Abstract
PurposeThe remarkable amount of preclinical data achieved on 89Zr-PET imaging led to a significant clinical translation, concerning mainly immuno-PET applications. The aim of this systematic review is to provide a complete overview on clinical applications of 89Zr-PET imaging, using a systematic approach to identify and collect published studies performed in humans, sorted by field of application and specific disease subsections.MethodsA systematic literature search of articles suiting the inclusion criteria was conducted on Pubmed, Scopus, Central, and Web Of Science databases, including papers published from January 1967 to November 2020. Eligible studies had to be performed on humans through PET imaging with 89Zr-labeled compounds. The methodological quality was assessed through the Quality Assessment of Diagnostic accuracy Studies-2 tool.ResultsA total of 821 articles were screened. 74 studies performed on humans were assessed for eligibility with the exclusion of further 18, thus 56 articles were ultimately selected for the qualitative analysis.Conclusions89Zr has shown to be a powerful PET-imaging tool, in particular for radiolabeling antibodies in order to study antigen expression, biodistribution, anticancer treatment planning and follow-up. Other than oncologic applications, 89Zr-radiolabeled antibodies have been proposed for use in inflammatory and autoimmune disorders with interesting results. 89Zr-labeled nanoparticles represent groundbreaking radiopharmaceuticals with potential huge fields of application. To evaluate the clinical usefulness of 89Zr PET-imaging in different conditions and in real-world settings, and to widen its use in clinical practice, further translation of preclinical to clinical data is needed.
Highlights
Among the large and still growing number of valuable radiotracers developed for positron emission tomography (PET) applications in precision medicine, the emerging radiometal Zirconium-89 (89Zr) has recently shown great potential in various fields of application
From the overall group of 821, 437 articles concerning preclinical studies, four studies performed on phantoms, 79 studies focusing on 89Zr production and/or radiolabeling chemistry, as well as 68 reviews, 141 articles not satisfying the inclusion criteria and 18 articles not in English language were excluded
Breast cancer As treatment options with targeting agents such as trastuzumab, pertuzumab and trastuzumab-emtansine for patients with metastatic breast cancer are largely dependent upon the presence of human epidermal growth factor receptor 2 (HER2), the development of non-invasive imaging techniques for the assessment of HER2 status has
Summary
Among the large and still growing number of valuable radiotracers developed for positron emission tomography (PET) applications in precision medicine, the emerging radiometal Zirconium-89 (89Zr) has recently shown great potential in various fields of application. Produced by a medical cyclotron at a low cost, in a reasonable time and without high impurity, 89Zr decays via positron emission (23%) and electron capture (77%) to a metastable level of Yttrium (89mY), which in turn decays via γ-ray emission to stable 89Y [73]. The associated photons of 908.97 keV (99% abundance) emitted from the excited state can be separated by setting the energy windows and are not in coincidence with the PET signal, due to the half-life of the metastable level (t1/2 = 15.8 s) [11]. With a long half-life of 3.3 days, 89Zr as other long-lived radionuclides, such as 64Cu (t1/2 = 12.7 h), 76Br (t1/2 = 16.2 h), 86Y (t1/2 = 14.7 h) and 124I (t1/2 = 4.2 days), is apt to follow radiopharmaceuticals for several days and up to one week[59], allowing for reliable biodistribution assessment [75]. Assuming that 89Zr shares the same residualizing properties of other known radionuclides, such as 90Y, it might be internalized and trapped after binding to the surface of cells, resulting
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
