Indian Journal of Nuclear Medicine
Home | About IJNM | Search | Current Issue | Past Issues | Instructions | Ahead of Print | Online submissionLogin 
Indian Journal of Nuclear Medicine
  Editorial Board | Subscribe | Advertise | Contact
Users Online: 1437 Print this page  Email this page Small font size Default font size Increase font size


 
 Table of Contents     
LETTER TO THE EDITOR
Year : 2020  |  Volume : 35  |  Issue : 1  |  Page : 89-90  

Practical consideration regarding stability of F-18 2-deoxy-2-[18F] fluoro-D-glucose, procured from a distant commercial production site


Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Date of Submission21-Nov-2019
Date of Acceptance22-Nov-2019
Date of Web Publication31-Dec-2019

Correspondence Address:
Prof. Bhagwant Rai Mittal
Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Sector-12, Chandigarh - 160 012
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijnm.IJNM_198_19

Rights and Permissions

How to cite this article:
Vatsa R, Singh H, Rana N, Kumar R, Mittal BR. Practical consideration regarding stability of F-18 2-deoxy-2-[18F] fluoro-D-glucose, procured from a distant commercial production site. Indian J Nucl Med 2020;35:89-90

How to cite this URL:
Vatsa R, Singh H, Rana N, Kumar R, Mittal BR. Practical consideration regarding stability of F-18 2-deoxy-2-[18F] fluoro-D-glucose, procured from a distant commercial production site. Indian J Nucl Med [serial online] 2020 [cited 2020 Feb 25];35:89-90. Available from: http://www.ijnm.in/text.asp?2020/35/1/89/274376



Sir,

F-18 2-deoxy-2-[18 F] fluoro-D-glucose (F-18 FDG) is the most widely used positron emission tomography (PET) radiopharmaceutical.[1],[2] Due to rapidly increasing PET scanners' installation and hence demand of F-18 FDG, large-scale commercial production of F-18 FDG has grown considerably. Synthesis of F-18 FDG on large scale for commercial supply poses challenges to the radiochemist, especially in terms of stability of the radiopharmaceutical. According to literature, the shelf-life of F-18 FDG is 8 h, but at higher radioactive concentrations, radiochemical stability of F-18 FDG is reported to decrease significantly with time.[3],[4] Hereby, we share the practical experience regarding stability issues of F-18 FDG when the production facility is situated at long distances from the end users.

Due to ongoing upgradation of medical cyclotron facility at our center, commercially synthesized F-18 FDG was procured for continuity of patient services. The PET scans performed with commercially procured F-18 FDG showed increased tracer uptake in the skeleton and degenerative processes including osteophytes. The logistics of supply were reviewed, and samples were subjected to radiochemical purity testing to look for free F-18. The radioactive fluorine (F-18) was produced using18 O (p, n) 18 F reaction, and F-18 FDG was synthesized in an automated synthesis module. A total of 2400 mCi of F-18 FDG in 6 ml was dispatched for supply via road transport to a distance of approximately 300 km. There was a gap of 6 h between the end of synthesis till first dose administration. The radiochemical purity at the time of dispatch in all batches was >99%. However, at user end, the radiochemical purity was observed to be suboptimal and decreased with time leading to increased free F-18 content. For preparation with <90% radiochemical purity, purification was done using solid-phase extraction-based alumina cartridge (Waters, USA) shown in [Figure 1]. The difference in the radiochemical purity is also appreciable from the biodistribution of F-18 FDG (supplied by the commercial supplier) and repurified F-18 FDG in a patient [Figure 2]. Measures to increase the shelf life of commercially available F-18 FDG are required, considering the time lag between production and tracer administration. Quality control should be done if any alteration in radiotracer distribution is suspected.
Figure 1: Instant thin layer chromatography (ITLC) chromatogram of F-18 2-deoxy-2-[18F] fluoro-D-glucose using 95% acetonitrile (ACN) as mobile phase (a) before purification showing two peaks (F-18 Rf0 and F-18 FDG Rf0.4) and (b) after purification with alumina column showing single peak of F-18 2-deoxy-2-[18F] fluoro-D-glucose

Click here to view
Figure 2: A 66-year-old female diagnosed with ovarian carcinoma underwent F-18 2-deoxy-2-[18F] fluoro-D-glucose positron emission tomography/computed tomography post neoadjuvant chemotherapy and surgery for response evaluation. Increased tracer uptake was noted in multiple osteophytes (arrow) and right atlantoaxial joint (arrowhead) on maximum intensity projection image (MIP) (a) and axial positron emission tomography/computed tomography (b) image with degenerative changes and osteophyte noted on corresponding CT image (c). Due to high tracer uptake in osteophytes which is not commonly seen with F-18 2-deoxy-2-[18F] fluoro-D-glucose, possibility of free F-18 was considered and regional images of neck were repeated using purified F-18 2-deoxy-2-[18F] fluoro-D-glucose which revealed no 2-deoxy-2-[18F] fluoro-D-glucose uptake in right atlantoaxial joint region (d) denoting absence of disease activity

Click here to view


Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Nabi HA, Zubeldia JM. Clinical applications of 18F-FDG in oncology. J Nucl Med Technol 2002;30:3-9.  Back to cited text no. 1
    
2.
Cuaron J, Dunphy M, Rimner A. Role of FDG-PET scans in staging, response assessment, and follow-up care for non-small cell lung cancer. Front Oncol 2012;2:208.  Back to cited text no. 2
    
3.
Fawdry RM. Radiolysis of 2-[18F] fluoro-2-deoxy-D-glucose (FDG) and the role of reductant stabilisers. Appl Radiat Isot 2007;65:1193-201.  Back to cited text no. 3
    
4.
Walters LR, Martin KJ, Jacobson MS, Hung JC, Mosman EA. Stability evaluation of 18F-FDG at high radioactive concentrations. J Nucl Med Technol 2012;40:52-6.  Back to cited text no. 4
    


    Figures

  [Figure 1], [Figure 2]



 

Top
  
 
  Search
 
  
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
    References
    Article Figures

 Article Access Statistics
    Viewed141    
    Printed0    
    Emailed0    
    PDF Downloaded30    
    Comments [Add]    

Recommend this journal