The radiosynthesis of [¹¹C]ibrutinib was fully automated using a commercial TracerMaker™ ¹¹C synthesis platform. The method and setup of the automated synthesis platform were adapted with only minor changes from our previously published method for [¹¹C]tolebrutinib (15). Commercially available anhydrous tetrahydrofuran (THF) solvent was used, eliminating the need for freshly distilled THF, and the semi-preparative high-performance liquid chromatography (HPLC) employed a flow rate of 6.0 ml/min. [¹¹C]Ibrutinib was produced in 45–50 min overall synthesis time from end of bombardment (EOB) with a retention time of 12–13 min (Figure 2A). [¹¹C]Ibrutinib was synthesized in 5.4 ± 2.5% (n = 9) RCY (non-decay corrected) relative to [¹¹C]CO₂, with RCP >99%, as confirmed by co-injection of authentic standard (Figure 2B), and A_m of 58.8 ± 30.8 GBq/μmol (1.55 ± 0.83 Ci/μmol) as measured by HPLC. The chromatogram from the semi-preparative HPLC purification shows only a minor radioactive by-product eluting at 3 min (Figure 2A). No radioactive by-products were seen in the analytical HPLC chromatograms (Figure 2B), indicating that the [¹¹C]CO carbonylation reaction under these conditions is highly selective for the secondary N-piperidinyl moiety over the primary pyrimidin-4-amine.

We evaluated the utility of [¹¹C]ibrutinib in EAE mouse models of MS using female C57BL/6 mice (EAE score = 2.5) as compared with sham-treated animals (EAE score = 0.0). Regions of interest (ROIs) of the spinal cord were selected from the MRI (Figure 3A). Figures 3B,C show representative static PET/MR images with [¹¹C]ibrutinib (0–60 min average image) in the EAE mice compared with the sham group, respectively. As demonstrated in the time activity curves (TACs) shown in Figure 4A, a 49% higher accumulation of radioactivity was measured in the sacral section of the spinal cord of the EAE mice (EAE score = 2.5) as compared with the sham at 5.5 min post-injection (p.i.), 1.27 ± 0.49 and 0.85 ± 0.04, respectively (p = 0.0409). Radioactivity accumulation decreased gradually but remained higher in EAE mice compared with sham mice until 40.5 min p.i., 0.48 ± 0.03 and 0.32 ± 0.05, respectively (p = 0.0336). Figure 4B shows that a 32% higher accumulation of radioactivity was measured in the lumbar region of EAE mice (EAE score = 2.5) as compared with the sham mice at 5.5 min p.i., 1.13 ± 0.37 and 0.80 ± 0.12, respectively (p = 0.0359). Radioactivity accumulation in the lumbar region of EAE mice cleared faster than in the sacral region of EAE mice, remaining higher than sham mice until 13.5 min p.i., 0.81 ± 0.09 and 0.62 ± 0.002, respectively (p = 0.03). Figures 4C,D show the thoracic and cervical sections of the spinal cord, respectively, for which there was no statistical difference from 0 to 60 min p.i. between the EAE mice and the sham mice. In accordance with previously published PET imaging results (16), whole-brain uptake was low, with SUV <0.5 from 5 to 60 min (Figure 4E). Biodistribution of the spinal cord (lumbar and thoracic regions combined) in mice sacrificed 60 min p.i. with [¹¹C]ibrutinib was 0.17% ID/g and 0.09% ID/g, in EAE mice and sham, respectively. The sacral region of the spinal is too small in this mouse model to be quickly and reliably extracted. Despite this time point being past the peak of radioactivity accumulation of 5 min, as well as excluding the sacral region, the results indicate a trend toward higher radioactivity accumulation in the EAE spinal cord compared with sham spinal cord. A limitation of our PET imaging studies is the low power of our animal studies (n = 2–3), and future work would involve increasing the sample size.

