Background. Traditional imaging techniques for the localization and monitoring of bacterial infections, although reasonably sensitive, suffer from a lack of specificity. This is particularly true for musculoskeletal infections. Bacteria possess a thymidine kinase (TK) whose substrate specificity is distinct from that of the major human TK. The substrate specificity difference has been exploited to develop a new imaging technique that can detect the presence of viable bacteria. Methodology/Principal Findings. Eight subjects with suspected musculoskeletal infections and one healthy control were studied by a combination of [124I]FIAU-positron emission tomography and CT ([124I]FIAU-PET/CT). All patients with proven musculoskeletal infections demonstrated positive [124I]FIAU-PET/CT signals in the sites of concern at two hours after radiopharmaceutical administration. No adverse reactions with FIAU were observed. Conclusions/Significance. [124I]FIAU-PET/CT is a promising new method for imaging bacterial infections.
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