Molecular imaging involves the non-invasive investigation of biological processes in vivo at the cellular and molecular level, which can play diverse roles in better understanding and treatment of various diseases. Recently, single domain antigen-binding fragments known as 'nanobodies' were bioengineered and tested for molecular imaging applications. Small molecular size (~15 kDa) and suitable configuration of the complementarity determining regions (CDRs) of nanobodies offer many desirable features suitable for imaging applications, such as rapid targeting and fast blood clearance, high solubility, high stability, easy cloning, modular nature, and the capability of binding to cavities and difficult-to-access antigens. Using nanobody-based probes, several imaging techniques such as radionuclide-based, optical and ultrasound have been employed for visualization of target expression in various disease models. This review summarizes the recent developments in the use of nanobody-based probes for molecular imaging applications. The preclinical data reported to date are quite promising, and it is expected that nanobody-based molecular imaging agents will play an important role in the diagnosis and management of various diseases.

Intrinsically germanium‐69‐labeled super‐paramagnetic iron oxide nanoparticles are synthesized via a newly developed, fast and highly specific chelator‐free approach. The biodistribution pattern and the feasibility of 69Ge‐SPION@PEG for in vivo dual‐modality positron emission tomography/magnetic resonance (PET/MR) imaging and lymph‐node mapping are investigated, which represents the first example of the successful utilization of a 69Ge‐based agent for PET/MR imaging.

The overexpression of integrin αvβ3 has been linked to tumor aggressiveness and metastasis in several cancer types. Because of its high affinity, peptides containing the arginine–glycine–aspartic acid (RGD) motif have been proven valuable vectors for noninvasive imaging of integrin αvβ3 expression and for targeted radionuclide therapy. In this study, we aim to develop a 44Sc-labeled RGD-based peptide for in vivo positron emission tomography (PET) imaging of integrin αvβ3 expression in a preclinical cancer model. High quality 44Sc (t1/2, 3.97 h; β+ branching ratio, 94.3%) was produced inexpensively in a cyclotron, via proton irradiation of natural Ca metal targets, and separated by extraction chromatography. A dimeric cyclic-RGD peptide, (cRGD)2, was conjugated to 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA) and radiolabeled with 44Sc in high yield (>90%) and specific activity (7.4 MBq/nmol). Serial PET imaging of mice bearing U87MG tumor xenografts showed elevated 44Sc-DOTA-(cRGD)2 uptake in the tumor tissue of 3.93 ± 1.19, 3.07 ± 1.17, and 3.00 ± 1.25 %ID/g at 0.5, 2, and 4 h postinjection, respectively (n = 3), which were validated by ex vivo biodistribution experiments. The integrin αvβ3 specificity of the tracer was corroborated, both in vitro and in vivo, by competitive cell binding and receptor blocking assays. These results parallel previously reported studies showing similar tumor targeting and pharmacokinetic profiles for dimeric cRGD peptides labeled with 64Cu or 68Ga. Our findings, together with the advantageous radionuclidic properties of 44Sc, capitalize on the relevance of this isotope as an attractive alternative isotope to more established radiometals for small molecule-based PET imaging, and as imaging surrogate of 47Sc in theranostic applications.

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Yttrium-90 (T(½) 64.1 hours, E(βmax)=2.28 MeV) is a pure β⁻ particle emitting radionuclide with well-established applications in targeted therapy. There are several advantages of ⁹⁰Y as a therapeutic radionuclide. It has a suitable physical half-life (∼64 hours) and decays to a stable daughter product ⁹⁰Zr by emission of high-energy β⁻ particles. Yttrium has a relatively simple chemistry and its suitability for forming complexes with a variety of chelating agents is well established. The ⁹⁰Sr/⁹⁰Y generator is an ideal source for the long-term continuous availability of no-carrier-added ⁹⁰Y suitable for the preparation of radiopharmaceuticals for radionuclide therapy. The parent radionuclide ⁹⁰Sr, which is a long-lived fission product, is available in large quantities from spent fuel. Several useful technologies have been developed for the preparation of ⁹⁰Sr/⁹⁰Y generators. There are several well-established radiopharmaceuticals based on monoclonal antibodies, peptides, and particulates labeled with ⁹⁰Y, that are in regular use for the treatment of some forms of primary cancers and arthritis. At present, there are no generators for the elution of ⁹⁰Y that can be set up in a hospital radiopharmacy. The radionuclide is procured from manufacturers and the radiopharmaceuticals are formulated on site. This article reviews the development of ⁹⁰Sr/⁹⁰Y generator and the development of ⁹⁰Y radiopharmaceuticals.

