This work was supported by the Diagnostic &#38; Research PET/MRI Center, and by the Departments of Biomedical Research and Radiology at Nemours/Alfred I. duPont Hospital for Children.

CAUTION: The protocol involves radioactive materials. Any additional dose of radioactive materials could lead to a proportional increase in the chance of adverse health effects such as cancer. Researchers must follow the &#39;as low as reasonably achievable&#39; (ALARA) dose practices to guide the radiosynthesis protocol with adequate protection in the hot cell or lead hood. Minimizing direct contact time, using a lead shield, and keeping maximum distance for any radiation exposure step in the radiosynthesis process are ...

     

Tryptophan is an essential amino acid for humans. It plays an important role in the regulation of mood, cognitive function, and behavior. Radiolabeled tryptophan derivatives, particularly the carbon-11-labeled [11C]AMT, have been extensively studied due to their unique role in mapping serotonin synthesis38,39, detecting and grading tumors40, guiding epilepsy surgery41,42...

In humans, tryptophan is an essential component of the daily diet. Tryptophan is primarily metabolized via the kynurenine pathway (KP). The KP is catalyzed by two rate-limiting enzymes, indoleamine 2, 3-dioxygenase (IDO) and tryptophan 2, 3-dioxygenase (TDO). More than 95% of tryptophan is converted into kynurenine and its downstream metabolites, ultimately generating nicotinamide adenine dinucleotide, which is essential to cellular energy transduction. The KP is a key regulator of the immune system and an important regulator of neuroplasticity and neurotoxic effects1,2. Abnormal tryptophan metabolism is implicated in various neurologic, oncologic, psychiatric, and metabolic disorders; therefore, radiolabeled tryptophan analogs have been extensively used in clinical investigation. The two most common clinically investigated tryptophan radiotracers are 11C-&#945;-methyl-L-tryptophan ([11C]AMT) and 11C-5-hydroxytryptophan (11C-5-HTP)3.
In the 1990s, 11C-5-HTP was used to visualize serotonin-secreting neuroendocrine tumors4 and to diagnose and monitor therapy of metastatic hormone-refractory prostatic adenocarcinoma5. Later, it was used as an imaging tool for the quantification of the serotonergic system in the endocrine pancreas6. 11C-5-HTP has also been a promising tracer for noninvasive detection of viable islets in intraportal islet transplantation and type 2 diabetes7,8. Over the past two decades, many radiolabeled amino acids have advanced to clinical investigation9,10. In particular, the carbon-11-labeled tryptophan analog [11C]AMT has received extensive attention for mapping brain serotonin synthesis11,12,13,14 and for localizing epileptic foci, epileptogenic tumors, tuberous sclerosis complex, gliomas, and breast cancers15,16,17,18,19,20,21,22,23,24,25,26. [11C]AMT also has high uptake in various low- and high-grade tumors in children27. Furthermore, kinetic tracer analysis of [11C]AMT in human subjects has been used to differentiate and grade various tumors and differentiate glioma from radiation-induced tissue injury15. [11C]AMT-guided imaging shows significant clinical benefits in brain disorders3,25. However, due to the short half-life of carbon-11 (20 min) and the laborious radiosynthesis procedures, [11C]AMT use is restricted to the few PET centers with an onsite cyclotron and a radiochemistry facility.
Fluorine-18 has a favorable half-life of 109.8 min, compared with the 20 min half-life of carbon-11. Increasingly, efforts have been focused on the development of fluorine-18-labeled radiotracers for tryptophan metabolism3,28. A total of 15 unique fluorine-18 radiolabeled tryptophan radiotracers have been reported in terms of radiolabeling, transport mechanisms, in vitro and in vivo stability, biodistribution, and tumor uptake in xenografts. However, rapid in vivo defluorination was observed for several tracers, including 4-, 5-, and 6-[18F]fluorotryptophan, precluding further clinical translation29. 5-[18F]Fluoro-&#945;-methyltryptophan (5-[18F]FAMT) and 1-(2-[18F]fluoroethyl)-L-tryptophan (L-[18F]FETrp, also known as (S)-2-amino-3-(1-(2-[18F]fluoroethyl)-1H-indol-3-yl)propanoic acid, molecular weight 249.28 g/mole), are the two most promising radiotracers with favorable in vivo kinetics in animal models and great potential to surpass [11C]AMT for the evaluation of clinical conditions with deregulated tryptophan metabolism28. 5-[18F]FAMT showed high uptake in IDO1-positive tumor xenografts of immunocompromised mice and is more specific to imaging the KP than [11C]AMT28,30. However, the in vivo stability of 5-[18F]FAMT remains a potential concern as no in vivo defluorination data have been reported beyond 30 min post injection of the tracer30.
A preclinical study in a genetically engineered medulloblastoma mouse model showed that when compared with 18F-fluorodeoxyglucose (18F-FDG), L-[18F]FETrp had high accumulation in brain tumors, negligible in vivo defluorination, and low background uptake, demonstrating a superior target-to-nontarget ratio31,32. Radiation dosimetry studies in mice indicated that L-[18F]FETrp had an approximately 20% lower favorable dosimetry exposure than the clinical 18F-FDG PET tracer33. In agreement with other researchers&#39; findings, preclinical study data provide substantial evidence to support the clinical translation of L-[18F]FETrp for the investigation of abnormal tryptophan metabolism in humans with brain disorders such as epilepsy, neuro-oncology, autism, and tuberous sclerosis28,31,32,33,34,35,36. An overall comparison between the three most widely investigated tracers for tryptophan metabolism, 11C-5-HTP, [11C]AMT, and L-[18F]FETrp, is shown in Table 1. Both 11C-5-HTP and [11C]AMT have a short half-life and laborious radiolabeling procedures. A protocol for the radiosynthesis of L-[18F]FETrp using a one-pot, two-step approach is described here. The protocol features the use of a small amount of radiolabeling precursor, a small volume of reaction solvents, low loading of toxic K222, and an environmentally benign and injectable mobile phase for purification and easy formulation.

