Seminars in nuclear medicine最新文献

{"title":"Imaging of immunocompromised patients: focus on fungal-specific PET tracers","authors":"Dima A. Hammoud","doi":"10.1053/j.semnuclmed.2026.05.003","DOIUrl":"10.1053/j.semnuclmed.2026.05.003","url":null,"abstract":"<div><div>The global population of immunocompromised patients is growing, accompanied by a rising incidence of opportunistic infections. Among these, invasive mold infections are associated with substantial morbidity and mortality, in part because of delayed diagnosis. Although current diagnostic methods have improved, they are still limited by lack of specificity, invasiveness, or both. Recently, several novel noninvasive, pathogen-specific PET imaging ligands have been developed and evaluated. Among them, [<sup>18</sup>F]-fluorocellobiose, a carbohydrate-based metabolic tracer, has demonstrated high specificity for live cellulolytic mold infections, including <em>Aspergillus</em> spp. It also shows promise for treatment monitoring and can be readily synthesized enzymatically from [<sup>18</sup>F]-fluorodeoxyglucose. ImmunoPET approaches targeting fungal cell wall components are likewise highly promising as panfungal ligands and may be further optimized through antibody engineering strategies to enhance target binding, functionality and pharmacokinetic properties. These newer PET ligands have the potential to overcome the limited specificity of [<sup>18</sup>F]-FDG, allowing more accurate localization of infectious lesions and, importantly, differentiation between invasive fungal infections and other types of pathogens. Such advances are especially significant for this vulnerable patient population, in whom rapid and accurate diagnosis can have major prognostic implications.</div></div><div>The global population of immunocompromised patients is growing, accompanied by a rising incidence of opportunistic infections. Among these, invasive mold infections are associated with substantial morbidity and mortality, in part because of delayed diagnosis. Although current diagnostic methods have improved, they are still limited by lack of specificity, invasiveness, or both. Recently, several novel noninvasive, pathogen-specific PET imaging ligands have been developed and evaluated. Among them, [<sup>18</sup>F]-fluorocellobiose, a carbohydrate-based metabolic tracer, has demonstrated high specificity for live cellulolytic mold infections, including <em>Aspergillus</em> spp. It also shows promise for treatment monitoring and can be readily synthesized enzymatically from [<sup>18</sup>F]-fluorodeoxyglucose. ImmunoPET approaches targeting fungal cell wall components are likewise highly promising as panfungal ligands and may be further optimized through antibody engineering strategies to enhance target binding, functionality and pharmacokinetic properties. These newer PET ligands have the potential to overcome the limited specificity of [<sup>18</sup>F]-FDG, allowing more accurate localization of infectious lesions and, importantly, differentiation between invasive fungal infections and other types of pathogens. Such advances are especially significant for this vulnerable patient population, in whom rapid and accurate diagnosis can have major prognostic implic","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"56 3","pages":"Pages 478-485"},"PeriodicalIF":5.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147975133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Updates on tuberculosis imaging","authors":"Ismaheel O. Lawal , Alfred O. Ankrah , Sofiullah Abubakar , Honest Ndlovu , Aisha Ismaila , Mike M. Sathekge","doi":"10.1053/j.semnuclmed.2026.04.005","DOIUrl":"10.1053/j.semnuclmed.2026.04.005","url":null,"abstract":"<div><div>Tuberculosis (TB) remains a leading infectious cause of morbidity and mortality worldwide, and major diagnostic and therapeutic challenges persist despite advances in microbiologic and molecular testing. Over the past decade, molecular imaging, especially with FDG PET/CT, has transformed our understanding of TB pathogenesis, the spectrum of early and subclinical disease, mechanisms of dissemination, and treatment response. This review synthesizes key recent developments in TB imaging, focusing on studies published since prior Seminars in Nuclear Medicine reviews. New non–human primate and human PET/CT data provide unprecedented insight into the spatial and temporal evolution of granulomas, demonstrating highly localized microanatomic seeding, bronchogenic spread pathways, and heterogeneous lesion biology that strongly influence treatment outcomes. Imaging studies in asymptomatic individuals reveal that metabolically active