U.S. patent number 3,852,414 [Application Number 05/288,683] was granted by the patent office on 1974-12-03 for bone seeking technetium 99m stannous phosphate complex.
This patent grant is currently assigned to New England Nuclear Corporation. Invention is credited to Norman Adler, Leopoldo Lazaro Gamin.
United States Patent |
3,852,414 |
Adler , et al. |
December 3, 1974 |
**Please see images for:
( Certificate of Correction ) ** |
BONE SEEKING TECHNETIUM 99M STANNOUS PHOSPHATE COMPLEX
Abstract
A metabolizable radioactive technetium-99m-stannous-ring
phosphate complex in which at least 15 to 20% by weight, and
preferably 40 to 100%, of the phosphate moiety is a ring or cyclic
phosphate of molecular weight less than 300 and in which no more
than 5 to 15% or 20% by weight of such phosphate moiety is a linear
polyphosphate of molecular weight greater than pyrophosphate, a
method of making the same, a method of using the same by in vivo
intravenous administration to a mammal of the sterile-non-pyrogenic
complex followed by radioassay scanning or imaging the skeletal
structure, and a kit made up of a stannous-phosphate complex in
which at least 15 to 20% and preferably 40 to 99% of the phosphate
moiety is the aforesaid ring or cyclic phosphate and in which no
more than 5 to 15% or 20% by weight of such phosphate moiety is a
linear polyphosphate of molecular weight greater than
pyrophosphate.
Inventors: |
Adler; Norman (Arlington,
MA), Gamin; Leopoldo Lazaro (Lexington, MA) |
Assignee: |
New England Nuclear Corporation
(Boston, MA)
|
Family
ID: |
23108182 |
Appl.
No.: |
05/288,683 |
Filed: |
September 13, 1972 |
Current U.S.
Class: |
424/1.61;
423/249 |
Current CPC
Class: |
A61K
51/0489 (20130101); A61K 2123/00 (20130101) |
Current International
Class: |
A61K
51/02 (20060101); A61K 51/04 (20060101); A61k
027/04 () |
Field of
Search: |
;423/2,249 ;424/1 |
Other References
Subramanian et al., Radiology, Vol. 99, pp. 192-196, April
1971..
|
Primary Examiner: Sebastian; Leland A.
Attorney, Agent or Firm: Dike, Bronstein, Roberts, Cushman
& Pfund
Claims
We claim:
1. A metabolizable radioactive bone seeking composition for in vivo
concentrating .sup.99m Tc in the skeletal structure of mammals
comprising a technetium-99m-stannous-phosphate complex, at least 15
to 20% by weight of the phosphate moiety of which is a ring
phosphate having the formula P.sub.n O.sub.3n.sup..sup.-n and a
molecular weight of less than 300, said phosphate moiety containing
no more than 25% by weight of linear polyphosphates of formulation
P.sub.n O.sub.3.sub.+1.sup.116 (n.sup.+2) having a molecular weight
greater than that of pyrophosphate.
2. A bone seeking composition according to claim 1, said phosphate
moiety being substantially free from said linear
polyphosphates.
3. A metabolizable radioactive bone seeking composition according
to claim 1, at least 30 to 40% by weight of said phosphate moiety
being said ring phosphate.
4. A metabolizable, radioactive bone seeking composition according
to claim 3, said phosphate moiety also including pyrophosphate, and
at least the major portion of any remaining phosphate moiety being
ortho phosphate.
5. A composition according to claim 1, where n is equal to 3.
6. A composition according to claim 1, more than 50% by weight of
said phosphate moiety being said ring phosphate.
7. A composition according to claim 3, said phosphate moiety
comprising a mixture of said ring phosphate, a pyrophosphate and an
orthophosphate and wherein n is 3.
8. A composition according to claim 3 wherein n is 3.
9. A composition according to claim 8, substantially the remaining
phosphate moiety comprising one or more phosphates having the
formula (P.sub.n O.sub.3n.sub.+1).sup..sup.-(n.sup.+2) where n is
less than 3.
