Skip to main content
Log in

Nuclear medicine and AIDS

  • Review Article
  • Published:
European Journal of Nuclear Medicine Aims and scope Submit manuscript

Abstract

Over the last decade the acquired immunodeficiency syndrome (AIDS) has become one of the leading causes of morbidity and mortality both in Europe and the United States. The disease is due to infection by the human immunodeficiency virus (HIV), which results in progressive loss of cellular immunity; consequently, patients are susceptible to both typical infections with high-grade pathogens and also low-grade opportunistic organisms. In addition, different cancers such as Kaposi's sarcoma and non-Hodgkin's lymphoma occur with increased frequency. Nuclear medicine has a central role to play in the diagnosis of these malignant and infectious conditions. This article reviews the role of radionuclide studies in the diagnosis of HIV-related disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Alazraki NP (1989) Gallium and indium: Which to use when. Aust NZ Nucl Med 17:10–15

    Google Scholar 

  • Arnett EN, Battle WE, Russo JV (1976) Intravenous injection of talc-containing durgs intended for oral use. A cause of pulmonary granulomatosis and pulmonary hypertension. Am J Med 60:711–178

    Article  PubMed  Google Scholar 

  • Bach MC, Bagwell SP, Masur H (1986) Utility of gallium imaging in the diagnosis ofMycobacterium avium-intracellulare infection in patients with the acquired immunodeficiency syndrome. Clin Nucl Med 11:175–177

    PubMed  Google Scholar 

  • Barron TN, Birnbaum N, Shane L, Goldsmith SJ, Rosen MJ (1985)Pneumocystis carinii pneumonia studied by gallium-67 scanning. Radiology 154:791–793

    PubMed  Google Scholar 

  • Benson DF, Kuhl DE, Hawkins RA (1983) The flurodeoxyglucose 8F scan in Alzheimer's disease and multi-infarct dementia. Arch Neurol 40:711–714

    PubMed  Google Scholar 

  • Binstock P, Barnett C, McCabe R (1987) Negative gallium scan in an AIDS patient withPneumocystis pneumonia. Br J Radiol 60:714–717

    PubMed  Google Scholar 

  • Bitran J, Beckerman C, Weinstein R, Bennett C, Ryo U, Pinsky S (1987) Patterns of gallium-67 scintigraphy in patients with acquired immunodeficiency syndrome and the AIDS related complex. J Nucl Med 28:1103–1106

    PubMed  Google Scholar 

  • Bradburne RM, Ettensohn DB, Opal SM, McCool FD (1989) Relapse ofPneumocystis carinii pneumonia in the upper lobes during aerosol pentamidine prophylaxis. Thorax 44:591–593

    PubMed  Google Scholar 

  • Cello JP (1989) Acquired immunodeficiency syndrome cholangiopathy: spectrum of disease. Am J Med 86:539–546

    Article  PubMed  Google Scholar 

  • Centers for Disease Control (1987) Revision of the CDC surveillance case definition for acquired immunodeficiency syndrome. MMWR 36 [Suppl 1]:3S-15S

    Google Scholar 

  • Charron M, Ackerman ES, Kolodny GM, Rosenthall L (1988) Focal lung uptake of gallium-67 in patients with acquired immunodeficiency syndrome secondary toPneumocystis carinii pneumonia. Eur J Nucl Med 14:424–426

    Article  PubMed  Google Scholar 

  • Coleman DL, Hattner RS, Luce JM (1984) Correlation between gallium lung scans and fibreoptic bronchoscopy in patients with suspectedPneumocystis carinii pneumonia and the acquired immunodeficiency syndrome. Am Rev Respir Dis 130:166–169

    Google Scholar 

  • Cordes M, Roll D, Langer M, Ruhnke M, Trautmann M, Holsten N, Eichstadt H, Graf KJ, Felix R (1989) Diagnostic value of early gallium-67 scans (4 h p.i.) in patients with AIDS and PCP. Eur J Nucl Med 15:172

    Google Scholar 

  • Delorenzo LJ, Huang CT, Maguire GP, Stone DJ (1987) Roentgenographic patterns ofPneumocystis carinii pneumonia in 104 patients with AIDS. Chest 91:323–327

    PubMed  Google Scholar 

  • Dowsett JF, Miller RF, Davidson R, Vaira D, Polydorou A, Cairns SR, Weller IVD (1988) Sclerosing cholangitis in acquired immunodeficiency syndrome. Scand J Gastroenterol 23:1267–1274

