Calabria Ferdinando F, Guadagnino Giuliana, Cimini Andrea, Leporace Mario
Department of Nuclear Medicine and Theragnostics, "Mariano Santo" Hospital, 87100 Cosenza, Italy.
Department of Infectious and Tropical Diseases, St. Annunziata Hospital, 87100 Cosenza, Italy.
Diagnostics (Basel). 2024 May 17;14(10):1043. doi: 10.3390/diagnostics14101043.
Infectious diseases represent one of the most common causes of hospital admission worldwide. The diagnostic work-up requires a complex clinical approach, including laboratory data, CT and MRI, other imaging tools, and microbiologic cultures. PET/CT with F-FDG can support the clinical diagnosis, allowing visualization of increased glucose metabolism in activated macrophages and monocytes; this tracer presents limits in differentiating between aseptic inflammation and infection. Novel PET radiopharmaceuticals have been developed to overcome these limits; C/F-labeled bacterial agents, several Ga-labeled molecules, and white blood cells labeled with F-FDG are emerging PET tracers under study, showing interesting preliminary results. The best choice among these tracers can be unclear. This overview aims to discuss the most common diagnostic applications of F-FDG PET/CT in infectious diseases and, as a counterpoint, to describe and debate the advantages and peculiarities of the latest PET radiopharmaceuticals in the field of infectious diseases, which will probably improve the diagnosis and prognostic stratification of patients with active infectious diseases.
传染病是全球范围内住院治疗最常见的病因之一。诊断检查需要采用复杂的临床方法，包括实验室数据、CT和MRI、其他成像工具以及微生物培养。使用F-FDG的PET/CT能够辅助临床诊断，使活化巨噬细胞和单核细胞中增加的葡萄糖代谢可视化；这种示踪剂在区分无菌性炎症和感染方面存在局限性。已开发出新型PET放射性药物来克服这些局限性；碳/氟标记的细菌制剂、几种镓标记的分子以及用F-FDG标记的白细胞是正在研究的新型PET示踪剂，已显示出有趣的初步结果。这些示踪剂中最佳选择可能并不明确。本综述旨在讨论F-FDG PET/CT在传染病中最常见的诊断应用，并作为对比，描述和探讨该领域最新PET放射性药物的优势和特点，这可能会改善活动性传染病患者的诊断和预后分层。
