Available online 14 November 2023

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Chronic immune diseases mainly include autoimmune and inflammatory diseases. Managing chronic inflammatory and autoimmune diseases has become a significant public health concern, and therapeutic advancements over the past 50 years have been substantial. As therapeutic tools continue to multiply, the challenge now lies in providing each patient with personalized care tailored to the specifics of their condition, ushering in the era of personalized medicine. Precise and holistic imaging is essential in this context to comprehensively map the inflammatory processes in each patient, identify prognostic factors, and monitor treatment responses and complications. Imaging of patients with inflammatory and autoimmune diseases must provide a comprehensive view of the body, enabling the whole-body mapping of systemic involvement. It should identify key cellular players in the pathology, involving both innate immunity (dendritic cells, macrophages), adaptive immunity (lymphocytes), and microenvironmental cells (stromal cells, tissue cells). As a highly sensitive imaging tool with vectorized molecular probe capabilities, PET/CT can be of high relevance in the management of numerous inflammatory and autoimmune diseases. Relying on key molecular concepts of immunity, the clinical usefulness of FDG-PET/CT in several relevant inflammatory and immune-inflammatory conditions, validated or emerging, will be discussed in this review, together with radiolabeled probe perspectives.

Section snippetsIntroduction: Concept of Inflammation and Immunity

Chronic immune diseases mainly including autoimmune and inflammatory diseases, can affect more than 10% of the general population. Recent evidence suggests that their incidence is on the rise.1 The classification of autoimmune diseases distinguishes between systemic autoimmune diseases, such as lupus, Sjögren's syndrome, and scleroderma, and organ-specific autoimmune diseases, including autoimmune thyroiditis and type 1 diabetes. Besides, chronic inflammatory disorders may include giant cell

Conclusion

PET imaging provides unparallel capabilities to map and quantify inflammatory and immune-mediated conditions at the whole-body level. FDG PET/CT has become the imaging modality of choice in the work-up of patients with FUO, by identifying the potential cause, localizing sites for further evaluation, and guiding further management. In cardiometabolic syndrome, FDG PET facilitates detailed molecular imaging of active atherosclerotic processes, offering insights into visceral abdominal fat tissue

Declaration of Competing Interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Ethical Statement

This review article does not deal with experiments nor with individual patient data and does not require IRB approval.

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