Combined PET and X-ray Computed Tomography Imaging in Pulmonary Infections and Inflammation

Jamshed Bomanji; Ahmad Almuhaideb; Alimuddin Zumla

Disclosures

Curr Opin Pulm Med. 2011;17(3):197-205. 

In This Article

The Future

The diagnosis of a pulmonary lesion seen on plain film or CT scan typically raises the question of infection (acute or chronic), which can be a difficult one to answer. Currently, the lack of clinical trials in respiratory infection imaging makes CT scanning and biopsy a necessity in a symptomatic patient. With the increasing awareness of the impact of radiation dosages and the discomfort associated with biopsy, it would be extremely beneficial to continue research in this area, especially with some of the newer agents postulated to be infection specific. This could negate biopsy or at the very least reduce patient anxiety and possibly decrease the need for high-resolution CT scanning.[1•]

18F-FDG PET/CT has a high sensitivity for infection and inflammation but poor specificity. One approach that may increase the diagnostic accuracy of PET for tuberculosis includes the combined use of 18F-FDG and 11C-acetate, as the latter accumulates in tumors but not in inflammatory lesions.[46] Thus, 11C-acetate may help differentiate inflammation from neoplasms. In the future, labeling antituberculous drugs such as isoniazid and rifampicin with positron-emitting isotopes may culminate in the development of tuberculosis-specific PET radiopharmaceuticals.

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