| Autor: |
Lawal IO; Department of Nuclear Medicine, University of Pretoria, Pretoria 0001, South Africa.; Nuclear Medicine Research Infrastructure (NuMeRI), Steve Biko Academic Hospital, Pretoria 0001, South Africa., Mokoala KMG; Department of Nuclear Medicine, University of Pretoria, Pretoria 0001, South Africa.; Nuclear Medicine Research Infrastructure (NuMeRI), Steve Biko Academic Hospital, Pretoria 0001, South Africa., Kgatle MM; Department of Nuclear Medicine, University of Pretoria, Pretoria 0001, South Africa.; Nuclear Medicine Research Infrastructure (NuMeRI), Steve Biko Academic Hospital, Pretoria 0001, South Africa., Dierckx RAJO; Medical Imaging Center, Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, 9700 RB Groningen, The Netherlands., Glaudemans AWJM; Medical Imaging Center, Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, 9700 RB Groningen, The Netherlands., Sathekge MM; Department of Nuclear Medicine, University of Pretoria, Pretoria 0001, South Africa.; Nuclear Medicine Research Infrastructure (NuMeRI), Steve Biko Academic Hospital, Pretoria 0001, South Africa., Ankrah AO; Department of Nuclear Medicine, University of Pretoria, Pretoria 0001, South Africa.; Medical Imaging Center, Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, 9700 RB Groningen, The Netherlands.; National Center for Radiotherapy Oncology and Nuclear Medicine, Korle Bu Teaching Hospital, Accra GA-222 7974, Ghana. |
| Abstrakt: |
Invasive fungal disease (IFD) leads to increased mortality, morbidity, and costs of treatment in patients with immunosuppressive conditions. The definitive diagnosis of IFD relies on the isolation of the causative fungal agents through microscopy, culture, or nucleic acid testing in tissue samples obtained from the sites of the disease. Biopsy is not always feasible or safe to be undertaken in immunocompromised hosts at risk of IFD. Noninvasive diagnostic techniques are, therefore, needed for the diagnosis and treatment response assessment of IFD. The available techniques that identify fungal-specific antigens in biological samples for diagnosing IFD have variable sensitivity and specificity. They also have limited utility in response assessment. Imaging has, therefore, been applied for the noninvasive detection of IFD. Morphologic imaging with computed tomography (CT) and magnetic resonance imaging (MRI) is the most applied technique. These techniques are neither sufficiently sensitive nor specific for the early diagnosis of IFD. Morphologic changes evaluated by CT and MRI occur later in the disease course and during recovery after successful treatment. These modalities may, therefore, not be ideal for early diagnosis and early response to therapy determination. Radionuclide imaging allows for targeting the host response to pathogenic fungi or specific structures of the pathogen itself. This makes radionuclide imaging techniques suitable for the early diagnosis and treatment response assessment of IFD. In this review, we aimed to discuss the interplay of host immunity, immunosuppression, and the occurrence of IFD. We also discuss the currently available radionuclide probes that have been evaluated in preclinical and clinical studies for their ability to detect IFD. |