10. A composition according to claim 8, substantially the remaining
phosphate moiety being one or more phosphates of formula (P.sub.n
O.sub.3n.sub.+1).sup..sup.-(n.sup.+2) of which not more than 20% by
weight has an n value greater than 2.
Description
BACKGROUND OF THE INVENTION
It has been known for some time that phosphates, including long
chain linear polyphosphates, when introduced into the blood stream
of mammals will selectively seek out and collect in the bone or
skeletal structure. Pro. Soc. Exp. Biol Med. Volume 100, pages
53-55 (1959); Journal of Labelled Compounds, April-June 1970, Vol.
VI, No. 2, pages 166-173; Journal of Nuclear Medicine, Vol. 11, No.
6, pages 380-381, 1970; Journal of Nuclear Medicine, Vol. 1, No. 1,
January 1960, pages 1-13. In these cases a phosphorous atom or
atoms of the phosphate are radioactive, i.e., .sup.32 P.
It has also been known for some time that technetium-99m (.sup.99m
Tc) is a preferred radionuclide for radioactively scanning organs
because of its short half life and because it radiates gamma rays
which can be easily measured, compared, for example, to beta rays.
See Radiology, Vol. 99, April 1971, pages 192-196.
It has also been known for some time to use divalent stannous tin
(SN.sup.+.sup.+) in the form of stannous chloride, or divalent iron
(Fe.sup..sup.+.sup.+) or reduced zirconium to bind radioactive
.sup.99m Tc to carriers, such as chelating agents, red blood cells,
albumin and other proteins, which selectively seek out certain
organs of the body, in order to carry the .sup.99m Tc with them to
such organs of the body where it is concentrated, whereby such
organ can be radio-actively scanned or imaged for diagnostic or
other purposes, e.g. radioactive treatment of a pathological
condition. See Journal of Nuclear Medicine, Vol. 11, No. 12, 1970,
page 761; Journal of Nuclear Medicine, Vol. 12, No. 1, 1971, pages
22-24; Journal of Nuclear Medicine, Vol. 13, No. 2, 1972, pages
180-181; Journal of Nuclear Medicine, Vol. 12, No. 5, May 1971,
pages 204-211; Radiology, Vol. 102, January 1972, pages 185-196;
Journal of Nuclear Medicine, Vol. 13, No. 1, 1972, pages 58-65.
Also, it has been suggested to label a stannous compound with
.sup.99m Tc for radioactively imaging bone marrow, Journal of
Nuclear Medicine, Vol. 11, 1970, pages 365-366.
It has also been known for some time that the stannous ion
Sn.sup..sup.+.sup.+ forms soluble complexes with long chain
polyphosphates, Journal Inorganic Nuc. Chem., Vol. 28, 1966, pages
493-502.
It has been suggested to employ the aforesaid .sup.99m Tc for
radioactively scanning the skeletal bone structure of mammals by
complexing or binding it to tripolyphosphate carrier by use of the
aforesaid stannous ion as a binding agent in order for such
phosphate to selectively carry the .sup.99m Tc to, and concentrate
it in, the skeletal bone structure upon in vivo intravenous
administration for subsequent radioactive scanning or imaging the
skeletal structure. Radiology, Vol. 99, April 1971, pages 192-196.
The use of .sup.99m Tc in this manner in alleged to have certain
advantages over the use of strontium, e.g. .sup.85 Sr, as the
radioactive label which has been used for radioactive bone scanning
in the past. These advantages are those which are inherent in
.sup.99m Tc, i.e. short half life and lower energy gamma rays.
However, the bone uptake (the percent of the total dosage which
becomes concentrated in the skeletal structure within a certain
time after in vivo intravenous administration) of such .sup.99m Tc
by the other organs of the body (the higher these ratios the
better), i.e. radioactive contrast, are not nearly as high as with
radioactive strontium.
