Macrocyclic complexes of radionuclides in nuclear medicine

The use of radiometal-labeled small complexes and biomolecules as diagnostic and therapeutic agents is a relatively new area of medical research. Radiopharmaceuticals are radiolabeled molecules designed to deliver ionizing radiation doses to specific disease sites. Between the targeting biomolecule and a radionuclide a bifunctional ligand is inserted, one end of which is covalently attached to the targeting molecule either directly or through a linker whereas the other strongly coordinates a metallic radionuclide. Selection of a bifunctional ligand is largely determined by the nature and oxidation state of a metal ion. The metal chelate can significantly affect the tumor uptake and biodistribution of radiopharmaceuticals based on small biomolecules. This is because in many cases the metal chelate contributes greatly to the overall size and lipophilicity of the radiopharmaceutical. Therefore, the design and selection of the ligand is very important for the development of a clinically useful therapeutic agent. The requirement for high thermodynamic and kinetic stability of the metal complex is often achieved through the use of macrocyclic ligands with a functionalized arm for covalent bonding to the biomolecule. In this review synthesis of bifunctional macrocyclic ligands and properties of radionuclide macrocyclic complexes used in nuclear medicine are presented. We describe results in two areas: substituted macrocyclic aza ligands for chelation of hard metal cations, and macrocycles containing sulphur for complexation of soft metal cations. Special attention was paid to stability of the complexes as well as to their lipophilicity, which affect biological properties of the formed radiopharmaceuticals. We also include a forecast of the near-term opportunities that are likely to determine practice in the next few years. (authors)