Department of Medicine-DIMED,Institute of Radiology, University of Padova, 35100 Padova, Italy.
Nuclear Medicine Unit, Department of Medicine-DIMED, University of Padova, 35128 Padova, Italy.
Int J Mol Sci. 2020 Jan 30;21(3):894. doi: 10.3390/ijms21030894.
Infectious and inflammatory pulmonary diseases are a leading cause of morbidity and mortality worldwide. Although infrequently used in this setting, molecular imaging may significantly contribute to their diagnosis using techniques like single photon emission tomography (SPET), positron emission tomography (PET) with computed tomography (CT) or magnetic resonance imaging (MRI) with the support of specific or unspecific radiopharmaceutical agents. F-Fluorodeoxyglucose (F-FDG), mostly applied in oncological imaging, can also detect cells actively involved in infectious and inflammatory conditions, even if with a low specificity. SPET with nonspecific (e.g., Gallium-citrate (Ga citrate)) and specific tracers (e.g., white blood cells radiolabeled with Indium-oxine (In) or Technetium (Tc)) showed interesting results for many inflammatory lung diseases. However, Ga citrate is unfavorable by a radioprotection point of view while radiolabeled white blood cells scan implies complex laboratory settings and labeling procedures. Radiolabeled antibiotics (e.g., ciprofloxacin) have been recently tested, although they seem to be quite unspecific and cause antibiotic resistance. New radiolabeled agents like antimicrobic peptides, binding to bacterial cell membranes, seem very promising. Thus, the aim of this narrative review is to provide a comprehensive overview about techniques, including PET/MRI, and tracers that can guide the clinicians in the appropriate diagnostic pathway of infectious and inflammatory pulmonary diseases.
感染和炎症性肺部疾病是全球发病率和死亡率的主要原因。尽管在这种情况下很少使用，但分子成像技术可以通过单光子发射断层扫描（SPET）、正电子发射断层扫描（PET）与计算机断层扫描（CT）结合、或磁共振成像（MRI）与特定或非特定放射性药物的支持，对其进行诊断，并做出重大贡献。氟代脱氧葡萄糖（F-FDG）主要应用于肿瘤成像，也可以检测到积极参与感染和炎症状态的细胞，即使特异性较低。非特异性（例如，枸橼酸镓（Ga 枸橼酸盐））和特异性示踪剂（例如，用铟-oxine（In）或锝（Tc）标记的白细胞）的 SPET 在许多炎症性肺病中显示出有趣的结果。然而，从放射防护的角度来看，Ga 枸橼酸盐并不理想，而放射性标记的白细胞扫描则需要复杂的实验室设置和标记程序。最近已经测试了放射性标记的抗生素（例如环丙沙星），尽管它们似乎非常不特异，并导致抗生素耐药性。新的放射性标记药物，如与细菌细胞膜结合的抗菌肽，似乎非常有前途。因此，本叙述性综述的目的是提供有关技术的全面概述，包括 PET/MRI 和示踪剂，以指导临床医生在感染和炎症性肺部疾病的适当诊断途径中做出决策。