STATEMENT OF THE INVENTION
It has been discovered that if, in the aforesaid .sup.99m
Tc-stannous-phosphate complex the phosphate moiety comprises a
cyclic or ring (meta) phosphate of formula P.sub.n O.sub.3n
.sup..sup.-n, preferably having a molecular weight of less than
300, rather than a polyphosphate, which is a linear straight or
branched chain phosphate having the general formula P.sub.n
O.sub.3n.sub.+1.sup.(.sup.-n.sup.+2), bone uptake of the .sup.99m
Tc and the ratios of bone uptake to uptake of .sup.99m Tc by other
organs, i.e. the liver, blood, kidneys and gastrointestinal system
(G.I.) are substantially increased. It has also been discovered
that optimum results are achieved if at least 15 to 25% by weight,
preferably at least 30 to 40% (between 80 and 90 to 100% is more
preferred), of such phosphate moiety is made up of such ring
phosphate and if such phosphate moiety contains no more than about
15 to 20% or 25%, preferably no more than 5 to 10% and more
preferably no more than 5% (less than 5% is the most preferred), by
weight of such polyphosphate of molecular weight greater than that
of pyrophosphate.
The term "phosphate moiety" as used herein refers to the phosphorus
and oxygen atoms only of the phosphate.
The presence of polyphosphates of formula P.sub.n
O.sub.3n.sub.+1.sup.(.sup.-n.sup.+2) and molecular weight greater
than 300, more particularly greater than that of pyrophosphate,
seems to reduce bone take-up and the aforesaid ratios, as compared
to complexes without such higher molecular weight polyphosphates.
However, as aforesaid, some of such higher molecular weight
polyphosphates can be tolerated, preferably not more than about 15
to 20% or 25%, more preferably no more than 5 to 10% and still more
preferably not more than 5% (less than 5% is the most preferred),
by weight of the total phosphate moiety.
The rest of the phosphate moiety of the complex, where the ring
phosphate does not constitute 100% of the phosphate moiety, is
preferably ortho (PO.sub.4.sup..sup.-3) and pyrophosphate
(phosphate moiety molecular weight of less than 300) and more
preferably pyrophosphate only.
A highly preferred ring phosphate is trimetaphosphate (P.sub.3
O.sub.9.sup..sup.-3 -molecular weight of 237) of the formula:
##SPC1##
The complex is made from water soluble alkali metal (preferably
sodium) or ammonium salt or acid salt of the ring phosphate, e.g.
sodium trimetaphosphate.
Preferably the sodium trimetaphosphate is admixed with a stannous
salt, e.g. SnCl.sub.2 (the stannous salts of other acids which are
pharmaceutically acceptable, i.e., safely intravenously
administered, can be used) to form the stannous-trimetaphosphate
complex, the pH of which is adjusted to 3-8, preferably 5-8, by a
pharmaceutically acceptable base, such as NaOH or Na.sub.2 CO.sub.3
or NaHCO.sub.3, followed by admixing with the
stannous-trimetaphosphate complex, an aqueous saline solution of
radioactive sodium pertechnetate (.sup.99m Tc) to form the .sup.99m
Tc-stannous-trimetaphosphate complex at the time it is desired to
intravenously administer the .sup.99m Tc complex. The
stannous-trimetaphosphate complex may be sealed in a sterile
non-pyrogenic container or vial as a solution or a dry lyophilized
solid and shipped as a kit with the freshly generated sterile and
nonpyrogenic .sup.99m Tc being added aseptically at the situs just
prior to use.
DETAILED DESCRIPTION OF INVENTION (INCLUDING EXAMPLES)
The following compositions were prepared:
TABLE 1 ______________________________________ Sample No.
Description ______________________________________ 1 A commercial
sodium polyphosphate sold by FMC Corporation under the trade name
FMC Glass H (average chain length of 21 and average M.W. about
2100). 1-1 A first high molecular weight fraction of the FMC Glass
H of Sample 1 obtained by fractionating an aqueous solution of
Sample 1 with acetone according to the technique described in Van
Wazer, Phosphorous And Its Compounds, Interscience Publishers, Inc.
