Advances in Inflammation and Infection Imaging

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: 30 September 2025 | Viewed by 3407

Special Issue Editor

Special Issue Information

Dear Colleagues,

Infectious and inflammatory diseases include a large group of diseases with different aetiologies. Infection is the invasion of a host organism by microorganisms such as viruses, prions, bacteria, and viroids, as well as larger organisms like parasites and fungal organisms. After invasion, these organisms may multiply and produce toxins. Hosts can fight infections using their immune system, usually producing inflammation.

Inflammation is part of the complex biological response by the organism to harmful stimuli such as pathogens, damaged cells, or irritants. Inflammation is not a synonym for infection; we almost always have inflammation associated with an infection, but we do not always have an infection if there is inflammation.

Several imaging methods may allow for the early, non-invasive detection of infectious and inflammatory diseases; in particular, molecular imaging methods may be very useful for the measurement of cellular and molecular processes in living subjects related to infectious and inflammatory diseases.

This Special Issue will highlight the advances of imaging methods in infectious and inflammatory diseases, in particular for the diagnosis and the assessment of response to therapy. Researchers are encouraged to submit both preclinical and clinical studies in the field. Clinical studies may include systematic or narrative reviews and retrospective or prospective studies emphasizing the role and need of imaging techniques in infectious or inflammatory diseases.

Prof. Dr. Giorgio Treglia
Guest Editor

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Keywords

  • imaging
  • infection
  • inflammation
  • radiology
  • nuclear medicine
  • molecular imaging
  • hybrid imaging

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Published Papers (3 papers)

