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Systematic review of in vivo microorganisms imaging with labeled vitamins, bacteriophages and oligomers

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Abstract

Infection is always accompanied by inflammation and the real challenge is the ability to discriminate between infection and inflammation, this represents the “condicio sine qua non” for choosing the correct therapy. The role of the nuclear physician should be that to choose the appropriate radiopharmaceutical for each patient’s condition, to administer the imaging agent, to acquire scintigraphic images, and finally to report a diagnosis or a treatment response. Unfortunately, all the radiopharmaceuticals commercially available are nowadays not able to recognize directly the presence of bacteria, for this reason there are some radiopharmaceuticals that are under experimental evaluation, in this review bacterial growth factors (Biotin and Cyanocobalamin), bacteriophages and phosphorodiamidate morpholino (MORF) will be described. A systematic review of the literature of reported diagnostic accuracy of labeled biotin scintigraphy in detection of infection diseases, as well as a review of the preclinical studies with labeled bacteriophages and phosphorodiamidate morpholino for bacteria-targeted imaging, are presented. The results of 7 clinical studies carried out from 1996 to 2010 using labeled Biotin scintigraphy in patients with bone infection indicate a pooled sensitivity of 95.4 % and specificity of 92.8 %. Scintigraphic images of preclinical studies with labeled bacteriophages and MORF showed high diagnostic accuracy in the diagnosis of infection. Labeled biotin, tested in a relatively small patients group (n = 357), still need further studies to reach a significative level of evidence. All the other described radiopharmaceuticals need further studies to allow their use in patients for finally distinguishing infection from sterile inflammation.

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  1. Regional Center of Nuclear Medicine, University of Pisa Medical School, Pisa, Italy

    Elena Lazzeri

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  1. Elena Lazzeri
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Correspondence to Elena Lazzeri.

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Elena Lazzeri declares no conflict of interest.

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Lazzeri, E. Systematic review of in vivo microorganisms imaging with labeled vitamins, bacteriophages and oligomers. Clin Transl Imaging 4, 265–272 (2016). https://doi.org/10.1007/s40336-016-0182-y

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