• Shivashankar Khanapur, Aren van Waarde, Rudi A J O Dierckx, Philip H Elsinga, and Michel J B Koole.
• Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; and.
• J. Nucl. Med. 2017 Mar 1; 58 (3): 466-472.

AbstractThe cerebral adenosine A2A receptor is an attractive therapeutic target for neuropsychiatric disorders. 18F-fluoroethyl and 18F-fluoropropyl analogs of 18F-labeled pyrazolo[4,3-e]-1,2,4-triazolo[1,5-c]pyrimidine (SCH442416) (18F-FESCH and 18F-FPSCH, respectively) were developed as A2A receptor-specific PET ligands. Our aim was to determine an appropriate compartmental model for tracer kinetics, evaluate a reference tissue approach, and select the most suitable PET ligand. Methods: A 90-min dynamic PET scan with arterial blood sampling and metabolite analysis was acquired for 22 healthy male Wistar rats starting at the time of 18F-FESCH (n = 12) and 18F-FPSCH (n = 10) injection. For each tracer, half the animals were vehicle-treated whereas the other half were pretreated with the A2A receptor-selective antagonist KW-6002, inducing full blocking. Regional tissue total volume of distribution (VT) was estimated by 1- and 2-tissue-compartment modeling (1TCM and 2TCM, respectively) and Logan graphical analysis. Midbrain, cerebellum, and hippocampus were evaluated as the reference region by comparing baseline VT with VT under full blocking conditions and comparing striatal nondisplaceable binding potential (BPND) using a simplified reference tissue model (SRTM) with distribution volume ratio minus 1 (DVR - 1) for 60- and 90-min scans. Results: On the basis of the Akaike information criterion, 1TCM and 2TCM were the most appropriate models for 18F-FPSCH (baseline striatal VT, 3.7 ± 1.1) and 18F-FESCH (baseline striatal VT, 5.0 ± 2.0), respectively. Baseline striatal VT did not significantly differ between tracers. After pretreatment, striatal VT was reduced significantly, with no significant decrease in hippocampus, midbrain, or cerebellum VT Baseline striatal SRTM BPND did not differ significantly from DVR - 1 except for 18F-FPSCH when using a 60-min scan and midbrain as the reference region, whereas Bland-Altman analysis found a smaller bias for 18F-FESCH and a 60-min scan. After pretreatment, striatal SRTM BPND did not significantly differ from zero except for 18F-FPSCH when using hippocampus as the reference region. Striatal SRTM BPND using midbrain or cerebellum as the reference region was significantly lower for 18F-FPSCH (range, 1.41-2.62) than for 18F-FESCH (range, 1.64-3.36). Conclusion: Dynamic PET imaging under baseline and blocking conditions determined 18F-FESCH to be the most suitable PET ligand for quantifying A2A receptor expression in the rat brain. Accurate quantification is achieved by a 60-min dynamic PET scan and the use of either cerebellum or midbrain as the reference region.© 2017 by the Society of Nuclear Medicine and Molecular Imaging.

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