1961 (pages 744-747) to precipitate out of the aqueous solution of
the FMC Glass H, as an oil, the highest molecular weight fraction
of polyphosphates (composition given in TABLE 2). 1-2 A second
acetone fraction of FMC Glass H achieved by adding more acetone to
precipitate out of the remaining supernatant of 1-1, as an oil, the
next higher molecular weight polyphosphates (composition given in
TABLE 2). The acetone decreases the solubility of the
polyphosphates in the water; the higher the molecular weight of the
polyphosphate the less soluble it is so that the highest molecular
weights are forced out of solution first. 1-3 A third acetone
fraction of FMC Glass H containing the next higher molecular weight
polyphosphates is precipitated out of the remaining supernatant
solution of 1-2, as an oil, upon addition of further amounts of
acetone (composition given in TABLE 2). 1-4 A fourth acetone
fraction of FMC Glass H containing the next higher molecular weight
polyphosphates (composition given in TABLE 2) is precipitated out
of the supernatant solution of 1-3, as an oil, by adding more
acetone. 1-5 A fifth acetone fraction of the FMC Glass H
(containing the next higher molecular weight polyphosphates)
(composition given in TABLE 2) is precipitated out of the remaining
supernatant solution of 1-4, as an oil, by adding more acetone. 1-6
A sixth acetone fraction of FMC Glass H (composition given in TABLE
2) is precipitated out of the remaining supernatant solution of
1-5, as a solid precipitate of the next higher molecular weight
polyphosphates by adding more acetone. 1-7 A seventh acetone
fraction of FMC Glass H (composition given in TABLE 2) is
precipitated out of the remaining supernatant solution of 1-6, as a
solid precipitate of the next higher molecular weight polyphosphate
by adding more acetone. 1-8 The residue fraction in the supernatant
liquid left after removal of the 1-7 fraction (composition given in
TABLE 2) is recovered by evaporating off the supernatant liquid. 2
An acetone end fraction of sample 1 after 90% by weight had been
previously fractionated off and leaving by removal of such end
fraction 3% by weight in the supernatant (composition given in
TABLE 2). 4 A mixture of 86% sodium trimetaphosphate (Na.sub.3
P.sub.3 O.sub.9), 3% sodium orthophosphate (Na.sub.3 PO.sub.4)
(molecular weight of phosphate moiety-95) and 10% sodium pyrophos
(Na.sub.4 P.sub.2 O.sub.7) (linear polyphosphate--molecu lar weight
of phosphate moiety-174) obtained by acetone fractionation of
sodium trimetaphosphate obtained from Monsanto. Sodium
trimetaphosphate as aforesaid, is one of a plurality of cyclic
phosphates having the general formula P.sub.n O.sub.3n.sup
..sup.-n. Sodium orthophosphate is a phosphate monomer. Sodium
pyrophosphate is a dipolyphosphate. 5 An acetone end fraction of a
food grade polyphosphate sold by FMC under the name FMC FG
(composition given in TABLE 2). 6 A commercial cyclic
trimetaphosphate sold by Stauffer Chemical, (composition given in
TABLE 2) 7 Sodium orthophosphate. 8 Sodium pyrophosphate. 9 Sodium
tripolyphosphate. 10 Sodium tetrapolyphosphate--Na.sub.6 P.sub.4
O.sub.13 --a polyphosphate--phosphate moiety having a M.W. of 348.
It, together with the pyrophosphate and tripolyphosphate, fall in
the class of linear chain polyphosphates having the general formula
P.sub.n O.sub.3n.sub.+1.sup..sup.-(n.sup.+2).
