###### Abstract  
Bone and soft tissue infections are potentially life-threatening and require immediate and intensive treatment. However, there is still no single diagnostic method that can reliably confirm or rule out such conditions. Imaging with radiopharmaceuticals (i.e., scintigraphy) is a powerful diagnostic tool in the management of patients with infectious or inflammatory diseases. In this work, a new and efficient way to modify the thiazole ring of the cefepime molecule has been proposed and experimentally verified. The developed organic synthesis routes allow for the coupling of the appropriate complexing ligand of the gallium-68 radionuclide with cefepime. The new NODAGA-Glu-CFM conjugate was radiolabeled with gallium-68 with a high yield and showed full stability in human serum. In addition, the [\({}^{68}\)Ga]Ga-NODAGA-Glu-CFM radioconjugate was hydrophilic and positively charged. Therefore, on the basis of these results, the [\({}^{68}\)Ga]Ga-NODAGA-Glu-CFM radioconjugate might be considered as a new promising radioconjugate for the diagnosis of bacterial infections. cefepime; synthesis; chelator; radiolabeling; gallium-68 Article Synthesis and Physicochemical Properties of Derivatives Suitable for Dervatives Suitable for Labeling with Gallium-68  
[PERSON], 1 Centre of Radiochemistry and Nuclear Chemistry, Institute of Nuclear Chemistry and Technology,  
03-195 Warsaw, Poland; [EMAIL_ADDRESS]  
1 Centre of Radiochemistry and Nuclear Chemistry, Institute of Nuclear Chemistry and Technology,
related to being overweight or obese. Unfortunately, the predictions are not optimistic and there will be more and more people with diabetes, with an estimated 578 million people affected by 2030 [13]. DFS involves deterioration of the blood supply to the foot, which becomes hypoxic and susceptible to infection. The spreading soft tissue infection results in bacterial infection of the bones. This is an indication for amputation, but there is difficulty in distinguishing between bone infections and non-infectious neuropathic bone lesions, which is why a clear diagnosis is so important [14]. At the time of diagnosis, more than 10% of people with DFS are accompanied by peripheral neuropathy and/or vascular disease [12]. The lifetime risk of foot ulceration in a person with diabetes may be as high as 25% [15; 16]. It is important to be aware that a lower limb amputation occurs due to diabetes every 30 seconds [16; 17; 18]. Osteomyelitis is often overlooked; thus, the correct diagnosis and prompt treatment of the infected area are important in DFS [19]. For this purpose, white blood cell (WBC) scintigraphy is used as the gold standard, but due to the time-consuming nature of this method, other approaches are being searched for [20; 21]. In the current literature, publications exist which suggest a similar diagnostic accuracy for the use of [18]Ffluorodeoxyglucose [22; 23], or alternatively, radiolabeled ciprofloxacin derivatives such as N\({}_{4}\)'-3-[18]Fluoropropycliprofloxacin [24], [18]F-ciprofloxacin [25] and \({}^{99}\)Tc-ciprofloxacin [13]. In the present study, we attempted to label another antibiotic--cefepime (CFM)--which is widely used in the treatment of diabetic foot infections caused by Gram-positive and Gram-negative bacteria [26; 27]. Cefepime is a fourth-generation cephalospororin that is registered for use above the age of two months according to the Food and Drug Administration (FDA). It is active against _S. pyogenes_, _S. pneumoniae_, _E. coli_, _H. influenzae_, _M. catarthalis_, _N. gonorrhoeae_, _P. aeruginosa_, _M. morganii_, _Proteusmirabilis_, some _Citrobacter_, _Enterobacter_, _Klebsiella_, _Providencia_ and _Serratia_. It is used for pneumonia, complicated urinary tract infections, complicated abdominal infections, peritonitis associated with dialysis, acute biliary infections and bacterial meningitis [28].