Molecular imaging in TB: from the bench to the clinic

Andreu, Nuria, Elkington, Paul T.G. and Wiles, Siouxsie (2012) Molecular imaging in TB: from the bench to the clinic. In, Cardona, Pere-Joan (ed.) Understanding Tuberculosis - Global Experiences and Innovative Approaches to the Diagnosis. Intech, pp. 307-332. (doi:10.5772/30595).

Abstract

Despite all efforts, tuberculosis (TB) still constitutes a serious global health threat with 9.4 million new cases and 1.7 million deaths worldwide in 2009 (World Health Organisation,2010). Furthermore, an estimated one third of the worlds’ population is infected with the bacterium responsible, Mycobacterium tuberculosis. The main handicaps in fighting TB include a vaccine which works poorly in the most affected populations, and an arduous treatment regimen, involving a combination of several drugs taken over many months. This is further complicated by the emergence of multi-drug resistant (MDR) and extensively drug-resistant (XDR) M. tuberculosis strains, which require even longer treatment times with less well-tolerated drugs. Eradication of TB will require the development of new drugs and vaccines, alongside improved methods for diagnosis and monitoring treatment efficacy. With the vast burden of disease falling in resource poor settings, the challenge will also be to develop methodologies that can be deployed with minimal investment in infrastructure, maintenance and staff expertise. Recent decades have seen the emergence of the new discipline of molecular imaging. In essence, molecular imaging enables the non-invasive visualisation, characterisation, and quantification of biological processes taking place within intact living subjects, be it a mouse or man (Filippi & Rocca, 2011; Horky & Treves, 2011; Pysz et al., 2010; Sandhu et al., 2010). Imaging has long been applied to managing TB; simple chest x-rays have allowed clinicians to visualise TB in people for over a century (Singh & Nath, 1994). However, the new molecular imaging techniques are revolutionising medical research, with the potential to translate into significant changes in clinical practice. In this chapter we describe the new generation of imaging modalities and how these are being applied to eradicating TB, from the laboratory bench and in to the clinic.

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Contributors

Author: Paul T.G. Elkington

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