Novel bacteria-specific PET imaging approach detects hard-to-diagnose lung infections

NEW ORLEANS—A new PET imaging technique can accurately detect and monitor Mycobacteroides abscessus lung infections—one of the most difficult-to-diagnose conditions in patients with lung diseases. This innovation, presented at the 2025 Society of Nuclear Medicine and Molecular Imaging Annual Meeting, offers a promising new diagnostic tool that could significantly improve diagnosis and treatment decisions for patients with chronic lung infections.

Mycobacteroides abscessus is a rapidly growing mycobacteria that primarily affects immunocompromised patients and those with underlying lung diseases, such as cystic fibrosis or chronic obstructive pulmonary disease. Conventional imaging tools are unable to distinguish the bacterial infection from these inflammatory diseases, and definitive diagnosis often requires invasive procedures.

“Given the constraints of conventional imaging, the development of noninvasive, bacteria-specific imaging techniques would be clinically valuable for diagnosing and selecting appropriate treatments for patients,” said Yuderleys Masias-Leon, MD, a postdoctoral research fellow at Johns Hopkins University Medical School in Baltimore, Maryland. “Our study evaluated the effectiveness of a new PET imaging approach to differentiate Mycobacteroides abscessus from the general inflammation that characterizes these lung diseases.”

Researchers tested the new technique—¹¹C-PABA PET—in both preclinical and clinical settings. In vitro studies were first performed to confirm that ¹¹C-PABA accumulated in the bacteria. Next, dynamic ¹¹C-PABA PET was performed in a mouse model of Mycobacteroides abscessus pulmonary infection. Moving to the clinic, a 33-year-old patient with cystic fibrosis and microbiologically-confirmed Mycobacteroides abscessus pulmonary infection also underwent dynamic ¹¹C-PABA PET.

¹¹C-PABA uptake was observed in all in vitro studies, and sustained accumulation of ¹¹C-PABA was noted in the lung lesions of Mycobacteroides abscessus-infected mice. In the patient with cystic fibrosis, dynamic ¹¹C-PABA PET demonstrated significantly higher PET uptake in the affected lesions compared to unaffected lung, confirming the Mycobacteroides abscessus pulmonary infection.

“This proof-of-concept data highlights the potential of ¹¹C-PABA PET as an innovative, bacteria-specific, non-invasive and clinically-translatable diagnostic tool,” stated Masias-Leon. “In the future, ¹¹C-PABA PET could offer rapid and accurate diagnosis to facilitate precision medicine and individualized care for patients with this infection.”

Abstract 252090. “Dynamic ¹¹C-PABA PET/CT for Visualizing Pulmonary Mycobacteroides abscessus Infections,” Yuderleys Masias-Leon, Carlos Ruiz-Gonzalez, Oscar Nino-Meza, Medha Singh, Mona Sarhan, Xueyi Chen, Kelly Flavahan, Amy Kronenberg, Elizabeth Tucker, Martin Lodge, Laurence Carroll, Nicole Parrish, Noah Lechtzin and Sanjay Jain, Johns Hopkins University School of Medicine, Baltimore, Maryland; and Joel Freundlich, Rutgers University Medical School, Newark, New Jersey.

Link to Abstract

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All 2025 SNMMI Annual Meeting abstracts can be found online.

About the Society of Nuclear Medicine and Molecular Imaging
The Society of Nuclear Medicine and Molecular Imaging (SNMMI) is an international scientific and medical organization dedicated to advancing nuclear medicine, molecular imaging, and theranostics—precision medicine that allows diagnosis and treatment to be tailored to individual patients in order to achieve the best possible outcomes.

SNMMI’s members set the standard for molecular imaging and nuclear medicine practice by creating guidelines, sharing information through journals and meetings and leading advocacy on key issues that affect molecular imaging and therapy research and practice. For more information, visit www.snmmi.org.

 

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