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European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 2/2023

Open Access 08-09-2022 | Computed Tomography | Original Article

First-in-human evaluation of [18F]CETO: a novel tracer for adrenocortical tumours

Authors: Isabella Silins, Anders Sundin, Mark Lubberink, Lleah O’Sullivan, Mark Gurnell, Franklin Aigbirhio, Morris Brown, Anders Wall, Tobias Åkerström, Sara Roslin, Per Hellman, Gunnar Antoni

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 2/2023

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Abstract

Purpose

[11C]Metomidate positron emission tomography (PET) is currently used for staging of adrenocortical carcinoma and for lateralization in primary aldosteronism (PA). Due to the short half-life of carbon-11 and a high non-specific liver uptake of [11C]metomidate there is a need for improved adrenal imaging methods. In a previous pre-clinical study para-chloro-2-[18F]fluoroethyletomidate has been proven to be a specific adrenal tracer. The objective is to perform a first evaluation of para-chloro-2-[18F]fluoroethyletomidate positron emission computed tomography ([18F]CETO-PET/CT) in patients with adrenal tumours and healthy volunteers.

Methods

Fifteen patients underwent [18F]CETO-PET/CT. Five healthy volunteers were recruited for test-retest analysis and three out of the five underwent additional [15O]water PET/CT to measure adrenal blood flow. Arterial blood sampling and tracer metabolite analysis was performed. The kinetics of [18F]CETO were assessed and simplified quantitative methods were validated by comparison to outcome measures of tracer kinetic analysis.

Results

Uptake of [18F]CETO was low in the liver and high in adrenals. Initial metabolization was rapid, followed by a plateau. The kinetics of [18F]CETO in healthy adrenals and all adrenal pathologies, except for adrenocortical carcinoma, were best described by an irreversible single-tissue compartment model. Standardized uptake values (SUV) correlated well with the uptake rate constant K1. Both K1 and SUV were highly correlated to adrenal blood flow in healthy controls. Repeatability coefficients of K1, SUV65–70, and SUV120 were 25, 22, and 17%.

Conclusions

High adrenal uptake combined with a low unspecific liver uptake suggests that 18F]CETO is a suitable tracer for adrenal imaging. Adrenal SUV, based on a whole-body scan at 1 h p.i., correlated well with the net uptake rate Ki.

Trial registration

ClinicalTrials.​gov, NCT05361083 Retrospectively registered 29 April 2022. at, https://​clinicaltrials.​gov/​ct2/​show/​NCT05361083
Appendix
Available only for authorised users
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Metadata
Title
First-in-human evaluation of [18F]CETO: a novel tracer for adrenocortical tumours
Authors
Isabella Silins
Anders Sundin
Mark Lubberink
Lleah O’Sullivan
Mark Gurnell
Franklin Aigbirhio
Morris Brown
Anders Wall
Tobias Åkerström
Sara Roslin
Per Hellman
Gunnar Antoni
Publication date
08-09-2022
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 2/2023
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-022-05957-9

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