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99mTc certolizumab pegol is an investigational radiopharmaceutical diagnostic imaging agent developed primarily by researchers at Universitair Ziekenhuis Gent (Ghent University Hospital). It consists of the TNF-alpha inhibitor certolizumab pegol—a PEGylated humanized Fab' fragment of an anti-TNF monoclonal antibody—labeled with the gamma-emitting radioisotope technetium-99m (99mTc). The agent is designed for molecular imaging using Single Photon Emission Computed Tomography (SPECT/CT) to visualize and quantify tumor necrosis factor (TNF) expression in vivo. Its primary clinical application is in the diagnosis and monitoring of inflammatory conditions, particularly axial spondyloarthritis (axSpA) and rheumatoid arthritis. By binding specifically to TNF-alpha at sites of active inflammation, the tracer allows clinicians to identify inflammatory lesions and potentially predict patient response to anti-TNF therapies.
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