Reference standards of ibrutinib were acquired from Toronto Research Chemicals (Toronto, ON, Canada). 3-(4-Phenoxyphenyl)-1-(piperidin-3-yl)-2,3-dihydro-1H-pyrazolo[3,4-d]pyrimidin-4-amine (1) was provided by Bristol Myer-Squibb Pharmaceuticals (Princeton, NJ, USA). Iodoethylene was acquired from Oakwood Chemicals (Estill, SC, USA). All other chemicals were acquired from Sigma-Aldrich (USA or Canada). No-carrier-added [¹¹C]CO₂ was produced on a MC-17 Cyclotron (Scanditronix, Vislanda, Sweden) using the ¹⁴N(p,α)¹¹C nuclear reaction in a pressurized gas target containing a nitrogen:oxygen mixture (99.5:0.5) The radiosynthesis was performed using a TracerMaker™ carbon-11 synthesis platform (Scansys Laboratorieteknik, Værløse, Denmark). Analytical HPLC was performed on a 1260 infinity II HPLC system (Agilent, Santa Clara, CA, USA) with a M177 γ-radiation detector (Ludlum Instruments, Sweetwater, TX, USA) connected in series after the UV detector.

The reaction mixture was prepared in advance by weighing bis(dibenzylideneacetone)palladium(0) (2 mg, 3.5 μmol) and NiXantphos (2 mg, 3.5 μmol) in a capped vial under argon atmosphere, 20 min before EOB iodoethylene in THF was added (0.25% v/v, 600 μL) and vortexed for 2 min. Five minute before EOB, the iodoethylene/palladium mixture was added to a reaction vessel pre-charged with 3-(4-phenoxyphenyl)-1-(piperidin-3-yl)-2,3-dihydro-1H-pyrazolo [3,4-d]pyrimidin-4-amine (3 mg, 7.5 μmol) under an argon atmosphere using a balloon.

Cyclotron produced non-carrier-added [¹¹C]CO₂ was first trapped on a Hayesep D column (700 mg) cooled to −180°C using liquid nitrogen on a TracerMaker™ synthesis platform. The Hayesep D column was first slowly heated to ambient temperature and further reduced online to [¹¹C]CO over heated (850°C) molybdenum powder (350 μm, GoodFellow, Huntingdon, UK) and concentrated on silica gel trap immersed in liquid nitrogen. After completed entrapment, the trap was heated to ambient temperature to release [¹¹C]CO and bubble through a closed reaction vessel (4 ml) containing the prepared reaction mixture. The reaction was then heated to 100°C, 3 min before being cooled to 50°C, and vented under helium flow (2 ml/min) for 1 min to evaporate excess THF. The mixture was redissolved in MeCN:H₂O (30:70, 3 ml) before being injected onto a semi-preparative HPLC column (Gemini C18 10 μm, 250 × 10 mm, Phenomenex, Torrance, CA, USA). [¹¹C]Ibrutinib was eluted with MeCN:ammonium acetate (45:55 v/v, 30 mM) at 6 ml/min (t_R = 11–13 min). Selected fraction was diluted with H₂O (15 ml) and pushed through a solid-phase extraction (SPE) cartridge (SepPak tC18, Waters, Milford, MA, USA). The SPE cartridge was washed with water (10 ml) before [¹¹C]ibrutinib was eluted with ethanol (1 ml) and formulated with saline (0.9%, 9 ml). The overall synthesis time from EOB was 45–49 min.

RCP and molar activity were determined by analytical HPLC (Alltima C18 5 μm, 250 × 4.5 mm, HiChrom, Leicestershire, UK). [¹¹C]Ibrutinib was eluted with MeCN:ammonium formate (50:50 v/v, 50 mM) at 2 ml/min (t_R = 7 min). Identity was confirmed by co-injection with verified reference standard. A_m was calculated by comparison with a reference standard of known concentration (1.25 mg in 50 ml). RCY was calculated by comparing radioactivity at EOB to radioactivity of formulated product.

