Cyclotron Production of Gallium-68 Radiopharmaceuticals Using the 68Zn(p,n)68Ga Reaction and Their Regulatory Aspects

Designing and implementing various radionuclide production methods guarantees a sustainable supply, which is important for medical use. The use of medical cyclotrons for radiometal production can increase the availability of gallium-68 (68Ga) radiopharmaceuticals. Although generators have greatly influenced the demand for 68Ga radiopharmaceuticals, the use of medical cyclotrons is currently being explored. The resulting 68Ga production is several times higher than obtained from a generator. Moreover, the use of solid targets yields end of purification and end of synthesis (EOS) of up to 194 GBq and 72 GBq, respectively. Furthermore, experiments employing liquid targets have provided promising results, with an EOS of 3 GBq for [68Ga]Ga-PSMA-11. However, some processes can be further optimized, specifically purification, to achieve high 68Ga recovery and apparent molar activity. In the future, 68Ga will probably remain one of the most in-demand radionuclides; however, careful consideration is needed regarding how to reduce the production costs. Thus, this review aimed to discuss the production of 68Ga radiopharmaceuticals using Advanced Cyclotron Systems, Inc. (ACSI, Richmond, BC, Canada) Richmond, Canada and GE Healthcare, Wisconsin, USA cyclotrons, its related factors, and regulatory concerns.

[1]  F. F. Ahmad Saad,et al.  Preparation, Optimisation, and In Vitro Evaluation of [18F]AlF-NOTA-Pamidronic Acid for Bone Imaging PET , 2022, Molecules.

[2]  R. Augusto,et al.  Production Review of Accelerator-Based Medical Isotopes , 2022, Molecules.

[3]  W. Wadsak,et al.  EANM position on the in-house preparation of radiopharmaceuticals , 2022, European Journal of Nuclear Medicine and Molecular Imaging.

[4]  Z. Ashhar,et al.  Upgrades and regulatory aspects of [18F]Fluorodeoxyglucose ([18F]FDG) production using the FASTLab2 synthesizer , 2021, Journal of Radioanalytical and Nuclear Chemistry.

[5]  Y. Seimbille,et al.  EANM guideline for harmonisation on molar activity or specific activity of radiopharmaceuticals: impact on safety and imaging quality , 2021, EJNMMI Radiopharmacy and Chemistry.

[6]  Johan Svedjehed,et al.  Demystifying solid targets: Simple and rapid distribution-scale production of [68Ga]GaCl3 and [68Ga]Ga-PSMA-11. , 2021, Nuclear medicine and biology.

[7]  P. Martini,et al.  A Universal Cassette-Based System for the Dissolution of Solid Targets , 2021, Molecules.

[8]  S. Archibald,et al.  The aluminium-[18F]fluoride revolution: simple radiochemistry with a big impact for radiolabelled biomolecules , 2021, EJNMMI Radiopharmacy and Chemistry.

[9]  S. Milton,et al.  Cyclotron-produced 68Ga from enriched 68Zn foils. , 2021, Applied Radiation and Isotopes.

[10]  M. Ocak,et al.  Guideline on current good radiopharmacy practice (cGRPP) for the small-scale preparation of radiopharmaceuticals , 2021, EJNMMI Radiopharmacy and Chemistry.

[11]  M. Hussain,et al.  Nuclear model analysis of the 65Cu(α, n)68Ga reaction for the production of 68Ga up to 40 MeV. , 2021, Applied radiation and isotopes : including data, instrumentation and methods for use in agriculture, industry and medicine.

[12]  P. Schaffer,et al.  Multi-curie production of gallium-68 on a biomedical cyclotron and automated radiolabelling of PSMA-11 and DOTATATE , 2019, EJNMMI Radiopharmacy and Chemistry.

[13]  Bradford D. Henderson,et al.  Cyclotron-based production of 68Ga, [68Ga]GaCl3, and [68Ga]Ga-PSMA-11 from a liquid target , 2020, EJNMMI Radiopharmacy and Chemistry.

[14]  N. Yusof,et al.  Preparation, Characterization, and Radiolabeling of [68Ga]Ga-NODAGA-Pamidronic Acid: A Potential PET Bone Imaging Agent , 2020, Molecules.

[15]  Krishan Kumar The Current Status of the Production and Supply of Gallium-68. , 2020, Cancer biotherapy & radiopharmaceuticals.

[16]  M. Benešová,et al.  [68Ga]Ga-DOTA-TOC: The First FDA-Approved 68Ga-Radiopharmaceutical for PET Imaging , 2020, Pharmaceuticals.

