotopes, 123I has nearly ideal nuclear properties for nuclear medical applications with a 13.3-hour half-life (T1/2) and 159 keV gamma emission (83%). Dispite the nearly ideal chemical and nuclear properties of 123I, the widespread application of 123I-based radiopharmaceuticals in clinical practice has been limited by high production costs (123I is produced in a cyclotron), relatively limited availability, and the presence of undesirable radionuclidic impurities (124I, T1/2=4.2 days; 125I, T1/2=60 days; 126I, T1/2=13.1 days). The relatively long T1/2 and beta particle emission can substantially increase the higher radiation burden to the patient. High energy gamma rays (>600 KeV) from these impurities can degrade images obtained using low energy collimators. Recent developments in production techniques have greatly reduced the levels of the undesirable radio-nuclides in 123I. Ready availability of pure 123I at modest cost, in concentrations suitable for the radiolabeling of a variety of useful biomolecules, should enhance the clinical applications of 123I-labeled compounds. Molecules labeled with 123I that are useful in cardiac imaging studies are fatty acid analogs, monoclonal antibodies, receptor binding agents, and norepinephrine analogs. This article will discuss developments in radioiodine (123I)-labeled radiotracers for mycordial imaging.

References (77)

  • DouganH et al.

    Efficient production of 15-(para[123I]iodophenyl) pentadecanoic acid

    Appl Radiat Isotope

    (1986)
  • RellasJS et al.

    Iodine-123 phenylpentadecanoic acid: Detection of acute myocardial infarction and injury in dogs using an iodinated fatty acid and single photon emission tomography

    Am J Cardiol

    (1983)
  • HansenCL et al.

    Iodine-123 phenylpentadecanoic acid and single photon emission computed tomography in identifying left ventricular regional metabolic abnormalities in patients with coronary heart disease: Comparison with thallium-201 myocardial tomography

    J Am Coll Cardiol

    (1988)
  • UgoliniV et al.

    Abnormal fatty acid and metabolism in dilated cardiomyopathy detected by iodine-123 phenylpentadecanoic acid and tomographic imaging

    Am J Cardiol

    (1988)
  • RamCV et al.

    Regression of left ventricular hypertrophy in hypertension: Effects of prazosin therapy

    Am J Med

    (1989)
  • SchoferJ et al.

    Iodine-123 metaiodobenzylguanidine scintigraphy: A noninvasive method to demonstrate myocardial adrenergic nervous system disintegrity in patients with iodopathic dilated cardiomyopathy

    J Am Coll Cardiol

    (1988)
  • SoddVJ et al.

    Production and use of I-123

  • DegumeCH et al.

    Note on the productionof I-123 for radiodiagnostic purposes

    Int J Appl Radiat Isotope

    (1973)
  • JungermanJA et al.

    Cyclotron production of high purity I-123 for medical applications

    J Radioanal Chem

    (1981)
  • RichardsP et al.

    An iodine-123 generator/iodination kit: A preliminary report

    J Radioanal Chem

    (1981)
  • GrahamD et al.

    Production of high purity I-123 using Xe-124

  • OpieLH

    Metabolism of the heart in health and disease. Part II

    Am Heart J

    (1969)
  • WeissES et al.

    Quantification of infarction in cross sections of canine myocardium in vivo with positron emission transaxial tomography and 11C-palmitate

    Circulation

    (1977)
  • WeissES et al.

    External detection and visualization of myocardial ischemia with 11C-substrates in vitro and in vivo

    Circ Res

    (1976)
  • SobelBE et al.

    Detection of remote myocardial infarction in patients with positron emission transaxial tomography and intravenous 11C-palmitate

    Circulation

    (1977)
  • EvansJR et al.

    Use of radioidinated fatty acid for photoscans of the heart

    Circ Res

    (1965)
  • RobinsonGD et al.

    Radioiodinated fatty acids for heart imaging: Iodine monochloride addition compared with iodine replacement labeling

    J Nucl Med

    (1975)
  • PoeND et al.

    Experimental basis for myocardial imaging with I-123-labeled hexadecenoic acid

    J Nucl Med

    (1976)
  • PoeND et al.

    Myocardial imaging with 123I-hexadecenoic acid

    Radiology

    (1977)
  • MachullaHJ et al.

    Comparative evaluation of fatty acids labeled with C-11, C1-34m Br-77, and I-123 for metabolic studies of the myocardium. Concise communication

    J Nucl Med

    (1978)
  • FreundliebC et al.

    Myocardial imaging and metabolic studies with [17-I-123]iodoheptadecanoic acid

    J Nucl Med

    (1980)
  • van derWall et al.

    I-123 labeled hexadecenoic acid in comparison with thallium-201 for myocardial imaging in coronary heart disease

    Eur J Nucl Med

    (1980)
  • van derWall et al.

    Metabolic myocardial imaging with 123I-labeled hepatadecanoic acid in patients with angina pectoris

    Eur J Nucl Med

    (1981)
  • van derWall et al.

    Myocardial scintigraphy with 123I-labeled heptadecanoic acid in patients with unstable angina pectoris

    Postgrad Med

    (1983)
  • van derWall et al.

    Dynamic myocardial scintigraphy with 123I-labeled free fatty acids in patients with myocardial infarction

    Eur J Nucl Med

    (1981)
  • RoeslerH et al.

    Tomoscintigraphic assessment of myocardial metabolic heterogeneity

    J Nucl Med

    (1983)
  • HockA et al.

    Myocardial imaging and metabolic studies with [17-123I]iodoheptadecanoic acid in patients with idiopathic congestive cardiomyopathy

    J Nucl Med

    (1983)
  • FreundliebC et al.

    Myocardial imaging and metabolic studies with [17-123I]iodoheptadecanoic acid

    J Nucl Med

    (1980)
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    • Improved small scale production of iodine-124 for radiolabeling and clinical applications

      2018, Applied Radiation and Isotopes
      Citation Excerpt :

      Applications of 124I range from simple imaging of the thyroid and parathyroid to functional studies of neurotransmitter receptors, through monoclonal antibodies for the study of cancer. Furthermore, 124I has been in use for labeling single molecules such as meta-iodobenzylguanidine (MIBG), amino acids, and fatty acids, to name only some, allowing investigation of diseases of different organs such as brain and heart (Seo et al., 2012; Israel et al., 2008; Farmakis et al., 2018; Samnick et al., 2018; Kulkarni and Corbett, 1990). Therefore, there has been a high demand for an efficient, reliable small-scale production of 124I for PET chemistry and for routinely clinical applications by using commercially available low energy cyclotrons.

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