PET Scans in Infectious Disease
Some specific types of infection can be very challenging to diagnose clinically. Sometimes MRI or CT do not give a clear answer, and Nuclear Medicine has a host of problem solving tools at it’s disposal, including PET.
Diseases where PET is a recommended test for assessing infection
Choosing the optimal test for imaging infectious disease can be complicated. It often involves discussion between Nuclear Medicine Physicians and other referring providers.
Attached are some guidelines on PET accessible to relevant clinicians.
- Infected Vascular Grafts
- Endocarditis
- Fever of Unknown Origin
- Discitis/Osteomyelitis
- Infected Joint Replacement
- Peripheral Bone Infection (Osteomyelitis)
What is wrong with the tests we already have?
MORE TIME, MORE WORK, MORE MONEY, MORE UNCERTAINTY
A Gallium 67-citrate scan has inferior imaging quality to FDG PET, and few suppliers even make it anymore as most sites in the world have switched to PET. The tracer is injected on day 1 and then imaged 48h later.
A white cell scan involves drawing blood from a patient, performing a separation and labeling process in a laboratory, and reinjecting a patient with their radioactive white blood cells. Patients are then imaged on 2 different days. Some sites don’t have the facilities to label cells and have to send blood sample between facilities. This is requires at least 6 hours of technologist work during a labour shortage. There have been several component shortages in the labeling process meaning we may not even be able to do it soon. While white cell imaging may outperform FDG in a very limited number of indications, the added costs and manpower attached may not be sustainable for the small gains.
FDG PET-CT for infection is a 1.5 hour appointment.
The Evidence is Clear on FDG
International consensus guidelines were initially published over 13 years ago Updated general guidance document published in 2025.
BREAKDOWN OF THE EVIDENCE BY INDICATION





What can I do to improve access to this test?
Let politicians and decisionmakers know this is important to you.

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