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An efficient and aseptic preparation of “sodium fluoride (18F) injection” in a GMP compliant facility

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Abstract

Introduction

“Sodium fluoride (18F) injection” is an isotonic NaCl solution containing [18F]NaF to be used as bone imaging agent. Although its NDA was approved by the US FDA in 1972, it has not been commercially available since 1975 due to mostly the popularity of 99mTc-MDP. Recently, advances in PET/CT technology and the often interrupted 99mTc supply have led to the renewed interest in the use of [18F]NaF to detect bone metastases in cancer patients. This report introduces an efficient, low-cost and aseptic preparation of “Sodium fluoride (18F) injection” for PET scan.

Method

18F-Fluoride in target water from cyclotron was adsorbed onto four different forms of anion-exchange resins then desorbed by isotonic NaCl solution into the product vial. One of the resins that yielded the product at the suitable pH was used for the aseptic preparation. The components for this setup, including stopcocks, extension tubes, etc., were all single-use, individually packed and sterile. The process was done in a lead-line isolator maintained in grade A (PIC/S) aseptic condition. The quality of the obtained “Sodium fluoride (18F) injection” was analyzed according to its monograph in the European Pharmacopoeia (EP).

Results

The resin in the chloride form yielded the product of pH 6.7 and was chosen for the subsequent preparation. The radiochemical yield was quantitative. The product met all criteria specified in EP, including biological, physical and chemical specifications.

Conclusions

This method is an efficient, space-saving and extremely low-cost operation that easily performed in an aseptic environment meeting GMP standard. The quality of the “Sodium fluoride (18F) injection” so yielded meets EP specifications. This setup provides hospital with facility meeting GMP standard a cost effective and efficient method for “Sodium fluoride (18F) injection” production without the need for the expensive automatic module and extra QC instrument.

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References

  1. Council of Europe. Radiopharmaceutical preparations: sodium fluoride (18F) injection. In: European Pharmacopoeia. 6th ed. 2008. p. 1008–9.

  2. United States Pharmacopeial Convention. Monographs: sodium fluoride F 18 Injection. In: USP31/NF26, vol. 2; 2008. p. 2195.

  3. Schirrmeister H, Guhlmann A, Elsner K, Kotzerke J, Glatting G, Rentschler M, et al. Sensitivity in detecting osseous lesions depends on anatomic localization: planar bone scintigraphy versus 18F PET. J Nucl Med. 1999;40:1623–9.

    CAS  PubMed  Google Scholar 

  4. Schirrmeister H, Guhlmann A, Kotzerke J, Santjohanser C, Kühn T, Kreienberg R, et al. Early detection and accurate description of extent of metastatic bone disease in breast cancer with fluoride ion and positron emission tomography. J Clin Oncol. 1999;17:2381–9.

    CAS  PubMed  Google Scholar 

  5. Schirrmeister H, Glatting G, Hetzel J, Nüssle K, Arslandemir C, Buck AK, et al. Prospective evaluation of the clinical value of planar bone scans, SPECT, and (18)F-labeled NaF PET in newly diagnosed lung cancer. J Nucl Med. 2001;42:1800–4.

    CAS  PubMed  Google Scholar 

  6. Hetzel M, Arslandemir C, König HH, Buck AK, Nüssle K, Glatting G, et al. F-18 NaF PET for detection of bone metastases in lung cancer: accuracy, cost-effectiveness, and impact on patient management. J Bone Miner Res. 2003;18:2206–14.

    Article  PubMed  Google Scholar 

  7. Even-Sapir E, Metser U, Flusser G, Zuriel L, Kollender Y, Lerman H, et al. Assessment of malignant skeletal disease: initial experience with 18F-fluoride PET/CT and comparison between 18F-fluoride PET and 8F-fluorid PET/CT. J Nucl Med. 2004;45:272–8.

    PubMed  Google Scholar 

  8. National Research Council. Molybdenum-99/Technetium-99m Supply Reliability. In: Medical isotope production without highly enriched uranium. Washington D.C.: The National Academies Press; 2009. p. 55–65.

  9. National Research Council. Medical isotope production without highly enriched uranium. Washington D.C.: The National Academies Press; 2009.

  10. Food and Drug Administration Center for Drug Evaluation and Research. Guidance: PET drug products—current good manufacturing practice (CGMP). In: Guidances (Drugs)/current good manufacturing practices (CGMPs). United States Department of Health and Human Services, 2005. http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/ucm070306.pdf. Accessed 30 Oct 2009.

  11. European Commission Enterprise and Industry, Vol 4: EU guidelines to good manufacturing practice: medicinal products for human and veterinary use; Annex 3: manufacture of radiopharmaceuticals. In: EudraLex, the rules governing medicinal products in the European Union. European Commission, 2008. http://ec.europa.eu/enterprise/pharmaceuticals/eudralex/vol-4/2008_09_annex3.pdf. Accessed 4 Nov 2009.

  12. Pharmaceutical Inspection Cooperation Scheme. Annex 1: manufacture of sterile medicinal products. In: PE 009-9 (Annexes) Guide to good manufacturing practice for medicinal products, Annexes. Pharmaceutical Inspection Convention, 2009. http://www.picscheme.org/publication.php?id=4. Accessed 4 Nov 2009.

  13. Mazza SM, Yoshizumi T. 48V radionuclide impurity in product streams from liquid cyclotron targets with titanium windows. Nucl Med Biol. 1994;21:677–9.

    Article  CAS  PubMed  Google Scholar 

  14. Lee SJ, Oh SJ, Chi DY, Kil HS, Kim EN, Ryu JS, et al. Simple and highly efficient synthesis of 3′-deoxy-3′-[18F]fluorothymidine using nucleophilic fluorination catalyzed by protic solvent. Eur J Nucl Med Mol Imaging. 2007;34:1406–9.

    Article  CAS  PubMed  Google Scholar 

  15. United States Pharmacopeial Convention. Reagents, indicators, and solutions: chromatographic reagents. In: USP31/NF26, vol. 1; 2008. p. 810–2.

  16. Hockley BG, Scott PJH. An automated method for preparation of [18F]sodium fluoride for injection, USP to address the technetium-99m isotope shortage. Appl Radiat Isotopes. 2009. doi:10.1016/j.apradiso.2009.08.012.

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Acknowledgments

This study was partially funded by Grant TCRD99-14 from Buddhist Tzu Chi General Hospital and by grant TCCT-981A13 from Tzu Chi College of Technology. The authors thank the Taiwanese Society of Medical Cyclotron for its effort in encouraging the clinical use of 18F-sodium fluoride and promoting the practice of latest GMP for PET drug production.

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Correspondence to Chih-Hao K. Kao.

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Kao, CH.K., Hsu, WL., Kao, PF. et al. An efficient and aseptic preparation of “sodium fluoride (18F) injection” in a GMP compliant facility. Ann Nucl Med 24, 149–155 (2010). https://doi.org/10.1007/s12149-010-0343-4

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  • DOI: https://doi.org/10.1007/s12149-010-0343-4

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