A group of two C57BL/6 mice (2-month-old) was immunized with 200 μg of myelin oligoglycoprotein (MOG35-55) (CSBio, Menlo Park, CA, USA), prepared in a 1:1 emulsion of complete Freund's adjuvant (Difco, Franklin Lakes, NJ, USA) to a concentration of 2 mg/ml injected subcutaneously in the lower back near the base of the tail. Within 2 h of MOG35-55 injection, mice received an intraperitoneal (i.p.) injection of 200 ng of pertussis toxin (List Biological Laboratories, Campbell, CA, USA) and again 24 h later. Mice were monitored daily for clinical signs of EAE, including body weight and standard EAE scoring (0, no paralysis; 1, limp tail; 2, limp tail with hind leg weakness; 3, limp tail with hind leg paralysis; 4, limp tail with complete hind leg paralysis and partial front leg paralysis; and 5, moribund or deceased). Mice did not progress past an EAE score of 2.5. A control sham group of mice was injected with saline as described above (n = 3). Animal studies were conducted under a protocol (#793) approved by the Animal Care Committee at the Centre for Additions and Mental Health, following Canadian Council on Animal Care guidelines. PET imaging was performed when mice reached an EAE score of 2.5, ~2 weeks post-induction, and the sham group with an EAE score of 0.0 was also imaged at ~2 weeks of saline injection.

For small animal PET combined with MR imaging studies, mice were anesthetized by isoflurane in O₂ (4%, 2 L/min induction; 1%−2%, 1 L/min maintenance) for lateral tail-vein catheterization and then transferred to a nanoScan™ PET/MRI 3T scanner (Mediso, Budapest, Hungary). Mice with an EAE score of 2.5 (n = 2) or 0.0 (n = 3) were injected through the tail-vein catheter with [¹¹C]ibrutinib (5.61–9.27 MBq, 151–250 μCi, 5.20–11.81 nmol/kg, 24–74 GBq/μmol, 648–2,000 mCi/μmol). Anesthesia was maintained throughout PET/MR scanning, while body temperature and respiration parameters were monitored. A short gradient echo (GRE) scout MR was acquired for positioning the mouse in the PET field of view followed by a T1-weighted material map MR acquisition (GRE 3D, repetition time (TR) 25 ms, echo time (TE) 4.76 ms) for PET and MR co-registration and PET scatter and attenuation corrections. PET scans were initiated at the time of radioligand injection, and the list mode data were acquired for 60 min with an energy window of 400–600 keV. Following PET scanning, the animals were sacrificed by cervical dislocation, and the spinal cord was collected, weighed, and transferred to γ-counting tubes for biodistribution determination. Tissue radioactivity was measured with a γ-counter and expressed as %ID/g.

List mode data were sorted into 33, 3D (3 × 5, 3 × 15, 3 × 20, 7 × 60, and 17 × 180 s) true sinograms (ring difference 84). 3D sinograms were converted in 2D sinograms using Fourier rebinning (24) with corrections for detector geometry, efficiencies, attenuation, and scatter, prior to image reconstruction using a 2D-filtered backprojection (FBKP) with a Hann filter at a cutoff of 0.50 cm⁻¹. A static image of the complete emission acquisition was reconstructed with the manufacturer's iterative 3D algorithm (six subsets, four iterations). The static iterative image was used for PET and MR co-registration and for presentation in figures. All data were corrected for dead-time and decay corrected to the start of acquisition. Dynamic FBKP images were used to extract TACs. Image analysis of the spinal cord (sacral, lumbar, thoracic, and cervical sections drawn manually) and brain (using the MR atlas of C57Bl/6J mice) (25) was performed using VivoQuant (4.0 patch1, Invicro LLC, Boston, MA, USA) and expressed as standardized uptake value (SUV), assuming tissue density of 1 g/ml.

Data are represented as the mean ± SD. Statistical comparisons were performed by an unpaired t-test (p < 0.05) with GraphPad Prism Version 8.3.1.