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Research

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11 pages, 7053 KiB  
Article
Diagnostic Value of Increased [18F]FDG Uptake in Locoregional Lymph Nodes on PET/CT in Patients with Suspected Fracture-Related Infection
by Paul Bosch, Andor W. J. M. Glaudemans, Jean-Paul P. M. de Vries, Johannes H. van Snick, Justin V. C. Lemans, Janna van den Kieboom, Monique G. G. Hobbelink, Geertje A. M. Govaert and Frank F. A. IJpma
Diagnostics 2025, 15(5), 616; https://doi.org/10.3390/diagnostics15050616 - 4 Mar 2025
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Abstract
Background: Diagnosing fracture-related infection (FRI) without clinical confirmatory signs is challenging. [18F]FDG-PET/CT has been shown to have good diagnostic accuracy. However, direct interpretation criteria are lacking. The aim of this study was to assess the diagnostic value of increased FDG-uptake in locoregional lymph [...] Read more.
Background: Diagnosing fracture-related infection (FRI) without clinical confirmatory signs is challenging. [18F]FDG-PET/CT has been shown to have good diagnostic accuracy. However, direct interpretation criteria are lacking. The aim of this study was to assess the diagnostic value of increased FDG-uptake in locoregional lymph nodes on [18F]FDG-PET/CT in patients with suspected upper and lower extremity FRI. Methods: This was a retrospective cohort study of patients who underwent [18F]FDG-PET/CT for suspected extremity FRI in two tertiary referral centers between January 2011 and December 2023. The sensitivity, specificity and diagnostic value of the presence, number and intensity of [18F]FDG uptake in locoregional lymph nodes was assessed. Uptake intensity was measured by calculating the maximum standard uptake value (SUVmax) of the ‘hottest’ lymph node. All scans were acquired according to the European Association of Nuclear Medicine (EANM) standards, and quantification was performed based on standardized EARL reconstructed images. FRI was diagnosed based on positive intra-operative microbiology results or development of clinical confirmatory signs within six months of follow-up. Results: One-hundred-and-twenty-four patients were included in the analysis, with 71 cases of confirmed FRI. The presence of locoregional lymph nodes alone showed poor diagnostic accuracy (sensitivity 55%, specificity 68%, diagnostic accuracy 62%). The number of active lymph nodes showed poor discriminative performance between FRI and non-infectious cases (AUC 0.63). Utilizing the SUVmax of the ‘hottest’ lymph nodes showed a moderate discriminative performance with an AUC of 0.71. The optimal cutoff point (SUVmax 3.48) resulted in a sensitivity of 72%, a specificity of 78% and a diagnostic accuracy of 75%. A logistic regression model was fitted to calculate the added value of lymph node assessment to the regular [18F]FDG-PET/CT assessment. This resulted in a sensitivity of 71%, a specificity of 82% and a diagnostic accuracy of 76%. Conclusions: Presence and number of locoregional lymph nodes with increased [18F]FDG-uptake alone has poor diagnostic accuracy for FRI. The SUVmax of the ‘hottest’ lymph node showed moderate diagnostic performance. Lymph node assessment slightly increased the diagnostic value of regular [18F]FDG-PET/CT assessment. Based on these results, increased [18F]FDG-uptake in locoregional lymph nodes should only be considered as a suggestive sign for a positive scan result in suspected FRI. Full article
(This article belongs to the Special Issue Advances in Inflammation and Infection Imaging)
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13 pages, 94490 KiB  
Article
Histopathological Evaluation of Somatostatin Receptor 2 Expression in Myocarditis—Rationale for the Diagnostic Use of Somatostatin Receptor Imaging
by Christian L. Polte, Kittichate Visuttijai, Kristina Vukusic, Joakim Sandstedt, Mikael Sandstedt, Emanuele Bobbio, Marie Björkenstam, Kristjan Karason, Niklas Bergh, Entela Bollano and Anders Oldfors
Diagnostics 2024, 14(21), 2374; https://doi.org/10.3390/diagnostics14212374 - 24 Oct 2024
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Abstract
Background/Objectives: Myocarditis is an inflammatory disease of the myocardium and remains to this day a challenging diagnosis. A promising novel imaging method uses the expression of somatostatin receptors (SSTRs) on inflammatory cells to visualize myocardial inflammation. However, little is known about the histopathological [...] Read more.
Background/Objectives: Myocarditis is an inflammatory disease of the myocardium and remains to this day a challenging diagnosis. A promising novel imaging method uses the expression of somatostatin receptors (SSTRs) on inflammatory cells to visualize myocardial inflammation. However, little is known about the histopathological correlate of SSTR imaging in different forms of myocarditis. Methods: In the present retrospective histopathological study, we systematically analysed the expression of SSTR subtype 2 (SSTR2) on inflammatory cells of 33 patients with biopsy- or explant-proven myocarditis (lymphocytic myocarditis (n = 5), giant-cell myocarditis (n = 11), and cardiac sarcoidosis (n = 17)), and in eight controls (multi-organ donors) without signs of myocardial inflammation and/or scars. Results: In all patients, immunohistochemical staining for SSTR2 was positive in areas with CD68-positive macrophages and multinucleated giant cells. Staining for SSTR2 was most prominent in the presence of multinucleated giant cells. The colocalization of both SSTR2 and CD68 on the same cell could be confirmed using immunofluorescence microscopy. Western blotting confirmed the upregulated expression of SSTR2 in cases of granulomatous inflammation (sarcoidosis) of the skeletal and heart muscle, in comparison with controls. Conclusions: In conclusion, our findings demonstrate the expression of SSTR2 on the protein level on CD68-positive macrophages and multinucleated giant cells in various forms of myocarditis, which provides a clear rationale for the diagnostic use of SSTR imaging in this patient group. Full article
(This article belongs to the Special Issue Advances in Inflammation and Infection Imaging)
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14 pages, 1842 KiB  
Systematic Review
Performance of [18F]FDG PET/CT in Diagnosing Cyst Infections in Patients with Autosomal Dominant Polycystic Kidney Disease: A Systematic Review and a Bivariate Meta-Analysis
by Giorgio Treglia, Domenico Albano, Alessio Rizzo, Antonio Bellasi, Andor W. J. M. Glaudemans and Olivier Gheysens
Diagnostics 2024, 14(15), 1603; https://doi.org/10.3390/diagnostics14151603 - 25 Jul 2024
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Abstract
Background: Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography ([18F]FDG PET/CT) has been suggested as a useful imaging method for diagnosing cyst infections in patients with autosomal dominant polycystic kidney disease (ADPKD). The aim of this article is to provide evidence-based data in [...] Read more.
Background: Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography ([18F]FDG PET/CT) has been suggested as a useful imaging method for diagnosing cyst infections in patients with autosomal dominant polycystic kidney disease (ADPKD). The aim of this article is to provide evidence-based data in this setting. Methods: A systematic literature review (exploring several bibliographic databases) and a bivariate meta-analysis were carried out to calculate the pooled diagnostic performance of [18F]FDG PET/CT in diagnosing probable cyst infection in ADPKD. Results: Ten studies (282 PET/CT scans and 249 patients) were included in the analysis. The pooled sensitivity and specificity of [18F]FDG PET/CT in this setting were 84.6% (95% confidence interval: 75.4–90.7) and 94.9% (95% confidence interval: 72.6–99.2), respectively, without statistical heterogeneity or significant publication bias. [18F]FDG PET/CT significantly changed patient management in more than half of ADPKD patients with suspected cyst infection. Conclusions: [18F]FDG PET/CT has high performance in diagnosing probable cyst infections in ADPKD patients with an impact on management in the majority of patients. Although more studies are warranted, the provided evidence-based data are an important step towards the integration of [18F]FDG PET/CT in clinical and diagnostic guidelines on probable cyst infection in ADPKD patients. Full article
(This article belongs to the Special Issue Advances in Inflammation and Infection Imaging)
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