Development and Optimization of Zirconium-89 Production and Clinical TF-PET/CT Imaging Protocols for Breast Tumor Imaging and Immunotherapy Planning: A Review

Zirconium-89 (⁸⁹Zr) has recently drawn significant interest to be a promising metallo-radionuclide for use in immuno-PET due to favorable decay characteristics. Despite all efforts that have been done over the last few years in the development of procedures for large-scale production and purification of ⁸⁹Zr and its stable coupling to mAbs as well as successful preclinical and clinical ⁸⁹Zr immuno-positron emission tomography (PET) studies, there is still gap for exploring new peptide-based pharmaceuticals radiolabeled with ⁸⁹Zr and the development of ⁸⁹Zr immuno-PET imaging protocols. The objectives of this study is intended to review the recent development and optimization of ⁸⁹Zr production and to discuss the ⁸⁹Zr immuno-PET clinical imaging applications for breast cancer. In addition, the ⁸⁹Zr PET imaging safety and protocols as well as the potential use of ⁸⁹Zr in 3-gamma PET Imaging are reviewed.