Current Status of Molecular Imaging in Infections

Abstract

There is an increased need to find non-invasive tools for early diagnosis and follow-up of infections. Nuclear medicine techniques may be used to diagnose, localize and evaluate the severity and the extent of infections before the occurrence of anatomical abnormalities. This review focuses on different approaches based on radiolabelled cells, peptides and antibodies or [18F]FDG to image infective diseases in agreement with what is being jointly evaluated by the European Association of Nuclear Medicine (EANM). This is particularly relevant, since the EANM has strated a wide program of collaboration with other European clinical societies to define common diagnostic flow-charts in many of these infective diseases. It emerges the role of radiolabelled WBC by SPECT/CT for prosthetic joint infections and of FDG by PET/CT for spondylodiscitis. Comparable values of accuracy have been described for WBC and FDG in the diagnosis of vascular fgraft infections, diabetic gfoot, endocarditis and peripheral bone osteomyelitis, with some exceptions.

Detection of Device Infection Using Nuclear Cardiology Imaging

“…Nuclear medicine offers useful tools to evaluate patients with suspected or confirmed infectious and inflammatory processes (4). Their role relies on the strength of noninvasive imaging tests that targeting molecular processes provide functional and metabolic information early during the course of the disease.…”

“…4 No. 1 52-59 low resolution have been overcome to a large extent during the last decade by the introduction of hybrid imaging (1,4,6).…”

“…Infection of vascular prosthesis (VPI) is quite rare (incidence of 0.5%-6% depending on surgical site) but it is associated to a significant increase in morbidity and mortality risk as well as to high costs (46,47 example. Dual-time-point images and a five point visual grading 18 F-FDG score, improving image quality, and enhancing delineation of the infected aortic grafts, may be used to enhance the diagnostic accuracy (4,52,56,57). Both WBC scintigraphy and 18 F-FDG PET/CT may be used to evaluate antimicrobial treatment response in VPI (1,20).…”

“…The diagnosis relies on careful patient' s assessment according to specific diagnostic flow-chart. A multidisciplinary approach is necessary and has been shown reducing mortality (1,(3)(4)(5). Strategies to facilitate early diagnosis are crucial for a favorable clinical outcome.…”

The value of 18F-FDG PET/CT for the diagnosis of device-related infections in patients with a left ventricular assist device: a systematic review and meta-analysis

“…For endocarditis and infections in patients with cardiac implantable electronic devices, i.e. pacemakers, implantable cardioverter defibrillators (ICDs), FDG-PET/CT has already been incorporated in ESC guidelines and its diagnostic value for this indication is supported by an extensive body of evidence [8][9][10][11]. Its value for the diagnosis of LVAD-related infections is still being investigated, but here supporting evidence is also emerging.…”