Infection Imaging: Focus on New Tracers?

J Nucl Med. 2023 Nov;64(Suppl 2):59S-67S. doi: 10.2967/jnumed.122.264869.


Infections account for relevant morbidity and mortality, especially if the cardiovascular system is affected. Clinical manifestations are often unspecific, resulting in a challenging diagnostic work-up. The use of molecular imaging methods, namely [18F]FDG PET and leukocyte scintigraphy, is increasingly recognized in recently published international guidelines. However, these 2 established methods focus on the host's immune response to the pathogen and are therefore virtually unable to differentiate infection from inflammation. Targeting the microorganism responsible for the infection directly with novel imaging agents is a promising strategy to overcome these limitations. In this review, we discuss clinically approved [18F]FDG PET with its advantages and limitations in cardiovascular infections, followed by new PET-based approaches for the detection of cardiovascular infections by bacteria-specific molecular imaging methods. A multitude of different targeting options has already been preclinically evaluated, but most still lack clinical translation. We give an overview not only on promising tracer candidates for noninvasive molecular imaging of infections but also on issues hampering clinical translation.

Keywords: cardiovascular system; infection; infective endocarditis; vascular graft infection.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cardiovascular Infections*
  • Cardiovascular System*
  • Fluorodeoxyglucose F18
  • Humans
  • Positron Emission Tomography Computed Tomography
  • Radiopharmaceuticals


  • Fluorodeoxyglucose F18
  • Radiopharmaceuticals