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>[18F]Fluoride in [18O]H2O</td>
			<td>PETNET Solutions Inc.</td>
			<td>N/A</td>
			<td></td>
		</tr>
		<tr>
			<td>4,7,13,16,21,24-hexaoxa-1,10-diazabicyclo[8.8.8]hexacosane</td>
			<td>ACROS</td>
			<td>291950010</td>
			<td>Kryptofix 222 or K222, 98%</td>
		</tr>
		<tr>
			<td>Acetic acid</td>
			<td>ACROS</td>
			<td>222142500</td>
			<td>99.8%</td>
		</tr>
		<tr>
			<td>Acetonitrile</td>
			<td>Sigma-Aldrich</td>
			<td>271004</td>
			<td>anhydrous, 99.8%</td>
		</tr>
		<tr>
			<td>Agilent 1260 HPLC system</td>
			<td>Agilent Technologies</td>
			<td>Agilent 1260</td>
			<td>Agilent 1260 series</td>
		</tr>
		<tr>
			<td>Analytcial chiral HPLC column</td>
			<td>Sigma-Aldrich</td>
			<td>12024AST</td>
			<td>Astec CHIROBIOTIC T, 25 cm &#215; 4.6 mm</td>
		</tr>
		<tr>
			<td>Carbon dioxide, 60 LBS</td>
			<td>Airgas</td>
			<td>REFR744R200S</td>
			<td>99.99%</td>
		</tr>
		<tr>
			<td>D-FETrp standard reference</td>
			<td>Affinity Research Chemicals Inc</td>
			<td>N/A</td>
			<td>Custom synthesis</td>
		</tr>
		<tr>
			<td>Empty sterile vial</td>
			<td>Jubilant HollisterStier</td>
			<td>7515</td>
			<td>20 mm closure, 10 mL</td>
		</tr>
		<tr>
			<td>Ethanol</td>
			<td>Decon Labs</td>
			<td>2716</td>
			<td>200 proof, USP grade. &#8805;99.9%</td>
		</tr>
		<tr>
			<td>Fisherbrand 13 mm Syringe Filter, 0.22 &#181;m, PVDF, sterile</td>
			<td>Fisher Scientific</td>
			<td>09-720-3</td>
			<td></td>
		</tr>
		<tr>
			<td>Hydrochloric acid</td>
			<td>Sigma-Aldrich</td>
			<td>30721</td>
			<td>&#8805;37%</td>
		</tr>
		<tr>
			<td>Isopropanol</td>
			<td>Decon Labs</td>
			<td>8316</td>
			<td>70%, sterile</td>
		</tr>
		<tr>
			<td>L-[18F]FETrp radiolabeling precursor</td>
			<td>Affinity Research Chemicals Inc</td>
			<td>N/A</td>
			<td>Custom synthesis</td>
		</tr>
		<tr>
			<td>L-FETrp standard reference</td>
			<td>Affinity Research Chemicals Inc</td>
			<td>N/A</td>
			<td>Custom synthesis</td>
		</tr>
		<tr>
			<td>Light C8 cartridge</td>
			<td>Waters</td>
			<td>WAT036770</td>
			<td>Sep-Pak&#160; C8 plus light cartridge</td>
		</tr>
		<tr>
			<td>Needle, 20 G x 1</td>
			<td>Becton-Dickinson &#38; Co.</td>
			<td>305175</td>
			<td></td>
		</tr>
		<tr>
			<td>Needle, 20 G x 1 &#189;</td>
			<td>Becton-Dickinson &#38; Co.</td>
			<td>305176</td>
			<td></td>
		</tr>
		<tr>
			<td>Needle, 21 G x 2</td>
			<td>Becton-Dickinson &#38; Co.</td>
			<td>305129</td>
			<td></td>
		</tr>
		<tr>
			<td>Neutral aluminum oxide</td>
			<td>Waters</td>
			<td>WAT023561</td>
			<td>Sep-Pak alumina N plus light</td>
		</tr>
		<tr>
			<td>Nylon membrane (0.20 &#181;m )</td>
			<td>MilliPore</td>
			<td>GNWP04700</td>
			<td>47 mm</td>
