Specific imaging of bacterial infection using 6''-18F-fluoromaltotriose: A second-generation PET tracer targeting the maltodextrin transporter in bacteria

Abstract

6''-18F-fluoromaltotriose is a PET tracer that can potentially be used to image and localize most bacterial infections, much like 18F-FDG has been used to image and localize most cancers. However, unlike 18F-FDG, 6''-18F-fluoromaltotriose is not taken up by inflammatory lesions and appears to be specific to bacterial infections by targeting the maltodextrin transporter that is expressed in gram-positive and gram-negative strains of bacteria. Methods: 6''-18F-fluoromaltotriose was synthesized with high radiochemical purity and evaluated in several clinically relevant bacterial strains in cultures and in living mice. Results: 6''-18F-fluoromaltotriose was taken up in both gram-positive and gram-negative bacterial strains. 6''-18F-fluoromaltotriose was also able to detect Pseudomonas aeruginosa in a clinically relevant mouse model of wound infection. The utility of 6''-18F-fluoromaltotriose to help monitor antibiotic therapies was also evaluated in rats. Conclusion: 6''-18F-fluoromaltotriose is a promising new tracer that has significant diagnostic utility, with the potential to change the clinical management of patients with infectious diseases of bacterial origin.