Abstract
Inflammatory diseases include a wide variety of highly prevalent conditions with high mortality rates in severe cases ranging from cardiovascular disease, to rheumatoid arthritis, to chronic obstructive pulmonary disease, to graft vs. host disease, to a number of gastrointestinal disorders. Many diseases that are not considered inflammatory per se are associated with varying levels of inflammation. Imaging of the immune system and inflammatory response is of interest as it can give insight into disease progression and severity. Clinical imaging technologies such as computed tomography (CT) and magnetic resonance imaging (MRI) are traditionally limited to the visualization of anatomical information; then, the presence or absence of an inflammatory state must be inferred from the structural abnormalities. Improvement in available contrast agents has made it possible to obtain functional information as well as anatomical. In vivo imaging of inflammation ultimately facilitates an improved accuracy of diagnostics and monitoring of patients to allow for better patient care. Highly specific molecular imaging of inflammatory biomarkers allows for earlier diagnosis to prevent irreversible damage. Advancements in imaging instruments, targeted tracers, and contrast agents represent a rapidly growing area of preclinical research with the hopes of quick translation to the clinic.
Highlights
Inflammation can manifest in all areas of the body and is often the common denominator between a plethora of diseases and infections
18 F-FDG requires a circulation time of 2–3 h to allow for accumulation in the arterial wall take will be seen at locations of increased macrophage density, which is reflective of inflammation and active plaque buildup (Figure 1) [38,46]
A monoclonal antibody that targets CD20, a cell surface marker that is expressed on most B cells, can be radiolabeled and used as a probe for the in vivo molecof Rheumatoid arthritis (RA) based on B lymphocyte accumulation in the synovial fluid (Figure 2) [4,105,106]
Summary
Inflammation can manifest in all areas of the body and is often the common denominator between a plethora of diseases and infections. Molecular imaging has traditionally required tracer molecules specific for biological processes These tracers consist of a contrast-generating agent, e.g., fluorescent dye, which is targeted for a molecule/function within the body. Such tracers offer high, controllable, and specific contrast, which is unachievable with endogenous contrast alone. Recent advancements in contrast agents allows for the extraction of functional and molecular information as well as anatomical information from standard imaging modalities. The low sensitivity and limited specificity of gadolinium-based contrast agents renders T1-weighted MRI suboptimal for molecular imaging [15]. The sensitivity of CEST imaging is directly related to the chemical exchange rate of the proton transfer, allowing for molecular imaging of specific metabolites that are found at low concentrations [21]. The purpose of this review is to highlight the existing molecular imaging techniques used to assess the inflammatory state of cardiovascular disease, rheumatoid arthritis, chronic obstructive lung disease, and gastrointestinal disorders
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