		</tr>
		<tr>
			<td>Pall Acrodisc 25 mm syringe sterile filter</td>
			<td>Pall Corporation</td>
			<td>4907</td>
			<td></td>
		</tr>
		<tr>
			<td>PETCHEM radiochemistry synthesis system</td>
			<td>PETCHEM Solutions Inc. Pinckney, MI</td>
			<td>N/A</td>
			<td>Radiosynthesizer</td>
		</tr>
		<tr>
			<td>pH strips 2.0 - 9.0</td>
			<td>EMD Millipore</td>
			<td>1.09584.0001</td>
			<td></td>
		</tr>
		<tr>
			<td>Potassium carbonate</td>
			<td>Sigma-Aldrich</td>
			<td>367877</td>
			<td>99.995%</td>
		</tr>
		<tr>
			<td>Quaternary methylammonium light cartridge</td>
			<td>Waters</td>
			<td>186004051</td>
			<td>Sep-Pak QMA light</td>
		</tr>
		<tr>
			<td>Semi-preparative C18 HPLC column</td>
			<td>Phenomenex</td>
			<td>00D-4253-N0</td>
			<td>100 &#215; 10 mm</td>
		</tr>
		<tr>
			<td>Semi-preparative chiral HPLC column</td>
			<td>Sigma-Aldrich</td>
			<td>12034AST</td>
			<td>Astec CHIROBIOTIC T, 25 cm &#215; 10 mm</td>
		</tr>
		<tr>
			<td>Sodium chloride injection 23.4%</td>
			<td>APP Pharmaceutical, LLC</td>
			<td>18730</td>
			<td>USP grade</td>
		</tr>
		<tr>
			<td>Sodium chloridei injection 0.9%</td>
			<td>Hospira</td>
			<td>NDC 0409-4888-10</td>
			<td>USP grade</td>
		</tr>
		<tr>
			<td>Sodium hydroxide</td>
			<td>Honeywell</td>
			<td>306576</td>
			<td>99.99%</td>
		</tr>
		<tr>
			<td>Spinal needle, 20 G x 3 &#189;</td>
			<td>Becton-Dickinson &#38; Co.</td>
			<td>405182</td>
			<td></td>
		</tr>
		<tr>
			<td>Sterile alcohol prep pads</td>
			<td>BioMed Resource Inc.</td>
			<td>PC661</td>
			<td></td>
		</tr>
		<tr>
			<td>Sterile empty vials, 2 mL</td>
			<td>Hollister Stier</td>
			<td>7505ZA</td>
			<td>13 mm closure</td>
		</tr>
		<tr>
			<td>Sterile empty vials, 30 mL</td>
			<td>Jubilant HollisterStier</td>
			<td>7520ZA</td>
			<td>20 mm closure</td>
		</tr>
		<tr>
			<td>Syringe PP/PE, 3 mL, Luer Lock</td>
			<td>Air-Tite</td>
			<td>4020-X00V0</td>
			<td></td>
		</tr>
		<tr>
			<td>Syringe PP/PE, 5 mL, Luer Lock</td>
			<td>Becton-Dickinson &#38; Co.</td>
			<td>309646</td>
			<td></td>
		</tr>
		<tr>
			<td>Syringe,&#160; PP/PE, 10 mL, NORM-JECT</td>
			<td>Air-Tite</td>
			<td>4100-000V0</td>
			<td></td>
		</tr>
		<tr>
			<td>Syringe, 1 mL, Luer Slip</td>
			<td>Becton-Dickinson &#38; Co.</td>
			<td>309659</td>
			<td></td>
		</tr>
		<tr>
			<td>Syringe, 3 mL, Luer-Lock</td>
			<td>Becton-Dickinson &#38; Co.</td>
			<td>309657</td>
			<td></td>
		</tr>
		<tr>
			<td>Ultra high purity argon</td>
			<td>Airgas</td>
			<td>AR UHP300</td>
			<td>99.999%</td>
		</tr>
		<tr>
			<td>Ultrapure water</td>
			<td>MilliporeSigma</td>
			<td>ZRQSVP300</td>
			<td>Direct-Q 3 tap to pure and ultrapure water purification system</td>
		</tr>
	</tbody>
</table>