subclinical TB is common and strongly predictive of future progression, redefining the spectrum of latent infection. In treatment monitoring, FDG PET/CT consistently outperforms conventional microbiologic biomarkers, correlating with lesion-level sterilization and identifying patients at risk for relapse, particularly when persistent metabolic activity remains at the end of therapy. The introduction of emerging tracers, such as integrin-targeted probes, offers complementary characterization of granuloma angiogenesis, immune microenvironments, and host–pathogen dynamics beyond glucose metabolism. Future priorities include the development of TB-specific radiotracers, the integration of PET with advanced computational modeling and AI-based quantification, and the translation of imaging biomarkers into individualized treatment strategies and drug-development pipelines. Collectively, these advances position molecular imaging as a central tool in elucidating TB biology and accelerating progress toward improved diagnostic, therapeutic, and prevention strategies.</div></div><div>Tuberculosis (TB) remains a leading infectious cause of morbidity and mortality worldwide, and major diagnostic and therapeutic challenges persist despite advances in microbiologic and molecular testing. Over the past decade, molecular imaging, especially with FDG PET/CT, has transformed our understanding of TB pathogenesis, the spectrum of early and subclinical disease, mechanisms of dissemination, and treatment response. This review synthesizes key recent developments in TB imaging, focusing on studies published since prior Seminars in Nuclear Medicine reviews. New non–human primate and human PET/CT data provide unprecedented insight into the spatial and temporal evolution of granulomas, demonstrating highly localized microanatomic seeding, bronchogenic spread pathways, and heterogeneous lesion biology that strongly influence treatment outcomes. Imaging studies in asymptomatic individuals reveal that metabolically active subclinical TB is common and","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"56 3","pages":"Pages 486-499"},"PeriodicalIF":5.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to <Advances in Dosimetry and Imaging for 203Pb and 212Pb Radiotheranostics’> <[Semin NuclMed55:1011-1031/https://doi.org/10.1053/j.semnuclmed.2025.09.006]>","authors":"Keamogetswe Ramonaheng ,&nbsp;Milani Qebetu ,&nbsp;Kaluzi Banda ,&nbsp;Pryaska Goorhoo ,&nbsp;Khomotso Legodi ,&nbsp;Sipho Mdanda ,&nbsp;Sandile Sibiya ,&nbsp;Yonwaba Mzizi ,&nbsp;Honest Ndlovu ,&nbsp;Joseph Kabunda ,&nbsp;Mengdie Yang ,&nbsp;Kuangyu Shi ,&nbsp;Mike Sathekge","doi":"10.1053/j.semnuclmed.2026.02.003","DOIUrl":"10.1053/j.semnuclmed.2026.02.003","url":null,"abstract":"","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"56 3","pages":"Pages 564-565"},"PeriodicalIF":5.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147370360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Structured reading for Tau PET Imaging in Alzheimer's disease and related dementias","authors":"Akintunde T. Orunmuyi ,&nbsp;Michael Wang ,&nbsp;Antoine Rogeau ,&nbsp;John Dickson ,&nbsp;Ashley M. Groves ,&nbsp;Jamshed Bomanji ,&nbsp;Francesco Fraioli ,&nbsp;Rimona S. Weil","doi":"10.1053/j.semnuclmed.2026.02.005","DOIUrl":"10.1053/j.semnuclmed.2026.02.005","url":null,"abstract":"<div><div>Tau PET provides in vivo characterisation of tau pathology, offering crucial insights into Alzheimer’s disease and related disorders (ADRD). This article describes an evidence-based approach to the review and reporting of tau PET in ADRD, aligned with recent international consensus guidelines. We describe visual interpretation using validated scoring systems and harmonising thresholds for quantitative analysis for structured reporting. Implementing a standardised practice enhances reproducibility and clinical decision-making, preparing tau PET for routine clinical use.</div></div><div>Tau PET provides in vivo characterisation of tau pathology, offering crucial insights into Alzheimer’s disease and related disorders (ADRD). This article describes an evidence-based approach to the review and reporting of tau PET in ADRD, aligned with recent international consensus guidelines. We describe visual interpretation using validated scoring systems and harmonising thresholds for quantitative analysis for structured reporting. Implementing a standardised practice enhances reproducibility and clinical decision-making, preparing tau PET for routine clinical use.</div>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"56 3","pages":"Pages 556-562"},"PeriodicalIF":5.