Scandium-44 (t½ = 3.9 h) is a relatively new radioisotope of potential interest for use in clinical positron emission tomography (PET). Herein, we report for the first time the room temperature radiolabeling of proteins with 44Sc for in vivo PET imaging. For this purpose, the Fab fragment of Cetuximab, a monoclonal antibody that binds with high affinity to epidermal growth factor receptor (EGFR) was generated and conjugated with N-[(R)-2-Amino-3-(p-isothiocyanato-phenyl) propyl]-trans-(S,S)-cyclohexane-1,2-diamine-N,N,N′,N″,N″-pentaacetic acid (CHX-A″-DTPA). The high purity of Cetuximab-Fab was confirmed by SDS-PAGE and mass spectrometry. The potential of the bioconjugate for PET imaging of EGFR expression in human glioblastoma (U87MG) tumor-bearing mice was investigated after 44Sc labeling. PET imaging revealed rapid tumor uptake (maximum uptake of ~12 %ID/g at 4 h post-injection) of 44Sc-CHX-A″-DTPA-Cetuximab-Fab with excellent tumor-to-background ratio, which might allow for same day PET imaging in future clinical studies. Immunofluorescence staining was conducted to correlate tracer uptake in the tumor and normal tissues with EGFR expression. This successful strategy for immunoPET imaging of EGFR expression using 44Sc-CHX-A″-DTPA-Cetuximab-Fab can make clinically translatable advances to select the right population of patients for EGFR-targeted therapy and also monitor the therapeutic efficacy of anti-EGFR treatments.

Positron emission tomography (PET) is an important modality in the field of molecular imaging, which is gradually impacting patient care by providing safe, fast, and reliable techniques that help to alter the course of patient care by revealing invasive, de facto procedures to be unnecessary or rendering them obsolete. Also, PET provides a key connection between the molecular mechanisms involved in the pathophysiology of disease and the according targeted therapies. Recently, PET imaging is also gaining ground in the field of drug delivery. Current drug delivery research is focused on developing novel drug delivery systems with emphasis on precise targeting, accurate dose delivery, and minimal toxicity in order to achieve maximum therapeutic efficacy. At the intersection between PET imaging and controlled drug delivery, interest has grown in combining both these paradigms into clinically effective formulations. PET image-guided drug delivery has great potential to revolutionize patient care by in vivo assessment of drug biodistribution and accumulation at the target site and real-time monitoring of the therapeutic outcome. The expected end point of this approach is to provide fundamental support for the optimization of innovative diagnostic and therapeutic strategies that could contribute to emerging concepts in the field of “personalized medicine”. This review focuses on the recent developments in PET image-guided drug delivery and discusses intriguing opportunities for future development. The preclinical data reported to date are quite promising, and it is evident that such strategies in cancer management hold promise for clinically translatable advances that can positively impact the overall diagnostic and therapeutic processes and result in enhanced quality of life for cancer patients.

Positron emission tomography (PET) imaging has transformed diagnostic nuclear medicine and become an essential strategy in cancer management. With the expected growth of this molecular imaging modality, there is a recognized need for new PET probes to address the clinical challenges in the early diagnosis and staging of various types of cancers. In this endeavor, the prospect of using Cu in the form of simple Cu ions as PET probe is not only a cost-effective proposition but also seems poised to broaden the palette of molecular imaging probes in the foreseeable future. The usefulness of Cu ions as PET probe is based on the fact that Cu is an essential element that plays an important role in cell proliferation and angiogenesis. Over the past few years, there has been continuous flow of evidences based on studies in animal models on the uptake of Cu ions in different types of tumors, including, hepatoma, colorectal cancer, prostate cancer, lung cancer, breast cancer, head and neck cancer, fibrosarcoma, melanoma, glioblastoma, and ovarian cancer. The widespread preclinical success of Cu ions as PET probe has recently resulted in translation of this radiotracer to clinical settings for noninvasive imaging and staging of prostate cancer in human patients. In this concise review, we have focused on the latest developments in PET imaging of cancer in preclinical and clinical settings using Cu ion as a probe and discussed the challenges and opportunities for future development.