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Micro-PET imaging of [18F]fluoroacetate combined with [18F]FDG to differentiate chronic Mycobacterium tuberculosis infection from an acute bacterial infection in a mouse model

a preliminary study

Tsao, Chin-Hoa,d,g; Wu, Chun-Yih; Chang, Chi-Weic; Wang, Hsin-Ellb; Shih, Bing-Fua; Liu, Ren-Shyanb,c,d,e,f

Nuclear Medicine Communications: June 2019 - Volume 40 - Issue 6 - p 639–644
doi: 10.1097/MNM.0000000000001017

Background Mycobacterium tuberculosis (TB) infection is one of the deadliest infectious diseases worldwide and is responsible for 1.7 million deaths per year. The increase in multidrug-resistant TB poses formidable challenges to the global control of tuberculosis. TB infection could easily yield false-positive results in fluorine-18-fluorodeoxyglucose ([18F]FDG) PET imaging for cancer detection because of its high [18F]FDG uptake. We describe the combined [18F]FDG PET with fluorine-18-fluoroacetate ([18F]FAC), a promising analog of carbon-11-acetate, for targeting glycolysis and de novo lipogenesis, respectively, to determine the metabolic differences between chronic TB infection and acute infection.

Materials and methods Six-month-old BALB/c mice were inoculated with Mycobacterium bovis to induce chronic TB infection, and Escherichia coli as well as Staphylococcus aureus to induce acute infection for an in-vivo imaging study. Eighteen days after inoculation for chronic TB infection and 5 days for acute infection, both [18F]FDG and [18F]FAC micro-PET were performed on the infected mice. Analysis of variance and the Tukey honest ad-hoc test were carried out to determine differences among treatment with different bacterial infections.

Results TB infection showed much lower [18F] FAC accumulation than acute infection. However, both TB infection and acute infection exhibited high [18F]FAC accumulation.

Conclusion The marked metabolic differences in de novo lipogenesis and glycolysis in [18F]FDG and [18F]FAC uptakes in micro-PET imaging, respectively, help to differentiate chronic TB infection from acute infection.

aDepartment of Nuclear Medicine, Mackay Memorial Hospital

bDepartment of Biomedical Imaging and Radiological Sciences, National Yang-Ming University

cNational PET/Cyclotron Center and Department of Nuclear Medicine, Taipei Veterans General Hospital

dInstitute of Clinical Medicine, National Yang-Ming University

eDepartment of Nuclear Medicine, Cheng-Hsin General Hospital

fMolecular and Genetic Imaging Core, Animal Consortium, Taipei

gDepartment of Medicine, Mackay Medical College, New Taipei City

hDepartment of Biomedical Imaging and Radiological Sciences, China Medical University, Taichung, Taiwan

Correspondence to Ren-Shyan Liu, MD, Department of Nuclear Medicine, Cheng-Hsin General Hospital, No. 45, Cheng-Hsin Street, Pei-Tou, 112 Taipei, Taiwan Tel: +886 228 757 301 x578; fax: +886 228 749 431; e-mails:;

Received October 9, 2018

Received in revised form February 15, 2019

Accepted March 18, 2019

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