______________________________________
An aqueous solution of each of the phosphate composition samples 1
through 10 (40 mg. phosphate/1 ml. solution) were made with
distilled water in which the dissolved oxygen content was reduced
in a conventional manner by bubbling through such water gaseous
nitrogen for a period of 2 hours. The water and phosphates were
mixed to form the solutions in a nitrogen atmosphere and in a
nitrogen flushed container. The reason for this is to reduce
oxidation of the divalent Sn.sup.+.sup.+ to be subsequently admixed
with each solution sample. However, it is not essential (but highly
preferred) to use nitrogen-treated water or a nitrogen atmosphere
or a nitrogen-flushed container. Other known pharmaceutically
acceptable conditions, which will inhibit oxidation of the
Sn.sup.+.sup.+ upon subsequent mixing thereof with the phosphate
solution, can be used, including the use of conventional
pharmaceutically acceptable reducing agents and anti-oxidants in
the products used.
Each of these solutions, samples 1 through 10, in an amount equal
to 100 ml. was mixed with 0.16g of solid SnCl.sub.2. 2H.sub.2 O
under a nitrogen atmosphere. The SnCl.sub.2. 2H.sub.2 O was made by
adding to 84.5 mg. of metallic tin, sufficient concentrated HCl
with mixing until all the tin has dissolved followed by removing
excess acid and water by lyophilization (this operation also being
carried out in a vacuum or in a nitrogen atmosphere and in a
nitrogen flushed container to prevent oxidation of stannous to
stannic). Antioxidants, which can be administered intravenously,
may also be used. A stannous (SN.sup.+.sup.+) -phosphate complex or
mixture of some kind was formed in each case, the phosphate moiety
of each sample corresponding to the phosphate moieties of the
phosphates set forth in TABLE 2. Thus, in the case of sample 1-7,
60% of the phosphate moiety was trimetaphosphate whereas in sample
1, 96.5% of the phosphate moiety constitutes long chain linear
polyphosphates of 5 or more phosphorous atoms.
Sufficient aqueous solution of 3N NaOH (sodium carbonate or
bicarbonate can also be used), in the case of all samples except 8,
and 3N HCl, in the case of sample 8, is then added to each sample
to give a pH of 6.0 to achieve a pH suitable for subsequent
intravenous in vivo administration into the body of a mammal, in
this case adult mice. The pH adjustment is preferably done under a
nitrogen atmosphere also.
After thorough mixing, the solutions are sterilized by passing them
through a Millipore biological filter of 0.22 micron pore size
under a nitrogen atmosphere. Thereafter milliliter portions of each
of the sterile solutions are poured into individual sterile and
non-pyrogenic storage glass vials under aseptic conditions and the
vials are aseptically sealed so that the interior and contents of
each sealed vial is sterile and non-pyrogenic and under a nitrogen
atmosphere.
In the case of each sample, vials are lyophilized by conventional
freeze drying equipment under aseptic conditions to remove water.
This provides a solid stannous-phosphate complex which aids in
shipping and which is more stable than the complex in solution.
Each vial contains 1.35 mg. SnCl.sub.2 and 40 mg. of the
phosphate.
The vials can be sealed and stored until needed subsequently to
form the technetium-99m-stannous-phosphate complex at the use
situs.
To prepare the technetium-99m complex, 3 to 7 (5) ml. of fresh
sodium pertechnetate, removed as a sterile non-pyrogenic eluate
from a sterile NEN .sup.99m Tc Generator (any other source of
pharmaceutically acceptable .sup.99m Tc can be used, including
.sup.99m Tc generators manufactured by others than NEN), in a 0.9%
saline solution is aseptically added to each vial containing the
sterile and non-pyrogenic stannous-phosphate complex and the vial
is swirled until a solution is obtained. In each case a
technetium-99m-stannous-phosphate complex or mixture of some kind
is formed in aqueous solution (9 mg. per ml. solution when 5 mil of
pertechnetate are used), the phosphate moiety of which corresponds
to the phosphate moieties of the phosphate compounds of each sample
set forth in TABLE 2.
