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Radiotracers are widely used in medical imaging, using techniques of gamma-camera imaging (scintigraphy and SPECT) or positron emission tomography (PET). In bone marrow infection, there is no single routine test available that can detect infection with sufficiently high diagnostic accuracy. Here, we review radiotracers used for imaging of bone marrow infection, also known as osteomyelitis, with a focus on why these molecules are relevant for the task, based on their physiological uptake mechanisms. The review comprises [ 67 Ga]Ga-citrate, radiolabelled leukocytes, radiolabelled nanocolloids (bone marrow) and radiolabelled phosphonates (bone structure), and [ 18 F]FDG as established radiotracers for bone marrow infection imaging. Tracers that are under development or testing for this purpose include [ 68 Ga]Ga-citrate, [ 18 F]FDG, [ 18 F]FDS and other non-glucose sugar analogues, [ 15 O]water, [ 11 C]methionine, [ 11 C]donepezil, [ 99m Tc]Tc-IL-8, [ 68 Ga]Ga-Siglec-9, phage-display selected peptides, and the antimicrobial peptide [ 99m Tc]Tc-UBI 29-41 or [ 68 Ga]Ga-NOTA-UBI 29-41 .

Radiotracers for Bone Marrow Infection Imaging