Work

Vancomycin-based tracers guiding in situ visualization of bacteria on osteosynthesis devices and surgical debridement

Year: 2025

Type: article

Abstract: PURPOSE: Bacterial infections associated with musculoskeletal injuries are challenging to detect and distinguish from sterile inflammation. Here we present the combined first-time application of a bacteria-targeted positron emission tomography (PET) tracer and a near-infrared fluorescent tracer to detect infected osteosynthesis implants and guide surgical treatment. METHODS: F]PQ-VE1-vancomycin for PET imaging and/or vancomycin-IRDye800CW for optical imaging were fixed to post-mortem human tibiae and femora. PET/CT and fluorescence imaging were used to quantify the bacterial load before and after surgical debridement. RESULTS: Pre-debridement, PET imaging showed a significant 2.2-fold higher tracer uptake on biofilm-covered plates compared to plates without biofilm (p < 0.001). Post-debridement, the PET signal was marginal, demonstrating effective biofilm removal. Fluorescence-guided surgery enabled real-time visualization and removal of bacterial biofilms. CONCLUSION: Combined preoperative PET and intraoperative fluorescence imaging with vancomycin-based tracers allows noninvasive detection and real-time infection management, as demonstrated by these preliminary findings.

Source: European Journal of Nuclear Medicine and Molecular Imaging

DOI: 10.1007/s00259-025-07249-4