radiosynthesis of 1-(2-[18f]fluoroethyl)-l-tryptophan using a one-pot, two-step protocol

The kynurenine pathway (KP) is a primary route for tryptophan metabolism. Evidence strongly suggests that metabolites of the KP play a vital role in tumor proliferation, epilepsy, neurodegenerative diseases, and psychiatric illnesses due to their immune-modulatory, neuro-modulatory, and neurotoxic effects. The most extensively used positron emission tomography (PET) agent for mapping tryptophan metabolism, &#945;-[11C]methyl-L-tryptophan ([11C]AMT), has a short half-life of 20 min with laborious radiosynthesis procedures. An onsite cyclotron is required to radiosynthesize [11C]AMT. Only a limited number of centers produce [11C]AMT for preclinical studies and clinical investigations. Hence, the development of an alternative imaging agent that has a longer half-life, favorable in vivo kinetics, and is easy to automate is urgently needed. The utility and value of 1-(2-[18F]fluoroethyl)-L-tryptophan, a fluorine-18-labeled tryptophan analog, has been reported in preclinical applications in cell line-derived xenografts, patient-derived xenografts, and transgenic tumor models.
This paper presents a protocol for the radiosynthesis of 1-(2-[18F]fluoroethyl)-L-tryptophan using a one-pot, two-step strategy. Using this protocol, the radiotracer can be produced in a 20 &#177; 5% (decay corrected at the end of synthesis, n &#62; 20) radiochemical yield, with both radiochemical purity and enantiomeric excess of over 95%. The protocol features a small precursor amount with no more than 0.5 mL of reaction solvent in each step, low loading of potentially toxic 4,7,13,16,21,24-hexaoxa-1,10-diazabicyclo[8.8.8]hexacosane (K222), and an environmentally benign and injectable mobile phase for purification. The protocol can be easily configured to produce 1-(2-[18F]fluoroethyl)-L-tryptophan for clinical investigation in a commercially available module.

