Department of Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, AP-HP, DMU SMART IMAGING, CHU Bicêtre, Paris, France; Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France; Université Paris-Saclay, Commissariat à l'énergie Atomique et aux Énergies Alternatives (CEA), Centre National de la Recherche Scientifique (CNRS), INSERM, BioMaps, Le Kremlin-Bicêtre, France.
Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France; Department of Rheumatology, Hôpital Bicêtre Assistance Publique -Hôpitaux de Paris, Le Kremlin-Bicêtre, France; Center for Immunology of Viral Infections and Auto-Immune Diseases (IMVA), Université Paris-Saclay, Institut pour la Santé et la Recherche Médicale (INSERM) UMR 1184, Le Kremlin Bicêtre, Paris, France.
Semin Nucl Med. 2024 May;54(3):379-393. doi: 10.1053/j.semnuclmed.2023.10.005. Epub 2023 Nov 14.
Chronic immune diseases mainly include autoimmune and inflammatory diseases. Managing chronic inflammatory and autoimmune diseases has become a significant public health concern, and therapeutic advancements over the past 50 years have been substantial. As therapeutic tools continue to multiply, the challenge now lies in providing each patient with personalized care tailored to the specifics of their condition, ushering in the era of personalized medicine. Precise and holistic imaging is essential in this context to comprehensively map the inflammatory processes in each patient, identify prognostic factors, and monitor treatment responses and complications. Imaging of patients with inflammatory and autoimmune diseases must provide a comprehensive view of the body, enabling the whole-body mapping of systemic involvement. It should identify key cellular players in the pathology, involving both innate immunity (dendritic cells, macrophages), adaptive immunity (lymphocytes), and microenvironmental cells (stromal cells, tissue cells). As a highly sensitive imaging tool with vectorized molecular probe capabilities, PET/CT can be of high relevance in the management of numerous inflammatory and autoimmune diseases. Relying on key molecular concepts of immunity, the clinical usefulness of FDG-PET/CT in several relevant inflammatory and immune-inflammatory conditions, validated or emerging, will be discussed in this review, together with radiolabeled probe perspectives.
慢性免疫性疾病主要包括自身免疫性疾病和炎症性疾病。管理慢性炎症和自身免疫性疾病已成为一个重大的公共卫生关注点，过去 50 年来的治疗进展非常显著。随着治疗工具的不断增加，现在的挑战在于为每个患者提供针对其具体病情量身定制的个性化护理，从而迎来个性化医疗时代。在这种情况下，精确和全面的成像对于全面描绘每位患者的炎症过程、识别预后因素以及监测治疗反应和并发症至关重要。炎症性和自身免疫性疾病患者的影像学检查必须提供对全身的全面观察，实现对全身系统性受累的映射。它应该识别病理学中的关键细胞参与者，包括固有免疫（树突状细胞、巨噬细胞）、适应性免疫（淋巴细胞）和微环境细胞（基质细胞、组织细胞）。作为一种具有向量分子探针能力的高灵敏度成像工具，PET/CT 在许多炎症和自身免疫性疾病的管理中具有重要意义。本综述将讨论 FDG-PET/CT 在几种已验证或新兴的相关炎症和免疫炎症疾病中的关键免疫分子概念的临床应用，并探讨放射性标记探针的观点。