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147532283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing PET/CT and SPECT/CT in infection imaging: Acquisition, interpretation, and pitfalls","authors":"Elite Arnon-Sheleg ,&nbsp;Zohar Keidar","doi":"10.1053/j.semnuclmed.2026.03.013","DOIUrl":"10.1053/j.semnuclmed.2026.03.013","url":null,"abstract":"<div><div>The adoption of hybrid imaging, including F18-FDG PET/CT and radiolabeled leukocyte (WBC) SPECT/CT, has revolutionized the diagnosis and management of complex infectious diseases. Following the successful precedent of harmonization in oncology, the field of infection imaging is undergoing a similar transformation from subjective visual assessment to a multiparametric, quantitative, and standardized approach. This review provides a comprehensive roadmap for molecular imaging—from patient selection to integrated interpretation strategies that leverage the synergy between functional data and morphological CT hallmarks and explores various diagnostic pitfalls encompassing pharmacological interference, technical artifacts, and biological mimickers. Finally, structured reporting is highlighted as a vital tool for communicating actionable, evidence-based data to the multidisciplinary team, ultimately improving diagnostic accuracy and patient outcomes in the era of personalized medicine.</div></div><div>The adoption of hybrid imaging, including F18-FDG PET/CT and radiolabeled leukocyte (WBC) SPECT/CT, has revolutionized the diagnosis and management of complex infectious diseases. Following the successful precedent of harmonization in oncology, the field of infection imaging is undergoing a similar transformation from subjective visual assessment to a multiparametric, quantitative, and standardized approach. This review provides a comprehensive roadmap for molecular imaging—from patient selection to integrated interpretation strategies that leverage the synergy between functional data and morphological CT hallmarks and explores various diagnostic pitfalls encompassing pharmacological interference, technical artifacts, and biological mimickers. Finally, structured reporting is highlighted as a vital tool for communicating actionable, evidence-based data to the multidisciplinary team, ultimately improving diagnostic accuracy and patient outcomes in the era of personalized medicine.</div>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"56 3","pages":"Pages 401-413"},"PeriodicalIF":5.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retraction notice to Radiotracing the Future: Non-FDG Radiotracers Nuclear Medicine [Seminars Nucl Med 55 (2025) 648-663]","authors":"Giuseppe Arturo Fuso ,&nbsp;Gianfilippo Bianciardi ,&nbsp;Riccardo Mei ,&nbsp;Irene Brusa ,&nbsp;Stefano Emiliani ,&nbsp;Emilia Fortunati ,&nbsp;Cristina Nanni","doi":"10.1053/j.semnuclmed.2025.12.005","DOIUrl":"10.1053/j.semnuclmed.2025.12.005","url":null,"abstract":"","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"56 3","pages":"Page 563"},"PeriodicalIF":5.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standardization of infection [18F]FDG-PET/CT imaging protocols and reporting criteria","authors":"Ben F. Bulten ,&nbsp;Riemer H.J.A. Slart ,&nbsp;Andor W.J.M. Glaudemans ,&nbsp;Sören Hess ,&nbsp;Erik H.J.G. Aarntzen ,&nbsp;Olivier Gheysens","doi":"10.1053/j.semnuclmed.2026.03.014","DOIUrl":"10.1053/j.semnuclmed.2026.03.014","url":null,"abstract":"<div><div>[¹⁸F]FDG-PET/CT (infection PET) has emerged as a key modality in the evaluation and management of patients with suspected or proven infection. Despite several recommendations addressing general preparation, acquisition, interpretation and reporting, infection PET/CT remains insufficiently standardized across indications and centers. This review provides a comprehensive overview of general and indication-specific aspects of infection PET and proposes clinically applicable suggestions to harmonize protocols, maximize the diagnostic performance and its contribution to patient management.</div></div><div>[¹⁸F]FDG-PET/CT (infection PET) has emerged as a key modality in the evaluation and management of patients with suspected or proven infection. Despite several recommendations addressing general preparation, acquisition, interpretation and reporting, infection PET/CT remains insufficiently standardized across indications and centers. This review provides a comprehensive overview of general and indication-specific aspects of infection PET and proposes clinically applicable suggestions to harmonize protocols, maximize the diagnostic performance and its contribution to patient management.</div>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"56 3","pages":"Pages 528-547"},"PeriodicalIF":5.