Nuclear Imaging of Bacterial Infection

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Computed Tomography: 0.50
Procedures: 0.50
Head, Spine, and Musculoskeletal: 0.25
Neck and Chest: 0.25

Magnetic Resonance Imaging: 0.50
Procedures: 0.50
Neurological: 0.25
Musculoskeletal: 0.25

Nuclear Medicine Technology: 1.25
Procedures: 1.25
Other Imaging Procedures: 1.25

Radiography: 0.50
Procedures: 0.50
Head, Spine and Pelvis Procedures: 0.25
Thorax and Abdomen Procedures: 0.25

Registered Radiologist Assistant: 1.00
Procedures: 1.00
Abdominal Section: 0.25
Thoracic Section: 0.25
Musculoskeletal and Endocrine Sections: 0.25
Neurological, Vascular, and Lymphatic Sections: 0.25

Sonography: 0.50
Procedures: 0.50
Abdomen: 0.25
Superficial Structures and Other Sonographic Procedures: 0.25

Outline

1. Introduction
2. Imaging Infection: The State of the Art
   1. Structural Imaging Techniques
   2. Functional Imaging Techniques
3. Clinical Uses of NM in Imaging Infection
   1. Musculoskeletal Infection–Osteomyelitis
   2. Cardiovascular System Infection
   3. FUO
4. Newer Approaches to Microorganism-Specific Imaging
   1. Antibiotics
   2. Carbohydrates
   3. Cofactor or DNA Synthesis
   4. Iron Transport and Storage
   5. D-Amino Acids
5. Conclusion

Objectives

Upon completion of this course, students will:

1. know the patient population(s) for which diagnosing infections can be difficult due to infectious and inflammatory conditions having similar signs and symptoms
2. understand where structural imaging techniques excel in infection diagnosis
3. be familiar with the strengths of the various medical imaging methods that are used to diagnose infection
4. know the most commonly used noninvasive technique for tissue structure evaluation
5. understand the advantages and disadvantages of MR structural imaging
6. know what is anticipated by the clinicians using NM techniques for infectious disease evaluation
7. know what the uptake of radiolabeled diphosphonate in pathologic processes depends upon in bone scintigraphy
8. know the phases of a TPBS and what they demonstrate
9. be familiar with the facts of scintigraphy with labeled autologous white blood cells
10. be familiar with the administered activity range in MBq for the various NM imaging techniques
11. know what can be done to possibly improve WBC scintigraphy’s specificity
12. understand the advantage of ⁶⁷Ga-citrate imaging over WBC scintigraphy for immune-compromised patients
13. be familiar with the patient preparation requirements for ¹⁸F-FDG imaging
14. understand the reasons why the diagnosis of osteomyelitis commonly delayed
15. know the test of choice for the assessment of peripheral bone infections in patients who have undergone intervention
16. be familiar with the strengths and weaknesses of the various NM imaging techniques for spinal osteomyelitis
17. be familiar with the NM imaging options for the assessment for possible prosthetic joint infection in both early and late stages post-surgery
18. know how NM imaging can best contribute to the diagnosis of cardiovascular system infections
19. know what has been suggested by a recent metaanalysis about ⁶⁷Ga-citrate imaging for FUO
20. be familiar with the targeted unique microbial pathways used by some of the newer radiotracer methods for bacterial infection evaluation
21. be familiar with the mechanisms, targeted bacterial pathogen, and the pathogens tested in vivo for recently developed bacteria-specific radiotracers
22. know the reported capabilities of ¹⁸F-FPTMP in rodent models
23. be familiar with how 2-deoxy-2-¹⁸F-fluoro-D-glucose-6-phosphate is made and its clinical utility
24. be familiar with the various radiotracer options for targeting the maltodextrin transporter in the assessment for bacterial infections
25. be familiar with the creation and use of 2-deoxy-2-¹⁸F-fluorosorbitol
26. understand how radiolabeled PABA incorporates in the body for imaging
27. know the method that has been shown to greatly increase the ¹⁸F-PABA uptake
28. understand the demonstrated downsides found with ¹²⁴I-FIAU imaging
29. be familiar with some of the basic information on ⁶⁸Ga citrate and its use
30. be familiar with how D-amino acids can be use in the imaging process