Aseptic techniques and sterile, non-pyrogenic ingredients and
containers were used at all steps, such procedures being standard
to those skilled in the art.
Each of the technetium-99m-stannous-phosphate complex-containing
solutions is aseptically intravenously injected in vivo into a vein
in the tail of adult mice (average weight 0.040 kgs) in an amount
equal to between 1 and 3 mCi and a volume of 0.12 ml (8 mg. of
phosphate per ml solution in samples 1 through 10).
Three hours after intravenous administration, some of the mice to
which each sample was administered were sacrificed and the various
organs of their bodies (skeletal, liver, G.I., blood, kidneys) were
counted by conventional gamma ray counting techniques to determine
uptake of .sup.99m Tc by each organ and thereby determine contrast
of bone uptake as compared to uptake by other organs. As aforesaid,
it is not only important to have a high bone uptake (based on total
technetium-99m dosage) but it is also important that the ratio of
uptake by the bone to uptake by the other organs be high.
The results are set forth in TABLE 2 below, in which the uptakes
(the bone uptake figures represent the average bone uptake for the
skeletal system) are in terms of percent of the total
technetium-99m activity injected (corrected for radioactive decay)
which has collected in the various organs indicated 3 hours after
in vivo intravenous injection, in which the ratio amounts are
computed from the uptake amounts, in which "Percent Having
Phosphate Moiety M.W. Less than 300" refers to weight percent of
the phosphate moiety based on the total phosphate moiety of the
sample identified in the first horizontal column, in which the
percents referred to under Phosphate Composition are weight
percents of the whole phosphate moiety of the sample (as aforesaid,
phosphate moiety as used herein is limited to that part of the
compound or complex made up of phosphate phosphorus and oxygen
atoms), in which Ortho P1 refers to the phosphate moiety of sodium
orthophosphate, Pyro P2 refers to the phosphate moiety of sodium
pyrophosphate, Tripoly P3 refers to the phosphate moiety of sodium
tripolyphosphate, Tetrapoly P4 refers to the phosphate moiety of
sodium tetrapolyphosphate, Trimeta R3 refers to the phosphate
moiety of sodium trimetaphosphate, Tetrameta R4 refers to the
phosphate moiety of sodium tetrametaphosphate, both trimeta and
tetrametaphosphates falling within the class of cyclic or ring
phosphates having the formula P.sub.3 O.sub.3n.sup..sup.-n, in
which "Pentapoly And Longer Linear Chains" refers to the phosphate
moiety of soidum pentapolyphosphate and longer linear (linear as
used herein includes straight and branched linear phosphate chains)
polyphosphates of formula P.sub.n
O.sub.3n.sub.+1.sup..sup.-(n.sup.+2), in which "Average M.W."
refers to the average molecular weight of the phosphate moiety of
the sample and in which "Fraction In Raw Stock" with reference to
samples 1-1, 1-2, 1-3, 1-4, 1-6, 1-7 and 1-8 refers to the
normalized percent by weight of each of these samples in sample 1,
which is the raw stock which is fractionated. ##SPC2##
Conventional gamma counting techniques for measuring technetium 99m
take-up in the organs are conventional gamma ray-excitable
scintillation counters for radioassaying multiple samples of the
organs of the sacrificed mice.
Also, conventional scanning by radioactive imaging using a gamma
ray-excited scintillation or gamma camera and a dual crystal
rectilinear scanner was used in vivo. In vivo scintiphotos of the
total body using the Anger camera were obtained as well as
rectilinear total body scans.
The figures given in TABLE 2 are average figures achieved by the
aforesaid conventional counting techniques, each sample having been
intravenously administered to mice followed by radioactive
counting.
