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Nuclear Imaging of Bacterial Infection: The State of the Art and Future Directions
Ilona Polvoy1, Robert R Flavell1, Oren S Rosenberg2
1Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California.
Abstract:
Increased mortality rates from infectious diseases is a growing public health concern. Successful management of acute bacterial infections requires early diagnosis and treatment, which are not always easy to achieve. Structural imaging techniques such as CT and MRI are often applied to this problem. However, these methods generally rely on secondary inflammatory changes and are frequently not specific to infection. The use of nuclear medicine techniques can add crucial complementary information, allowing visualization of infectious pathophysiology beyond morphologic imaging. This review will discuss the current structural and functional imaging techniques used for the diagnosis of bacterial infection and their roles in different clinical scenarios. We will also present several new radiotracers in development, with an emphasis on probes targeting bacteria-specific metabolism. As highlighted by the current coronavirus disease 2019 epidemic, caused by the novel severe acute respiratory syndrome coronavirus 2, similar thinking may apply in imaging viral pathogens; for this case, prominent effects on host proteins, most notably angiotensin-converting enzyme 2, might also provide worthwhile imaging targets.
Insights
Diagnosing bacterial infections is challenging. Nuclear medicine imaging offers superior visualization of infection pathophysiology compared to structural methods like CT and MRI, aiding early detection and treatment.
Area of Science:
- Medical Imaging
- Nuclear Medicine
- Infectious Disease Diagnosis
Background:
- Rising mortality from infectious diseases necessitates improved diagnostic tools.
- Current structural imaging (CT, MRI) often lacks specificity for infection, relying on secondary inflammatory signs.
- Nuclear medicine provides functional insights into infectious processes, complementing morphologic imaging.
Purpose of the Study:
- To review current structural and functional imaging techniques for bacterial infection diagnosis.
- To discuss the role of these techniques in various clinical settings.
- To highlight novel radiotracers targeting bacterial metabolism and potential viral imaging targets.
Main Methods:
- Review of existing literature on structural and functional imaging in infection.
- Discussion of nuclear medicine techniques and their applications.
- Exploration of emerging radiotracers and imaging strategies for pathogens.
Main Results:
- Structural imaging (CT, MRI) shows inflammatory changes but is often non-specific.
- Nuclear medicine techniques visualize pathophysiology, offering crucial complementary diagnostic information.
- New radiotracers targeting bacterial metabolism show promise for specific infection imaging.
Conclusions:
- Nuclear medicine imaging is vital for visualizing infectious pathophysiology, improving diagnosis beyond structural methods.
- Emerging radiotracers targeting bacterial metabolism offer enhanced specificity.
- Similar imaging strategies may be applicable to viral pathogens, targeting host interactions.
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