The reaction scheme is shown in Figure 1. The radiolabeling includes the following two steps: 1) reaction of the tosylate radiolabeling precursor with [18F]fluoride provides the 18F-labeled intermediate, and 2) deprotection of the tert-butyloxycarbonyl and tert-butyl-protecting groups in the intermediate affords the final product L-[18F]FETrp. Both reaction steps continue at 100 &#176;C for 10 min.
Before receivin...

Watch this Scientific Journal Video about Radiosynthesis of 1-2-[18F]Fluoroethyl-L-Tryptophan using a One-pot, Two-step Protocol at JoVE.com

Radiosynthesis of 1-2-[18F]Fluoroethyl-L-Tryptophan using a One-pot, Two-step Protocol

Here, we describe the radiosynthesis of 1-(2-[18F]Fluoroethyl)-L-tryptophan, a positron emission tomography imaging agent for studying tryptophan metabolism, using a one-pot, two-step strategy in a radiochemistry synthesis system with good radiochemical yields, high enantiomeric excess, and high reliability.

Radiosynthesis of 1-(2-[18F]Fluoroethyl)-L-Tryptophan using a One-pot, Two-step Protocol

The kynurenine pathway (KP) is a primary route for tryptophan metabolism. Evidence strongly suggests that metabolites of the KP play a vital role in tumor ...

