Advanced Molecular Imaging Systems and Their Potential Role in Diagnosis and Treatment of the Infection and Inflammation in the CoViD-19
Inflammation is one of the responses of the immune system to defend and repair tissues and therefore it is a mechanism that acts to confront dangerous situations, from pathogenic microbes to traumatic events. It is not just a limited local phenomenon, as recent research has shown the existence of a significant inflammatory systemic component even in pathologies where it was considered absent or irrelevant: cardiovascular diseases, atherosclerosis and stroke, neurodegenerative diseases, tumors and infectious diseases, caused by viruses and bacteria.
Based on the evidence so far, researchers argue that CoViD-19 should be considered as an inflammatory disease, as the severity of the inflammation is often associated with a disregulation of the inflammatory immune response, that goes in overdrive. In fact, it’s becoming clear that, in particular for some of the vulnerable patient groups, it’s the response of their immune system – inflammation – that explains why they get so sick and die. Specifically, we are seeing that the risks associated with diabetes, obesity, cardiac disease, lung disease, and in general age and sex are all related to the immune system not functioning properly when confronted by the virus. Understanding inflammation is therefore very important for survival and curing from CoViD-19 while it is an extremely complex phenomenon.
Hence, the role of inflammation in CoViD-19 must be studied and understood, in particular for the strategies and techniques to be used in the battle against CoViD-19. Among the molecular imaging modalities that can play a very important and ultimately even a central role is the Nuclear Medicine imaging (PET, SPECT). Typically used so far radiological imaging techniques such as CT, MRI and ultrasound, have high sensitivity but lack specificity and mostly document the post-factum damage. By contrast, the nuclear medicine modalities allow the in-vivo detection of different physiologic and pathologic on-going phenomena and offer noninvasive tools to detect early pathophysiological changes before anatomical changes occur, and to guide treatment.
However, standard nuclear medicine techniques have limitations in terms of sensitivity and specificity (due to nonspecific standard imaging agents such as FDG). New advanced dynamic multi-organ (systemic) imaging technologies that are already available in the research arena and are constantly being improved, could translate into increased sensitivity of early detection and differentiation, in staging etc, and avoiding the long-term side effects of inflammation. In addition, novel radiopharmaceutical probes have the possibility to improve specificity of the targeted disease processes (either viral or bacterial infection, and the associated inflammation).
We believe that this is the time and we see utmost urgency to have these research advances to be transferred to the clinical research field and then to expedite its translation to clinical practice.
International Advisory Committee
F. Garibaldi (co-chair) – INFN, Rome, Italy
J. Prior (co-chair) – Head of Nuclear medicine CHUV - Lausanne – Switzerland
J.M. Benlloch – i3M, University of Valencia, Spain
I. Buvat – Institute Curie, Orsay, France
V. Bonvicini – INFN, Trieste, Italy
G. Cuttone – INFN, LNF, Catania, Italy
A. Del Guerra – University of Pisa, Pisa, Italy
A. Gori – University of Milan, Milan, Italy
M. Grigioni – ISS, TISP Centre, Rome, Italy
T. Jones - University of California Davis, USA
P. Lecoq – CERN, Switzerland
S. Majewski - University of California Davis, USA
E. Nappi – INFN Bari, Italy
G .Pantaleo – CHUV, Division of Immunology, Lausanne, Switzerland
M. Pomper – Johns Hopkins University Hospital, Baltimore, MD, USA
R. Rappuoli – GlaxoSmithKline, Siena, Italy
M. Rescigno – University Humanita, Milan, Italy
O. Schillaci – Nuclear Medicine, University of Tor Vergata, Rome, Ialy
K. Shi – University Hospital Bern, Switzerland
H. Shi – Fudan Hospital, Shanghai, China
A. Signore – Nuclear Medicine, Sapienza University of Rome, Italy
V. Sossi – University of British Columbia, Canada
D. Townsend - University of Singapore
H. Tsoumpas – University of Leeds, UK
E. Vicenzi – IRCCS Ospedale San Raffaele, Milano, Italy