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当前用于感染成像的放射性药物和圣杯。

Currently Available Radiopharmaceuticals for Imaging Infection and the Holy Grail.

机构信息

Department of Radiology, Thomas Jefferson University, Philadelphia, PA 19107; Department of Nuclear Medicine, Kahramanmaras Sutcu Imam University Faculty of Medicine, Avsar Kampus, Kahramanmaras 46040, Turkey.

Department of Radiology, Thomas Jefferson University, Philadelphia, PA 19107.

出版信息

Semin Nucl Med. 2018 Mar;48(2):86-99. doi: 10.1053/j.semnuclmed.2017.10.003.

Abstract

Infection is ubiquitous. However, its management is challenging for both the patients and the health-care providers. Scintigraphic imaging of infection dates back nearly half a century. The advances in our understanding of the pathophysiology of disease at cellular and molecular levels have paved the way to the development of a large number of radiopharmaceuticals for scintigraphic imaging of infection. These include radiolabeling of blood elements such as serum proteins, white blood cells (WBCs), and cytokines, to name a few. Infectious foci have also been imaged using a radiolabeled sugar molecule by taking advantage of increased metabolic activity in the infectious lesions. Literature over the years has well documented that none of the radiopharmaceuticals and associated procedures that facilitate imaging infection are flawless and acceptable without a compromise. As a result, only a few compounds such as Tc-hexamethylpropyleneamineoxime, F-FDG, the oldest but still considered as a gold standard In-oxine, and, yes, even Ga-citrate in some countries, have remained in routine clinical practice. Nonetheless, the interest of scientists and physicians to improve the approaches to imaging and to the management of infection is noteworthy. These approaches have paved the way for the development of numerous, innovative radiopharmaceuticals to label autologous WBCs ex vivo or even those that could be injected directly to image infection or inflammation without direct involvement of WBCs. In this review, we briefly describe these agents with their pros and cons and place them together for future reference.

摘要

感染无处不在。然而,无论是患者还是医疗保健提供者,都很难对其进行管理。感染的闪烁成像可以追溯到近半个世纪前。我们对疾病的细胞和分子水平的病理生理学的理解的进步,为大量放射性药物的开发铺平了道路,这些放射性药物可用于感染的闪烁成像。其中包括对血液成分(如血清蛋白、白细胞(WBC)和细胞因子)进行放射性标记,仅举几例。还利用感染病灶中代谢活性的增加,使用放射性标记的糖分子对感染灶进行成像。多年来的文献充分证明,在没有妥协的情况下,没有一种放射性药物及其相关程序可以完美无缺地用于感染成像。因此,只有少数几种化合物,如 Tc-六甲基丙烯胺肟、F-FDG(最古老但仍被认为是金标准的 In-oxine),以及在某些国家甚至 Ga-枸橼酸盐,仍保留在常规临床实践中。尽管如此,科学家和医生对改善感染成像和管理方法的兴趣值得注意。这些方法为开发许多创新的放射性药物铺平了道路,这些放射性药物可以对自体白细胞进行体外标记,甚至可以直接注射这些放射性药物来对感染或炎症进行成像,而无需白细胞的直接参与。在这篇综述中,我们简要描述了这些药物的优缺点,并将它们放在一起以备将来参考。

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