Following intravenous administration, the technetium
99m-stannous-ring phosphate complexes of the invention are rapidly
cleared from the blood by deposition in bone and excretion into
urine. Thus, the technetium-99m-stannous-ring phosphate complexes
are metabolizable. The deposition of the .sup.99m Tc-stannous-ring
phosphate complexes of the invention appears to be primarily a
function of the bone blood flow as well as being related to the
efficiency of the bone in extracting the complex from the blood
which perfuses the bones.
It was observed that the deposition of the .sup.99m Tc in the
skeleton is bilaterally symmetrical with increased accumulations
being present in the axial skeleton as compared to the appendicular
skeleton. There is also increased deposition in the distal aspect
of long bones.
Localized areas of abnormal accumulation of the
radio-pharmaceutical may be seen in primary malignancies of the
bone, metastatic malignancies of the bone, acute or chronic
osteomyelitis, arthritides, recent fractures, areas of ectopic
calcification, Paget's disease, regional migratory osteoporosis,
areas of aseptic necrosis and in general any pathological situation
involving bone in which there is increased osteogenic activity or
localized increased osseous blood perfusion.
The acute toxicity level in mice (LD.sub.50/30) for Sample No. 2
has been determined to be 150 mg/Kg body weight and for Sample No.
6 it is 800 mg/Kg and for Sample No. 8 it is 70 mg/Kg. Subacute
toxicity studies in mice of Sample 2 have shown no signs of
toxicity after 15 daily injections at dose levels as high as 63
mg/Kg body weight/day. A similar subacute study in dogs indicates
no signs of toxicity at a dose level of 3.6 mg/Kg body
weight/day.
It was found that samples 4 and 6 were only one-fourth as toxic to
mice as sample 2 and one-eighth as toxic to mice as sample 1.
The complexes of the invention have been used successfully as a
skeletal imaging or scanning agent to visualize areas of altered
blood flow to the bone and altered osteogenic activity, including
suspected bone lesions not shown on X-ray, bone survey performed as
part of the work-up in patients with known or suspected malignancy,
to follow the response of metastatic or primary bone lesions to
radiation therapy, metabolic bone disease, to diagnose arthritis
and osteomyelitis, and to diagnose and determine healing rate of
bone fractures.
The technetium-99m (.sup.99m Tc) labeling reactions involved in
preparing the .sup.99m Tc stannous-phosphate complexes of the
invention depend on maintaining the tin in the reduced or stannous
(Sn.sup..sup.+2) state. Oxidants present in the pertechnetate
supply may adversely affect quality.
The radioactive dosage of the .sup.99m Tc complex of the invention
may vary from 1 to 25 mCi (millicuries) but preferably is from 10
to 15 mCi. The dosage in terms of the .sup.99m Tc complex may vary
over a wide range, i.e. from 0.001 to 30 mg per kilogram body
weight of mammal.
The concentration of ring phosphate moiety in the final solution is
preferably between 1 and 40, more preferably between 2 and 20 mgs
per ml of solution.
An advantage of a complex containing a relatively large amount of
ring phosphate is that the ring phosphate, in addition to providing
excellent up-take and bone-to-other-organ ratios, has a low
toxicity. Where the phosphate moiety contains phosphate other than
ring phosphate it is advantageous for such other phosphate to be
pyrophosphate because of its high bone uptake.
Scanning may be commenced as early as one hour after intravenous
administration and may be as long after injection as clinically
useful amounts of .sup.99m Tc remain in the organ.
Another manner of making the complex of the invention is to weigh 4
mg. of SnCl.sub.2. 2H.sub.2 O and 100 mg of sodium trimetaphosphate
into a flask (the flask is sterile and non-pyrogenic and is flushed
with nitrogen before weighing and is kept under nitrogen during
this step and for the next step). Add, under aseptic conditions, 12
ml of sterile, non-pyrogenic sodium pertechnetate in 0.9% saline
solution. Shake the mixture until a solution is obtained followed
by intravenous injection (preferably the pH of the mixture is
aseptically adjusted to pH 4-8 before intravenous injection).