    PubMed  Google Scholar 

  • Ell PJ, Costa DC, Harrison M (1987) Imaging cerebral damage in HIV infection. Lancet 11:569–570

    Article  Google Scholar 

  • Engelberg LA, Lerner CW, Tapper ML (1984) Clinical features of pneumocystic pneumonia in the acquired immunodeficiency syndrome. Am Rev Respir Dis 130:689–694

    PubMed  Google Scholar 

  • Fineman DS, Palestro CJ, Kim CK, Needle LB, Vallabhajosula S, Solomon RW, Goldsmith SJ (1989) Detection of abnormalities in febrile AIDS patients with In-III-labelled leukocyte and Ga-67 scintigraphy. Radiology 170:677–680

    PubMed  Google Scholar 

  • Fischmann AJ, Wilkinson R, Khaw B-A, Callahan RJ, Ahmad M, Locke E, Nossiff ND, Strauss HW, Rubin RH (1988) Imaging of localized bacterial infections with radiolabelled nonspecific antibody fragments. J Nucl Med 29:887

    Google Scholar 

  • Fischman AJ, Rubin RH, Fuccello AJ, Kroon DJ, Wilkinson RA, White JA, Callahan RJ, Strauss HW (1989) Rapid detection of focal sites of infection with chemotactic peptide labelled with indium-III. J Nucl Med 30:805

    Google Scholar 

  • Friedkand RP, Prusiner SB, Jagust WJ (1984) Bitemporal hypometabolism in Creutzfeldt-Jakob disease measured by position emission tomography with [18F]-2-flurodeoxyglucose. J Comput Assist Tomogr 8:978–981

    PubMed  Google Scholar 

  • Goodman PC, Broaddus VC, Hopewell PC (1984) Chest radiographic patterns in the acquired immunodeficiency syndrome. Am Rev Respir Dis 129:A6

    Google Scholar 

  • Griffiths MH, Kocjan G, Miller RF, Godfrey-Fausset P (1989) Diagnosis of pulmonary disease in human immunodeficiency virus infection: role of transbronchial biopsy and bronchoalveolar lavage. Thorax 44:554–558

    PubMed  Google Scholar 

  • Habiban MR, Stabb EV, Matthews HA (1975) Gallium citrate Ga-67 scans in febrile patients. JAMA 233:1073–1076

    Article  PubMed  Google Scholar 

  • Halpern SE, Haindl W, Beauregard J (1988) Scintigraphy with In-III-labelled monoclonal anti-tumour antibodies: kinetics, biodistribution and tumour detection. Radiology 168:529–536

    PubMed  Google Scholar 

  • Hopewell PC, Luce JM (1986) Pulmonary manifestations of the acquired immunodeficiency syndrome. Clin Imunol Allergy 6:489–518

    Google Scholar 

  • Jagust WJ, Freidland RP, Budinger TF (1985) Positron emission tomography with [18F] flurodeoxyglucose differentiates normal pressure hydrocephalus from Alzheimer-type dementia. J Neurol Neurosurg Psychiatry 48:1091–1096

    PubMed  Google Scholar 

  • Jaramillo D, Kim EE (1986) Demonstration of a cold abcess by gallium-67 imaging in a patient with job sydrome. Am J Roentgenol 147:610–611

    Google Scholar 

  • Kaplan LD, Wolfsy CB, Volberding PA (1987) Treatment of patients with acquired immunodeficiency syndrome and associated manifestations. JAMA 257:1367–1374

    Article  PubMed  Google Scholar 

  • Kim EE (1980) Diffuse pulmonary gallium concentration (gamut) Semin Nucl Med 10:108–110

    PubMed  Google Scholar 

  • Kissin MW, Williamson RCN (1979) Gallium-67 scanning in pyrexia of unknown origin. Br Med J 2:1330–1331

    Google Scholar 

  • Kohn H, Armbruster C, Konig B, Vetter N, Mostbeck A (1989) Value of nuclear medicine procedures for diagnosis of opportunistic lung infections in AIDS patients. Eur J Nucl Med 15:442

    Google Scholar 

  • Kramer EL, Sanger JJ, Garay SM, Greene JB, Tin S, Banner H, McCauley DI (1987) Gallium-67 scans of the chest in patients with acquired immunodeficiency syndrome. J Nucl Med 28:1107–1114

    PubMed  Google Scholar 

  • Kramer EL, Sanger JJ, Tin S, Banner H (1988) The variable presentation of PCP on Ga-67 scans in HIV+ patients. J Nucl Med 29:829

