Using Nuclear Medicine Imaging Wisely in Diagnosing Infectious Diseases

Area of Science:

• Nuclear medicine
• Infectious disease diagnostics
• Medical imaging

Background:

• Increasing emphasis on efficient and accurate diagnostic testing, highlighted by the "Choosing Wisely" campaign.
• Nuclear imaging offers early and accurate diagnoses for infectious disease syndromes, especially in complex cases.
• Challenges exist due to varying radiologist expertise in advanced nuclear medicine modalities.

Purpose of the Study:

• To provide clinicians with a rational, evidence-based guide for utilizing nuclear medicine tests.
• To illustrate the application of nuclear imaging in complex infectious disease cases using a methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia example.
• To guide infectious disease consultants on selecting appropriate nuclear medicine tests for complex syndromes.

Main Methods:

• Review of current literature and clinical guidelines on nuclear medicine applications in infectious diseases.
• Case study analysis of MSSA bacteremia with multiple potential infection sources.
• Evaluation of Fluorodeoxyglucose-positron emission tomography (FDG-PET) with computed tomography (CT) and sulfur colloid imaging with tagged white blood cell (WBC) scanning.

Main Results:

• FDG-PET/CT and tagged WBC scans show significant promise for diagnosing various infections.
• These modalities facilitate rapid and accurate diagnoses of endovascular graft infections, vertebral osteomyelitis (V-OM), diabetic foot infections, and prosthetic joint infections (PJIs).
• The utility of these tests can be influenced by institutional radiologist expertise.

Conclusions:

• Nuclear medicine imaging plays a vital role in the diagnosis of complex infectious diseases.
• Infectious disease consultants benefit from understanding the appropriate use of nuclear medicine tests.
• Strategic application of FDG-PET/CT and tagged WBC scans can improve diagnostic accuracy and patient management.