Al[¹⁸F]F-NOTA-octreotide: From an emergency solution to the routine tracer – An experience

Ziel/Aim ⁶⁸Ga-radiolabelled SST analogues are widely used in NET imaging which is hampered by the growing demand, leading to shortages in availability and increasing costs for generators. While adoption to cyclotron-based ⁶⁸Ga-production is technically challenging and requires large investments, Al[¹⁸F]F-NOTA-octreotide could pose a resort. The presented work describes the single center experience of short-term replacement of ⁶⁸Ga-tracer by Al[¹⁸F]F-NOTA-octreotide under GMP conditions to ensure patient care.

Methodik/Methods Synthesis was performed on GAIA V2 utilizing ⁶⁸Ga-consumables replacing the cartridges by QMA and HLB. 6 µL of 0.01 M AlCl₃ was preloaded to the reactor and incubated with fluorine-18 in 0.5 mL eluent for 5 min at 50°C. After adding 120 µg NOTA-octreotide in 0.5 ml ethanol-containing buffer, the reaction was incubated at 100°C for 10 min. Following purification and final formulation, quality control was performed according to the Eu Ph. 249 ± 30 MBq Al[¹⁸F]F-NOTA-octreotide were injected to patients (N = 41) suffering of NET and PET/CT images were acquired 60 min p.i. on VISION 450 (Siemens Healthineers).

Ergebnisse/Results Synthesis was setup on a ⁶⁸Ga-module providing stable radiochemical yields lower than published (16.2 ± 5.3 % dc). It was possible to obtain up to 6.2 GBq product within 30 min with good radiochemical purity (94.1 ± 2.0 %). Validated quality control was successfully implemented. Al[¹⁸F]F-NOTA-octreotide showed high, focal uptake in NET lesions in all patients with excellent image quality and spatial resolution. Further, physiological uptake in liver and salivary glands was lower as compared to [⁶⁸Ga]Ga-DOTA-TATE.

Schlussfolgerungen/Conclusions The compound was a suitable alternative ensuring patient care during a ⁶⁸Ga-supply problem. Although it was obtained in rather stable yields, the reaction is relatively sensible, which needs to be considered when implementing. The improved availability in conjunction with clinical advantages, may render Al[¹⁸F]F-NOTA-octreotide more than just an alternative in the future.

Publication History

Article published online:
08 April 2021