[17]  B. Guérin,et al.  Automated radiosynthesis of 68Ga for large-scale routine production using 68Zn pressed target. , 2020, Applied radiation and isotopes : including data, instrumentation and methods for use in agriculture, industry and medicine.

[18]  M. Wuest,et al.  Taking cyclotron 68Ga production to the next level: Expeditious solid target production of 68Ga for preparation of radiotracers. , 2020, Nuclear medicine and biology.

[19]  Peter J. H. Scott,et al.  Production of radiometals in liquid targets , 2020, EJNMMI Radiopharmacy and Chemistry.

[20]  S. Fanti,et al.  PSMA-PET/CT imaging in prostate cancer: why and when , 2019, Clinical and Translational Imaging.

[21]  D. Antuganov,et al.  Modification of an Anion-Exchange Procedure for 68Ga Preconcentration and Automated Synthesis of [68Ga]Ga-PSMA-11 , 2019, Radiochemistry.

[22]  M. Hofman,et al.  Lutetium-177 prostate-specific membrane antigen (PSMA) theranostics: practical nuances and intricacies , 2019, Prostate Cancer and Prostatic Diseases.

[23]  M. Essler,et al.  Ethanol effects on 68Ga-radiolabelling efficacy and radiolysis in automated synthesis utilizing NaCl post-processing , 2019, EJNMMI Radiopharmacy and Chemistry.

[24]  S. Qaim Theranostic radionuclides: recent advances in production methodologies , 2019, Journal of Radioanalytical and Nuclear Chemistry.

[25]  Nicholas R. Schmit,et al.  Cyclotron production of 68Ga in a liquid target: Effects of solution composition and irradiation parameters. , 2019, Nuclear medicine and biology.

[26]  M. Malinconico,et al.  Rapid and automated production of [68Ga]gallium chloride and [68Ga]Ga-DOTA-TATE on a medical cyclotron. , 2019, Nuclear Medicine and Biology.

[27]  R. M. van Dam,et al.  The Search for an Alternative to [68Ga]Ga-DOTA-TATE in Neuroendocrine Tumor Theranostics: Current State of 18F-labeled Somatostatin Analog Development , 2019, Theranostics.

[28]  A. Tameez ud din,et al.  Neuroendocrine Tumor Therapy with Lutetium-177: A Literature Review , 2019, Cureus.

[29]  Mai Lin,et al.  Fully automated preparation of 68Ga-PSMA-11 at curie level quantity using cyclotron-produced 68Ga for clinical applications. , 2019, Applied radiation and isotopes : including data, instrumentation and methods for use in agriculture, industry and medicine.

[30]  M. Morigi,et al.  Production of Ga-68 with a General Electric PETtrace cyclotron by liquid target. , 2018, Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics.

[31]  R. Baum,et al.  PSMA diagnostics and treatments of prostate cancer become mature , 2018, Clinical and Translational Imaging.

[32]  C. G. Lepera,et al.  Production of curie quantities of 68Ga with a medical cyclotron via the 68Zn(p,n)68Ga reaction. , 2018, Applied radiation and isotopes : including data, instrumentation and methods for use in agriculture, industry and medicine.

[33]  Mateusz Adam Synowiecki,et al.  Production of novel diagnostic radionuclides in small medical cyclotrons , 2018, EJNMMI Radiopharmacy and Chemistry.

[34]  N. Raj,et al.  The Role of 68Ga-DOTATATE Positron Emission Tomography/Computed Tomography in Well-Differentiated Neuroendocrine Tumors: A Case-Based Approach Illustrates Potential Benefits and Challenges. , 2018, Pancreas.

[35]  R. Mach,et al.  Consensus nomenclature rules for radiopharmaceutical chemistry - Setting the record straight. , 2017, Nuclear medicine and biology.

[36]  F. Alves,et al.  Production of copper-64 and gallium-68 with a medical cyclotron using liquid targets , 2017 .

[37]  Kathy Willowson,et al.  Lutetium 177 PSMA radionuclide therapy for men with prostate cancer: a review of the current literature and discussion of practical aspects of therapy , 2017, Journal of medical radiation sciences.

[38]  W. Breeman,et al.  Radiolabeling of DOTA-like conjugated peptides with generator-produced 68Ga and using NaCl-based cationic elution method , 2016, Nature Protocols.

[39]  F. Rösch,et al.  Improved radiolabeling of DOTATOC with trivalent radiometals for clinical application by addition of ethanol , 2016, EJNMMI Radiopharmacy and Chemistry.

