Nuclear imaging of bacterial infection- state of the art and future directions.

Polvoy, Ilona; Flavell, Robert R; Ohliger, Michael; Rosenberg, Oren; Wilson, David M

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 computed tomography (CT) and magnetic resonance imaging (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 (NM) 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 COVID-19 epidemic, caused by the novel coronavirus SARS-CoV-2, similar thinking may apply in imaging viral pathogens; for this case prominent effects on host proteins most notably ACE2 might also provide worthwhile imaging targets.