Improved in vivo PET imaging of the adenosine A2A receptor in the brain using [18F]FLUDA, a deuterated radiotracer with high metabolic stability

Eur J Nucl Med Mol Imaging. 2021 Aug;48(9):2727-2736. doi: 10.1007/s00259-020-05164-4. Epub 2021 Feb 2.

Abstract

Purpose: The adenosine A2A receptor has emerged as a therapeutic target for multiple diseases, and thus the non-invasive imaging of the expression or occupancy of the A2A receptor has potential to contribute to diagnosis and drug development. We aimed at the development of a metabolically stable A2A receptor radiotracer and report herein the preclinical evaluation of [18F]FLUDA, a deuterated isotopologue of [18F]FESCH.

Methods: [18F]FLUDA was synthesized by a two-step one-pot approach and evaluated in vitro by autoradiographic studies as well as in vivo by metabolism and dynamic PET/MRI studies in mice and piglets under baseline and blocking conditions. A single-dose toxicity study was performed in rats.

Results: [18F]FLUDA was obtained with a radiochemical yield of 19% and molar activities of 72-180 GBq/μmol. Autoradiography proved A2A receptor-specific accumulation of [18F]FLUDA in the striatum of a mouse and pig brain. In vivo evaluation in mice revealed improved stability of [18F]FLUDA compared to that of [18F]FESCH, resulting in the absence of brain-penetrant radiometabolites. Furthermore, the radiometabolites detected in piglets are expected to have a low tendency for brain penetration. PET/MRI studies confirmed high specific binding of [18F]FLUDA towards striatal A2A receptor with a maximum specific-to-non-specific binding ratio in mice of 8.3. The toxicity study revealed no adverse effects of FLUDA up to 30 μg/kg, ~ 4000-fold the dose applied in human PET studies using [18F]FLUDA.

Conclusions: The new radiotracer [18F]FLUDA is suitable to detect the availability of the A2A receptor in the brain with high target specificity. It is regarded ready for human application.

Keywords: A2A receptor; Adenosine receptors; FESCH; Fluorine-18; Neurodegeneration; Positron-emission tomography.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenosine
  • Animals
  • Brain / diagnostic imaging
  • Brain / metabolism
  • Fluorine Radioisotopes
  • Mice
  • Positron-Emission Tomography*
  • Radiopharmaceuticals
  • Rats
  • Receptor, Adenosine A2A* / metabolism
  • Swine

Substances

  • Fluorine Radioisotopes
  • Radiopharmaceuticals
  • Receptor, Adenosine A2A
  • Adenosine