Also, the sterile stannous chloride can first be aseptically mixed
with the sterile .sup.99m Tc saline solution to form a .sup.99m
Tc-stannous complex, followed by adding the sterile sodium ring
phosphate under aseptic conditions to form the .sup.99m
Tc-stannous-ring phosphate, adjusting the pH to 4-8, followed by
intravenous injection.
It can be seen from TABLE 2 that the .sup.99m Tc-stannous-phosphate
complexes, the phosphate moiety of which is cyclic (in the form of
a ring) and has a molecular weight of less than 300, e.g. samples
1-7, 1-8, 2, 4, 5 and 6, provide surprising and markedly higher
bone uptake of .sup.99m Tc and higher ratios of bone uptake to
other organs, as compared to those complexes, the phosphate moiety
of which is in the form of linear long chains of molecular weight
above that of pyrophosphate, e.g. samples 1, 1-1, 1-2, 1-3, 1-4,
1-6, 9 and 10.
In accordance with the invention, the ring phosphate moiety of the
.sup.99m Tc-stannous-phosphate complex should be at least 15 or
20%, preferably at least 30 to 40%, more preferably more than 50 or
60% and most preferably 80 to 90% or more, by weight of the total
phosphate moiety of the complex.
Trimetaphosphate is a highly preferred ring phosphate.
Although the stannous (Sn.sup.+.sup.+) ion is by far preferred, the
divalent ferrous (Fe.sup.+.sup.+) ion in the form of ferrous
ascorbate, and reduced zirconium can also be used but without as
good results. All these metals can exist in a plurality of redox
states.
The phosphate may be added to the solid SnCl.sub.2 as an aqueous
solution, or it may be added to a solution of the SnCl.sub.2 to
form the Sn.sup.+.sup.+-phosphate complex followed by adding the
.sup.99m Tc solution.
Very little Sn.sup.+.sup.+ need be used to form the complex of the
invention, e.g. less than 7 to 10% of the phosphate based on
molecular weights.
The weight ratio of Sn.sup.+.sup.+ ion to the ring phosphate moiety
may vary over a wide range, i.e. from 10.sup..sup.-3 to 0.50,
preferably 0.01 to 0.4. The maximum ratio of dictated by the amount
beyond solubility of the Sn.sup.+.sup.+. The minimum amount
required that amount necessary to bind a sufficient amount of
.sup.99m Tc to the ring phosphate to achieve good bone uptake and
contrast. This can be determined by routine experiment.
The pH of the stannous-phosphate complex should be between 3 and
8.
The water used for making the complexes of the invention is
distilled and is at an elevated termperature of 200.degree.F during
removal of dissolved oxygen and reduction of oxidants by bubbling
the nitrogen gas therethrough.
The maximum amount of .sup.99m Tc is that beyond the capacity of
the Sn.sup.+.sup.+-ring phosphate complex to bind the .sup.99m Tc.
This can be determined by routine thin layer radiochromatography to
determine the percent of free or unbound .sup.99m Tc in the
complex. The minimum amount is dictated by that amount below which
there is an insufficient amount to give good scanning of bone
uptake and contrast, which also can be determined by routine
experiment. Generally, the amount of .sup.99m Tc added to the
Sn.sup.+.sup.+-ring phosphate complex should be sufficient to
achieve the counting rate desired by the doctor or laboratory
personnel for the volume to be injected; ordinarily, as aforesaid,
the activity dosage varies from 5 to 25 millicuries.
Although sodium ring (meta) phosphates are preferred, any alkali
metal, such as potassium and lithium, or ammonium can be used as
the cation so long as it is pharmaceutically acceptable so that it
can be safely administered intravenously. Also, the acid
pyrophosphates of such cations can be used.
Although in the examples give above saline water was used as the
vehicle, any other vehicle which is pharmaceutically acceptable for
intravenous administration can be used.
It is not intended that the invention be limited to any theory
which may have been given above or to the specific examples set
forth above but only by the claims appended hereto and their
equivalents.
* * * * *