Comparison of two 18F-fluorinated glycopeptides for PET imaging of the functional liver mass

04.04.2026

Zierke MA, Hofer K, Samadikhah K, Rangger C, Wängler C, Wängler B, Junker A, Schmid AM, Haubner R (2026) Comparison of two 18F-Fluorinated Glycopeptides for PET Imaging of the Functional Liver Mass. EJNMMI Radiopharmacy and Chemistry, 11(1), 35.
DOI10.1186/s41181-026-00445-z.

Abstract

Background: The non-invasive determination of the asialoglycoprotein receptor (ASGR) expression on liver tissue might be a predictive parameter helping to prevent severe liver diseases as well as liver failure after surgery and transplantation. Recently, we introduced [68Ga]Ga-NODAGA-NonaLysan, which showed even a higher liver uptake as the gold standard [99mTc]Tc-Galactosyl Serum Albumin. Here we describe the synthesis and evaluation of two 18F-labeled analogues, prepared using either a SiFA- or an AlF-labeling approach.

Results: The two precursors could be produced in high purity (> 97%). Both labeling strategies allowed production of the radiopharmaceuticals in high radiochemical purity. The radiochemical yield was up to 58% d.c. for [18F]SiFA-NonaLysan and up to 71% d.c. for Al[18F]F-NOTA-6-Ahx-NonaLysan. In vitro evaluation showed high stability in PBS and human serum. Both compounds possessed nanomolar affinity for the ASGR (IC50 = 0.9 ± 1.1 nM and 3.0 ± 2.1 nM, respectively). However, based on the design differences, Al[18F]F-NOTA-6-Ahx-NonaLysan showed a 100-fold lower logD as found for [18F]SiFA-NonaLysan. In consequence, the protein binding effect was higher for [18F]SiFA-NonaLysan, and the lipophilic character drastically affected the pharmacokinetic pattern. Initial liver uptake was higher for [18F]SiFA-NonaLysan (100% ID/g vs. 70% ID/g 10 min p.i.), but was accompanied by a quick organ washout and activity accumulation in the intestines. A much better activity retention was observed for Al[18F]F-NOTA-6-Ahx-NonaLysan. PET/MR imaging confirmed the differences in liver uptake, with a higher retention found for the latter. Based on the receptor function, both compounds are internalized and subsequently degraded. For Al[18F]F-NOTA-6-Ahx-NonaLysan, all radioactive liver metabolites found were more hydrophilic than the intact compound. For [18F]SiFA-NonaLysan, the contrary is the case, and almost all liver metabolites were more lipophilic. The hepatobiliary excretion of these metabolites prevents a stable activity retention in the hepatic tissue.

Conclusion: In this study, we successfully synthesized two new 18F-labeled radiopharmaceuticals targeting the ASGR. The in vivo evaluation revealed two different pharmacokinetic profiles. Extremely high uptake was found for [18F]SiFA-NonaLysan in the initial phase, followed by a quick organ washout. Al[18F]F-NOTA-6-Ahx-NonaLysan showed a lower but more stable activity retention in the liver, indicating advantageous imaging properties.

Keywords
Aluminum fluoride; Asialoglycoprotein receptor; Fluorine-18; Positron emission tomography; Silicon-fluoride acceptor.