THE ROLE OF PET/CT IMAGING IN THE ASSESSMENT OF INFECTION

Diagnosis (essentially early detection of infection) and also management decision-making pose clinical challenges. Many resources are invested in developing precise, non- invasive diagnostic tests and efficient therapies for infectious processes. Nuclear medicine procedures are part of the evaluation armamentarium of patients with suspected or confirmed infection. Their strength relies on the fact that they are non-invasive tests that provide both functional as well as metabolic information early during the course of disease. The most frequent nuclear medicine procedures used in the assessment of infection are bone, Gallium and labeled white blood cells scans. PET/CT, using mainly labeled glucose (FDG), is redefining the diagnostic work-up and is currently leading to changes in the management of patients with suspected or known infections. Current evidence supports the use of FDG imaging as a first-line diagnostic tool in patients with suspected or known infectious processes, with convincing data available mainly for indications such as fever of unknown origin (FUO), vertebral osteomyelitis, vasculitis and vascular graft infection. Whether FDG-PET/CT or hybrid imaging with new, more infectious-specific tracers will replace standard nuclear medicine procedures or stand-alone conventional imaging modalities, is still debatable. The future looks promising and the role of molecular hybrid imaging techniques in the assessment of inflammatory and infectious processes is undoubtedly on the rise.