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Imaging Tuberculosis and AIDS Associated Infections

  • Ismaheel O. Lawal
  • Mike M. SathekgeEmail author
Chapter

Abstract

About a quarter of the world population is infected with Mycobacterium tuberculosis. About 1–3 of every ten infected individuals will develop symptomatic tuberculosis (TB) in their lifetime. Microscopy and culture are the gold standards for diagnosis and treatment response assessment in TB management. The yield of microscopy and culture can be low; hence, other biomarkers are necessary to guide management. Imaging plays a supportive role in TB management. FDG PET/CT is a useful noninvasive imaging modality for pretreatment assessment, prediction, and monitoring of therapy response, and end-of-treatment prediction of relapse. FDG is nonspecific as it cannot differentiate TB from other infection/inflammatory condition or neoplastic disease. Evidence from preclinical studies is emerging to support the potential of mycobacterial-specific imaging using radiolabeled antimycobacterial drugs and other probes that specifically target the tubercle bacilli for noninvasive imaging and for studying biokinetics of commonly used chemotherapy drugs in TB treatment.

Immunosuppression associated with human immunodeficiency virus (HIV) infection predisposes people living with HIV (PLWHIV) to an array of opportunistic infections. PLWHIV also suffer from infections seen in immunocompetent individuals. Ga-67 citrate single photon emission imaging has played an essential role in the management of HIV-associated opportunistic infections. This role is now being slowly taken over by Ga-68 citrate PET/CT imaging due to the latter’s better image resolution, lower radiation burden, and wider availability.

Many newer probes with potential for clinical translation are being reported in the literature for SPECT and PET imaging of TB and other HIV-associated infections. In this chapter, we describe the clinical need for imaging in TB and other HIV-associated infections. We will then describe SPECT and PET imaging of these infectious diseases and concluded by giving our thoughts on the prospects of radionuclide imaging in the management TB and HIV-associated infections.

Keywords

Tuberculosis HIV AIDS Opportunistic infections FDG PET/CT Ga-68 citrate PET/CT Mycobacterial-specific imaging SPECT imaging 

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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Nuclear MedicineSteve Biko Academic Hospital and University of PretoriaPretoriaSouth Africa

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