Imaging infection/inflammation in the new millennium

Abstract

In the closing half of the past century a wide variety of approaches were developed to visualise infection and inflammation by gamma scintigraphy. Use of autologous leucocytes, labelled with indium-111 or technetium-99m, is still considered the "gold standard" nuclear medicine technique for the imaging of infection and inflammation. However, the range of radiopharmaceuticals used to investigate infectious and non-microbial inflammatory disorders is expanding rapidly. Developments in protein/peptide chemistry and in radiochemistry should lead to agents with very high specific activities. Recently, positron emission tomography with fluorine-18 fluorodeoxyglucose has been shown to delineate infectious and inflammatory foci with high sensitivity. The third millennium will witness a gradual shift from basic (non-specific) or cumbersome, even hazardous techniques (radiolabelled leucocytes) to more sophisticated approaches. Here a survey is presented of the different approaches in use or under investigation.