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147676203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric infection imaging focusing on FDG PET/CT: Techniques, safety, and indications","authors":"Murat Alp Oztek ,&nbsp;Barry L. Shulkin ,&nbsp;Marguerite T. Parisi","doi":"10.1053/j.semnuclmed.2026.03.011","DOIUrl":"10.1053/j.semnuclmed.2026.03.011","url":null,"abstract":"<div><div>Scintigraphic imaging remains pivotal in the evaluation of children with infectious and inflammatory diseases. Data acquired over the last several decades has demonstrated high efficacy of 2-[¹⁸F]Fluoro-2-deoxy-<span>d</span>-glucose positron emission tomography/computed tomography (FDG-PET/CT) for evaluation of infection; efficacy which far surpasses that of conventional agents like ⁶⁷Gallium-citrate, labeled white blood cells and bone scintigraphy with ^99mtechnetium methylene diphosphonate. While this manuscript provides an overview of scintigraphy in pediatric infection imaging, the primary focus is on the use of FDG-PET/CT for this indication. Safety concerns, recent advances in scanner technology and indications for FDG-PET/CT in infection are addressed.</div></div><div>Scintigraphic imaging remains pivotal in the evaluation of children with infectious and inflammatory diseases. Data acquired over the last several decades has demonstrated high efficacy of 2-[¹⁸F]Fluoro-2-deoxy-<span>d</span>-glucose positron emission tomography/computed tomography (FDG-PET/CT) for evaluation of infection; efficacy which far surpasses that of conventional agents like ⁶⁷Gallium-citrate, labeled white blood cells and bone scintigraphy with ^99mtechnetium methylene diphosphonate. While this manuscript provides an overview of scintigraphy in pediatric infection imaging, the primary focus is on the use of FDG-PET/CT for this indication. Safety concerns, recent advances in scanner technology and indications for FDG-PET/CT in infection are addressed.</div>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"56 3","pages":"Pages 511-527"},"PeriodicalIF":5.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"18F-FDG PET/CT in the evaluation of suspected infections following cardiothoracic surgical interventions","authors":"Manar Badarna ,&nbsp;Marah Andraous ,&nbsp;Zohar Keidar","doi":"10.1053/j.semnuclmed.2026.03.003","DOIUrl":"10.1053/j.semnuclmed.2026.03.003","url":null,"abstract":"&lt;div&gt;&lt;div&gt;The incidence of cardiothoracic infections is steadily increasing, due to the expanding clinical indications and growing rates of cardiovascular device implantations and surgical interventions. &lt;sup&gt;18&lt;/sup&gt;F-FDG PET/CT has emerged as a highly valuable functional imaging modality, particularly when conventional imaging modalities are non-diagnostic, offering a distinct advantage as it may enable early diagnosis, potentially before structural changes become apparent, and allowing a whole-body assessment. This review offers a comprehensive overview of &lt;sup&gt;18&lt;/sup&gt;F-FDG PET/CT imaging in the setting of infections post cardiothoracic surgeries, exploring its diagnostic utility across various clinical scenarios, including prosthetic and native valve endocarditis, cardiac implantable electronic device (CIED) infections and left ventricular assist device (LVAD) infections, vascular graft infections, and post- sternotomy infections. Our aim in this review is to explore clinical scenarios in which &lt;sup&gt;18&lt;/sup&gt;F-FDG PET/CT should be considered and to clarify its integration into established diagnostic algorithms. Furthermore, we aim to characterize different uptake patterns that are highly suggestive of infection, correlating with anatomical findings, thereby providing practical guidance for image interpretation. Finally, this review seeks to address the limitations of &lt;sup&gt;18&lt;/sup&gt;F-FDG PET/CT and recognize potential pitfalls in interpretation of imaging. In all, emphasizing the need for standardization of imaging protocols and interpretation criteria.