The overall goal of this protocol is to radiosynthesize an F18 radiolabeled tryptophan tracer by a one-pot, two-step approach. The radiotracer may find widespread application for imaging tryptophan metabolism. The technique uses the radioisotope with a longer half-life, less reaction precursor, and less reaction volume, and an environmentally benign phase for purification.The radiotracer may be used for diagnosis of various disorders affecting the brain, including but not limited to epilepsy, neuropsychiatric disorders, and neuro-oncology. This method can be applied to other commercially available radiolabeling modules. Once the F18 fluoride solution is received, begin by surveying the lead box on the surface, and from the distance of one meter, record the maximum radiation exposure rates.After performing a wipe test to ensure the shipping box is not contaminated, record the F18 fluoride dose and time. Transfer the F18 fluoride solution to the radiochemistry synthesis system. Connect the argon line with a short needle and the F18 fluoride transfer line with a long needle to the F18 fluoride vial.Then, close the hot cell glass door and lead door. Turn on the argon supply line by clicking Argon Supply. Increase the argon pressure and turn on the F18 fluoride pushing line to push the aqueous F18 fluoride through the QMA light cartridge.Once all the radioactivity is trapped in the QMA light cartridge, and the radioactivity detector reading is steady, increase the argon pressure and blow argon through the cartridge for another five minutes to remove excess water. After turning off the F18 fluoride pushing line, decrease the argon pressure to zero and switch the six-port two-position valve from the F18 fluoride trapping position to the elution position. Open the reaction vial, turn on the input MVP position one argon line, and push the K222 and potassium carbonate solution into the input MVP position one vial through the QMA light cartridge to elute out the radioactivity into the reaction vial.Switch the F18 fluoride elution position to the trapping position. Click the Heat button to heat the reactor at 110 degrees Celsius, turn on the output MVP position-four argon line that connects to the reactor, and evaporate the solvent into the output MVP position four vial. Click the Cool button to cool down the reactor to room temperature with compressed carbon dioxide.Turn off the sweeping line, switch the input MVP position one to position two, and add the anhydrous acetonitrile in the vial two. Two turn on the sweeping line and heater to azeotropically dry F18 fluoride at 110 degrees Celsius. Once the reactor reaches room temperature, turn off the sweeping line, switch the input MVP position two to position three, and add the tosylate radiolabeling precursor in the vial three.Close the reactor and heat the reaction mixtures at 100 degree Celsius for 10 minutes. To evaporate the reaction solvent, once the reactor cools down, turn on the sweeping line and evaporate the reaction solvent at 100 degree Celsius. Once the reactor cools down, turn off the sweeping line and switch the input MVP position three to position four.When the hydrochloric acid acetonitrile mixture is added, heat the reaction at 100 degree Celsius for 10 minutes to de-protect the tert-butyl and tert-butyloxycarbonyl protecting groups in the radiolabeling precursor. To neutralize the reaction, when the reactor reaches room temperature, switch the input MVP position four to position five and add two molar sodium hydroxide to the reaction mixture and turn off the input MVP argon line. Next, start transferring the reaction mixture to the intermediate file by clicking the F button in the output MVP to switch the output MVP from the venting position four to position five, and then by clicking the F button in the input MVP to switch the input MVP from position five to position six.After turning on the output MVP argon line, push the reaction mixture through the stacked neutral aluminum oxide and C8 cartridges to the intermediate vial installed before the HPLC sample loop. For rinsing the reactor, switch the output MVP position five to position six, push the rinse solution in the vial of output MVP position six through the reaction vial, cartridges, and the intermediate vial, successively. Next, begin purification of the mixture by switching the HPLC loop from injection position to load position and turning on the input MVP argon line.When the mixture is loaded to the five milliliter HPLC loop, switch the Load button to Inject, click Inject HPLC to start the HPLC chromatogram at a flow rate of three milliliters per minute, and then click the HPLC Monitor button to access the real-time HPLC chromatogram. Click the Diversion MVP button to divert the target HPLC fraction to the short C18 column at approximately 12 minutes. After the target radioactivity is collected in the C18 column, switch the four-port two-position diversion valve to the waste collection position, and flush the chiral column at the rate of four milliliters per minute for six minutes to remove the minor D F18 FETrp enantiomer and other ultraviolet impurities.Click the Diversion MVP button to divert the HPLC mobile phase back to the formulation MVP position one at three milliliters per minute. Observe that the mobile phase passes through the chiral column and C18 column to purify L-F18 FETrp retained in the C18 column. At approximately 32 to 34 minutes, collect the target fraction into the formulation MVP position two vial.Then push the formulation MVP position two vial solution through the delivery line and sterile filter into the final dose vial. Assay the final dose activity and volume after removing the sterile filter. Flush the system with ultra pure water followed by ethanol at a flow rate of four milliliters per minute for at least 15 minutes per wash.Turn off the HPLC pump and PLC box, close the program, shut down the compressed airline, argon line, carbon dioxide line, and the main power of the module. Withdraw approximately 0.1 milliliters of the final dose into a 0.2-milliliter insert of a QC vial. Run the hot sample as the partial sequence program is described in the text manuscript.Analyze the QC data by calculating the chemical and radiochemical purities in enantiomeric excess value and molar activity. After determining the pH value, release the dose if all testing results pass the acceptable range. The representative HPLC chromatograms for QC are shown.The insignificant peaks between the void volume in 10 minutes of the program were detected in the blank chromatogram. The non-radiolabeled standard reference L-fluoroethyl-trytophan showed the presence of a single isomer separated well from the standard reference of its D counterpart. The final dose of L-F18 tryptophan showed high chemical purity and radiochemical purity.The stability testing of the final product at the highest dose concentration for up to eight hours showed that L-F18 tryptophan was stable in terms of chemical purity, radiochemical purity, enantiomeric excess, and pH value. The chemical and radiochemical purities greater than 95%were achieved using this protocol. Two columns are used for tracer purification.Do remember to switch to the C18 column to remove the chemical impurities. We can quickly adapt this method to clinical production of the fluorine-18-labeled tryptophan radiotracer.