FDG PET/CT in infection and inflammation--current and emerging clinical applications

Area of Science:

• Nuclear Medicine
• Hybrid Imaging
• Radiochemistry

Background:

• 2-[(18)F]-fluoro-2-deoxy-d-glucose (FDG) Positron Emission Tomography/Computed Tomography (PET/CT) is an evolving hybrid imaging technique.
• While established in oncological imaging, its utility in infection and inflammation is increasingly recognized.

Purpose of the Study:

• To discuss the clinical utility of FDG PET/CT in suspected infection and inflammation.
• To highlight the advantages of FDG PET/CT over traditional imaging techniques.
• To review current and emerging evidence for FDG PET/CT in various disorders.

Main Methods:

• Review of clinico-radiological cases.
• Discussion of current and emerging evidence for FDG PET/CT applications.
• Brief summary of novel tracers like FDG-labelled leukocytes and gallium-68 PET tracers.

Main Results:

• FDG PET/CT can identify infection/inflammation sources before morphological changes on CT/MRI.
• It maps disease extent and severity, aids tissue sampling, and assesses therapy response.
• Distinct advantages include shorter examination, higher resolution, quantitative analysis, and combined functional/anatomical imaging.

Conclusions:

• FDG PET/CT is a valuable tool for evaluating diverse conditions characterized by infection and aseptic inflammation.
• It offers significant advantages over traditional radionuclide imaging.
• Emerging evidence supports its expanding role in various clinical indications, including fever of unknown origin and vasculitis.