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;The incidence of cardiothoracic infections is steadily increasing, due to the expanding clinical indications and growing rates of cardiovascular device implantations and surgical interventions. &lt;sup&gt;18&lt;/sup&gt;F-FDG PET/CT has emerged as a highly valuable functional imaging modality, particularly when conventional imaging modalities are non-diagnostic, offering a distinct advantage as it may enable early diagnosis, potentially before structural changes become apparent, and allowing a whole-body assessment. This review offers a comprehensive overview of &lt;sup&gt;18&lt;/sup&gt;F-FDG PET/CT imaging in the setting of infections post cardiothoracic surgeries, exploring its diagnostic utility across various clinical scenarios, including prosthetic and native valve endocarditis, cardiac implantable electronic device (CIED) infections and left ventricular assist device (LVAD) infections, vascular graft infections, and post- sternotomy infections. Our aim in this review is to explore clinical scenarios in which &lt;sup&gt;18&lt;/sup&gt;F-FDG PET/CT should be considered and to clarify its integration into established diagnostic algorithms. Furthermore, we aim to characterize different uptake patterns that are highly suggestive of infection, correlating with anatomical findings, thereby providing practical guidance for image interpretation. Finally, this review seeks to address the limitations of &lt;sup&gt;18&lt;/sup&gt;F-FDG","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"56 3","pages":"Pages 452-467"},"PeriodicalIF":5.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147532291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The evolving role of nuclear medicine in osteomyelitis: A narrative review of current evidence and future horizons","authors":"J. Gatón-Ramírez ,&nbsp;R.H.J.A. Slart ,&nbsp;O. Gheysens ,&nbsp;E. Noriega-Álvarez ,&nbsp;A.W.J.M. Glaudemans","doi":"10.1053/j.semnuclmed.2026.03.002","DOIUrl":"10.1053/j.semnuclmed.2026.03.002","url":null,"abstract":"&lt;div&gt;&lt;div&gt;Objective: The diagnosis of osteomyelitis (OM) remains a significant clinical challenge, often requiring a multimodality imaging approach to differentiate infection from non-infectious inflammatory conditions. This review focuses on primary and secondary osteomyelitis, with particular emphasis on fracture-related infections, sternal infections, and the assessment of dissemination of infection using nuclear medicine techniques, from established scintigraphic methods to advanced hybrid imaging and emerging technologies.&lt;/div&gt;&lt;div&gt;Findings: While three-phase bone scintigraphy remains a highly sensitive initial screening tool, its utility is limited by low specificity. White blood cell (WBC) scintigraphy, particularly when combined with SPECT/CT offers superior specificity and is considered a cornerstone for diagnosing musculoskeletal infections. ¹⁸F-FDG PET/CT has emerged as a powerful modality with high diagnostic accuracy, especially for evaluating fracture-related infections or dissemination of infection. However, its performance can be confounded by sterile postsurgical inflammation, though specific uptake patterns and a high negative predictive value are clinically valuable. Emerging frontiers, including dynamic PET acquisition, AI-driven image enhancement, and novel pathogen-specific radiotracers, promise to overcome current limitations by improving specificity and providing biologically targeted information.&lt;/div&gt;&lt;div&gt;Conclusion: The integration of scintigraphic and hybrid imaging techniques, tailored to the specific clinical scenario, is paramount for the accurate diagnosis of OM. Future developments are rapidly moving the field from non-specific inflammation imaging toward precise, pathogen-targeted molecular diagnostics.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Objective: The diagnosis of osteomyelitis (OM) remains a significant clinical challenge, often requiring a multimodality imaging approach to differentiate infection from non-infectious inflammatory conditions. This review focuses on primary and secondary osteomyelitis, with particular emphasis on fracture-related infections, sternal infections, and the assessment of dissemination of infection using nuclear medicine techniques, from established scintigraphic methods to advanced hybrid imaging and emerging technologies.&lt;/div&gt;&lt;div&gt;Findings: While three-phase bone scintigraphy remains a highly sensitive initial screening tool, its utility is limited by low specificity. White blood cell (WBC) scintigraphy, particularly when combined with SPECT/CT offers superior specificity and is considered a cornerstone for diagnosing musculoskeletal infections. ¹⁸F-FDG PET/CT has emerged as a powerful modality with high diagnostic accuracy, especially for evaluating fracture-related infections or dissemination of infection. However, its performance can be confounded by sterile postsurgical inflammation, though specific uptake patterns and a high negative predictive value are clinically valuable. Emerging frontiers, ","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"56 3","pages":"Pages 442-451"},"PeriodicalIF":5.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}