[40]  B. Hadaschik,et al.  Stellenwert der PSMA-Liganden-Bildgebung beim Prostatakarzinom , 2016, Der Urologe.

[41]  I. Velikyan 68Ga-Based Radiopharmaceuticals: Production and Application Relationship , 2015, Molecules.

[42]  T. Ross,et al.  Cation exchange-based post-processing of (68)Ga-eluate: a comparison of three solvent systems for labelling of DOTATOC, NO2AP(BP) and DATA(m.). , 2015, Applied radiation and isotopes : including data, instrumentation and methods for use in agriculture, industry and medicine.

[43]  Patrícia Rijo,et al.  Good manufacturing practices for medicinal products for human use , 2015, Journal of pharmacy & bioallied sciences.

[44]  G. Kodina,et al.  Preparation of highly purified 68Ga solutions via ion exchange in hydrochloric acid–ethanol mixtures , 2015, Journal of Radioanalytical and Nuclear Chemistry.

[45]  S. Qaim,et al.  Evaluation of excitation functions of the (68,67,66)Zn(p,xn)(68,67,66)Ga and 67Zn(p,α)64Cu reactions: validation of evaluated data through comparison with experimental excitation functions of the (nat)Zn(p,x)(66,67)Ga and (nat)Zn(p,x)64Cu processes. , 2015, Applied radiation and isotopes : including data, instrumentation and methods for use in agriculture, industry and medicine.

[46]  A. Chernyaev,et al.  Particle accelerators in modern world , 2014 .

[47]  M. Pandey,et al.  Cyclotron production of (68)Ga via the (68)Zn(p,n)(68)Ga reaction in aqueous solution. , 2014, American journal of nuclear medicine and molecular imaging.

[48]  F. Rösch,et al.  Targeting of gelatinase activity in malignant tumors with a 68Ga-labeled gelatinase inhibitor cyclic peptide , 2014 .

[49]  M. Pandey,et al.  Production of 89Zr via the 89Y(p,n)89Zr reaction in aqueous solution: effect of solution composition on in-target chemistry. , 2014, Nuclear medicine and biology.

[50]  R. Schibli,et al.  Identification, characterization and suppression of side-products formed during the synthesis of high dose ⁶⁸Ga-DOTA-TATE. , 2013, Applied radiation and isotopes : including data, instrumentation and methods for use in agriculture, industry and medicine.

[51]  Martin G Pomper,et al.  Clinical applications of Gallium-68. , 2013, Applied radiation and isotopes : including data, instrumentation and methods for use in agriculture, industry and medicine.

[52]  F. Rösch Post-processing via cation exchange cartridges: versatile options. , 2013, Recent results in cancer research. Fortschritte der Krebsforschung. Progres dans les recherches sur le cancer.

[53]  J. Engle,et al.  Very high specific activity ⁶⁶/⁶⁸Ga from zinc targets for PET. , 2012, Applied radiation and isotopes : including data, instrumentation and methods for use in agriculture, industry and medicine.

[54]  Tianjue Zhang,et al.  The present situation and the prospect of medical cyclotrons in China , 2011 .

[55]  Z. Kovács,et al.  Investigation of direct production of 68Ga with low energy multiparticle accelerator , 2011 .

[56]  E. Krenning,et al.  (68)Ga-labeled DOTA-peptides and (68)Ga-labeled radiopharmaceuticals for positron emission tomography: current status of research, clinical applications, and future perspectives. , 2011, Seminars in nuclear medicine.

[57]  D. Townsend,et al.  Physical and clinical performance of the mCT time-of-flight PET/CT scanner , 2011, Physics in medicine and biology.

[58]  J. C. Clark,et al.  Direct production of Ga-68 from proton bombardment of concentrated aqueous solutions of [Zn-68] Zinc Chloride , 2011 .

[59]  F. Rösch,et al.  Efficient post-processing of aqueous generator eluates facilitates 68Ga-labelling under anhydrous conditions , 2010 .

[60]  F. Tisato,et al.  Mononuclear six-coordinated Ga(III) complexes: A comprehensive survey , 2009 .

[61]  S. Rajabifar,et al.  Cyclotron production of 68Ga via proton-induced reaction on 68Zn target , 2009 .

[62]  Bernd J Pichler,et al.  Latest Advances in Molecular Imaging Instrumentation , 2008, Journal of Nuclear Medicine.

[63]  P. Schöffski,et al.  Biokinetics and imaging with the somatostatin receptor PET radioligand 68Ga-DOTATOC: preliminary data , 2001, European Journal of Nuclear Medicine.