First-in-human imaging using [11C]MDTC: a radiotracer targeting the cannabinoid receptor type 2

Eur J Nucl Med Mol Imaging. 2023 Jul;50(8):2386-2393. doi: 10.1007/s00259-023-06170-y. Epub 2023 Mar 6.

Abstract

Purpose: We report findings from the first-in-human study of [11C]MDTC, a radiotracer developed to image the cannabinoid receptor type 2 (CB2R) with positron emission tomography (PET).

Methods: Ten healthy adults were imaged according to a 90-min dynamic PET protocol after bolus intravenous injection of [11C]MDTC. Five participants also completed a second [11C]MDTC PET scan to assess test-retest reproducibility of receptor-binding outcomes. The kinetic behavior of [11C]MDTC in human brain was evaluated using tissue compartmental modeling. Four additional healthy adults completed whole-body [11C]MDTC PET/CT to calculate organ doses and the whole-body effective dose.

Results: [11C]MDTC brain PET and [11C]MDTC whole-body PET/CT was well-tolerated. A murine study found evidence of brain-penetrant radiometabolites. The model of choice for fitting the time activity curves (TACs) across brain regions of interest was a three-tissue compartment model that includes a separate input function and compartment for the brain-penetrant metabolites. Regional distribution volume (VT) values were low, indicating low CB2R expression in the brain. Test-retest reliability of VT demonstrated a mean absolute variability of 9.91%. The measured effective dose of [11C]MDTC was 5.29 μSv/MBq.

Conclusion: These data demonstrate the safety and pharmacokinetic behavior of [11C]MDTC with PET in healthy human brain. Future studies identifying radiometabolites of [11C]MDTC are recommended before applying [11C]MDTC PET to assess the high expression of the CB2R by activated microglia in human brain.

Keywords: Cannabinoid receptor type 2; Dosimetry; Human; Pharmacokinetic; Positron emission tomography.

MeSH terms

  • Adult
  • Animals
  • Brain / diagnostic imaging
  • Brain / metabolism
  • Humans
  • Mice
  • Positron Emission Tomography Computed Tomography*
  • Positron-Emission Tomography / methods
  • Radiopharmaceuticals* / pharmacokinetics
  • Receptors, Cannabinoid / metabolism
  • Reproducibility of Results

Substances

  • monodansylthiacadaverine
  • Radiopharmaceuticals
  • Receptors, Cannabinoid