Introduction: [18F]-labelled choline analogues, such as 2-[18F]-Fluoroethylcholine ( [18F]-FECH ), have
suggested to be the new generation of choline derivatives for the imaging of prostate and brain
tumours. In fact, tumour cells with enhanced proliferation rate exhibit an improved choline uptake due
to the increased membrane phospholipids biosynthesis. The aim of this dissertation is the development
and validation of a reliable automatic synthesis of [18F]-FECH. Moreover, in order to assure a safe
employment of the radiotracer in a research clinical trial, particular attention was paid to establish the
proper quality controls required.
Materials and Methods: [18F]-FECH was synthesized with varying synthetic approaches (one step and
two steps reaction, preparative HPLC or solid phase extraction purification) and by using two different
automatic synthesizers (FXF-N Tracer Lab Synthesizer and Mx Tracer Lab). In the first step, cyclotron
produced [18F]-Fluoride was reacted for 5 minutes at 80°C, with a 20 mg/ml solution of 1,2-
bis(tosyloxy)ethane (diOTsEt) in acetonitrile in order to obtain the [18F]-EtOTs intermediate. The
reaction was performed in anhydrous condition and in presence of tetrabutylammonium (TBA) as
transfer phase catalyst. In the second step, without any further purification, [18F]-EtOTs was reacted for
10 minutes at 100° C in the same reactor, with a 88.6 mg/ml solution of N,N-dimethylethanolamine
(DMAE) in acetonitrile. The reaction mixture was then purified by SPE or HPLC and then eluted with
16 ml of physiological solution. The effect of different precursors (Br2Et, diNosEt and BrOtsEt) on the
reactions was also assessed but with lower success. Quality controls on the final product were
performed by means of TLC, GC and HPLC equipped with conductimetric, UV and radiometric
detectors. Sterility and absence of bacterial endotoxin were assessed by following the European
Pharmacopeia guidelines.
Results: [18F]-FECH was prepared with a yield between 17±2 and 41 ±2 % uncorrected for decay in a
time ranging between 33 and 55 minutes, depending on the synthetic approach and on the synthesizer
used. Radiochemical purity was always greater than 99 % with both free [18F]-fluoride and [18F]-EtOTs
less than 0.5 % of the total radioactivity. The DMAE concentration always resulted less than 15 mg/L
and was detected with either GC or HPLC with conductimetric detection. The main chemical impurity
was due to dimethylmorpholinium (dMM), a cationic by-product derived from the direct reaction and
cyclization of diOTsEt and DMAE. The dMM concentration was detected by HPLC with
conductimetric detection and always resulted less than 180 mg/L. The absence of tosylated by-products
or free OTs- anions was assessed by HPLC with UV detection. Residual solvents and TBA
concentrations respected the limits fixed for an injectable radiopharmaceutical preparation and were
detected by means of GC in the same analysis conditions used for DMAE. All the sample analyzed
were sterile.
Conclusions: [18F]-FECH radiopharmaceutical was synthesized with an high yield and radiochemical
purity by using a automatic synthesizers. The complete elimination of the dMM by-product from the
final solution was not possible by means of a solid phase extraction as a purification method. A
research clinical trial was activated and, up to now, more than 150 patients were safely examined