Radionuclide Imaging of Invasive Fungal Disease in Immunocompromised Hosts

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 o...

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Main Authors: Ismaheel O. Lawal, Kgomotso M. G. Mokoala, Mankgopo M. Kgatle, Rudi A. J. O. Dierckx, Andor W. J. M. Glaudemans, Mike M. Sathekge, Alfred O. Ankrah
Format: Article
Language:English
Published: MDPI AG 2021-11-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/11/11/2057
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author Ismaheel O. Lawal
Kgomotso M. G. Mokoala
Mankgopo M. Kgatle
Rudi A. J. O. Dierckx
Andor W. J. M. Glaudemans
Mike M. Sathekge
Alfred O. Ankrah
author_facet Ismaheel O. Lawal
Kgomotso M. G. Mokoala
Mankgopo M. Kgatle
Rudi A. J. O. Dierckx
Andor W. J. M. Glaudemans
Mike M. Sathekge
Alfred O. Ankrah
author_sort Ismaheel O. Lawal
collection DOAJ
description 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.
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spelling doaj.art-bbac3dc4d30e4fc9a3e351b249db7e6a2023-11-22T23:01:42ZengMDPI AGDiagnostics2075-44182021-11-011111205710.3390/diagnostics11112057Radionuclide Imaging of Invasive Fungal Disease in Immunocompromised HostsIsmaheel O. Lawal0Kgomotso M. G. Mokoala1Mankgopo M. Kgatle2Rudi A. J. O. Dierckx3Andor W. J. M. Glaudemans4Mike M. Sathekge5Alfred O. Ankrah6Department of Nuclear Medicine, University of Pretoria, Pretoria 0001, South AfricaDepartment of Nuclear Medicine, University of Pretoria, Pretoria 0001, South AfricaDepartment of Nuclear Medicine, University of Pretoria, Pretoria 0001, South AfricaMedical Imaging Center, Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, 9700 RB Groningen, The NetherlandsMedical Imaging Center, Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, 9700 RB Groningen, The NetherlandsDepartment of Nuclear Medicine, University of Pretoria, Pretoria 0001, South AfricaDepartment of Nuclear Medicine, University of Pretoria, Pretoria 0001, South AfricaInvasive 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.https://www.mdpi.com/2075-4418/11/11/2057radionuclide imaginginvasive fungal diseaseimmunosuppressionHIV[<sup>18</sup>F]FDG PET/CT
spellingShingle Ismaheel O. Lawal
Kgomotso M. G. Mokoala
Mankgopo M. Kgatle
Rudi A. J. O. Dierckx
Andor W. J. M. Glaudemans
Mike M. Sathekge
Alfred O. Ankrah
Radionuclide Imaging of Invasive Fungal Disease in Immunocompromised Hosts
Diagnostics
radionuclide imaging
invasive fungal disease
immunosuppression
HIV
[<sup>18</sup>F]FDG PET/CT
title Radionuclide Imaging of Invasive Fungal Disease in Immunocompromised Hosts
title_full Radionuclide Imaging of Invasive Fungal Disease in Immunocompromised Hosts
title_fullStr Radionuclide Imaging of Invasive Fungal Disease in Immunocompromised Hosts
title_full_unstemmed Radionuclide Imaging of Invasive Fungal Disease in Immunocompromised Hosts
title_short Radionuclide Imaging of Invasive Fungal Disease in Immunocompromised Hosts
title_sort radionuclide imaging of invasive fungal disease in immunocompromised hosts
topic radionuclide imaging
invasive fungal disease
immunosuppression
HIV
[<sup>18</sup>F]FDG PET/CT
url https://www.mdpi.com/2075-4418/11/11/2057
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