Sc is a promising positron emission tomography (PET) radionuclide (T = 4.04 hours, E = 632 keV) and can be made available, using a cyclotron production route, in substantial quantities as a highly pure product. Herein, the authors report on a first-in-human PET/CT study using Sc-DOTATOC prepared with cyclotron-produced Sc. The production of Sc was carried out through the Ca(p,n)Sc nuclear reaction at Paul Scherrer Institut, Switzerland. After separation, Sc was shipped to Zentralklinik Bad Berka, Germany, where radiolabeling was performed, yielding radiochemically pure Sc-DOTATOC. Two patients, currently followed up after peptide receptor radionuclide therapy of metastatic neuroendocrine neoplasms, participated in this proof-of-concept study. Blood sampling was performed before and after application of Sc-DOTATOC. PET/CT acquisitions, performed at different time points after injection of Sc-DOTATOC, allowed detection of even very small lesions on delayed scans. No clinical adverse effects were observed and the laboratory hematological, renal, and hepatic profiles remained unchanged. In this study, cyclotron-produced Sc was used in the clinic for the first time. It is attractive for theranostic application with Lu, Y, or Sc as therapeutic counterparts. Sc-based radiopharmaceuticals will be of particular value for PET facilities without radiopharmacy, to which they can be shipped from a centralized production site.
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