    Google Scholar 

  • Krishnamurthy GT, Leiberman D, Brar HS (1985) Detection, localization and quantification of common bile duct obstruction by scintigraphy. J Nucl Med 26:726–735

    PubMed  Google Scholar 

  • Kroiss A, Bock F, Perneczky G, Auinger C, Weidlich G, Kleinpeter G, Neumayr A (1989) Clinical application of Tc-99m labelled granulocytes antibody in bone and joint diseases. Eur J Nucl Med 15:409

    Google Scholar 

  • Krown SE (1988) AIDS associated Kaposi's sarcoma: pathogenesis, clinical course and treatment. Editorial review. AIDS 2:71–80

    PubMed  Google Scholar 

  • Littenberg RL, Taketa RM, Alazraki NR, Halpern SE, Ashburn WL (1973) Gallium-67 for localization of septic lesions. Ann Intern Med 79:403–406

    PubMed  Google Scholar 

  • Maini CL, Pigorini F, Pau FM, Narciso P, Rosci MA, Galgani S, Volpini V, Leonetti C, Atzei G (1989)99mTc-HM-PAO brain SPELT in acquired immunodeficiency syndrome (AIDS). Eur J Nucl Med 15:418

    Article  Google Scholar 

  • Masur H, Ognibene FP, Yarehoan R, Shelhamer JH, Baird BF, Travis W, Suffredine AF, Deyton L, Kovacs JA, Falloon J, Davey R, Polis M, Metcalf J, Baseler M, Welsey R, Gill VJ, Franci AS, LaneHC (1989) CD4 counts as predictors of opportunistic pneumonias in human immunodeficiency virus (HIV) infection. Ann Intern Med 111:223–231

    PubMed  Google Scholar 

  • McCandless BK, Cooper JA (1989) Apical pattern of Ga-67 lung uptake in patients with acquired immunodeficiency syndrome treated with aerosolized pentamidine. J Nucl Med 30:744

    Google Scholar 

  • McNeil BJ, Sanders R, Alderson PO, Hessel SJ, Finberg H, Siegelman SS, Adams DF (1981) A prospective study of computed tomography, ultrasound and gallium imaging in patients with fever. Radiology 139:647–653

    PubMed  Google Scholar 

  • Mehta AC, Spies WG, Spies SM (1987) Utility of gallium scintigraphy in AIDS. Radiology 165 [P]:72–73

    Google Scholar 

  • Millar AB, Mitchell DM (1990) Non-invasive tests for investigation of pulmonary disease in HIV positive patients. Thorax 45: (in press)

  • Miller RF, Millar AB, Weller IVD, Semple SJG (1989) Empirical treatment without bronchoscopy forPneumocystis carinii pneumonia in the acquired immunodeficiency syndrome. Thorax 44:559–564

    PubMed  Google Scholar 

  • Miller RF, Leigh TR, Collins JV, Mitchell DM (1990) Invasive tests for investigation of pulmonary disease in HIV positive patients. Thorax 45: (in press)

  • Murray JF, Garay SM, Hopewell PC, Mills J, Snider GL, Stover DE (1987) NHLBI Workshop summary: pulmonary complications of the acquired immunodeficiency syndrome: an update. Am Rev Respir Dis 135:504–509

    PubMed  Google Scholar 

  • Navia BA, Jordan BO, Price RW (1986) The AIDS dementia complex. I. Clinical features Ann Neurol 19:517–524

    Article  PubMed  Google Scholar 

  • O'Connor RN, Brunham RC, Bowden DH (1988) Pulmonary talc granulomatosis mimickingPneumocystis carinii pneumonia. Can Med Assoc J 128:53–54

    Google Scholar 

  • O'Doherty MJ, Page CJ, Bradbeer CS, Shahmanesh M, Edwards A, Barlow D, Nunan TO, Bateman NT (1989) The place of lung99mTc DTPA aerosol transfer in the investigation of lung infections in HIV positive patients. Respir Med 83:395–401

    PubMed  Google Scholar 

  • Picard C, Meignan M, Rosso J, Cinotti L, Mayaud C, Revuz J (1987) Technetium-99m DTPA aerosol and gallium scanning in acquired immunodeficiency syndrome. Clin Nucl Med 12:501–506

    PubMed  Google Scholar 

  • Pohl P, Vogl G, Fill H, Rossler H, Zangerle R, Gerstenbrand F (1988) Single photon emission computed tomography in AIDS dementia complex. J Nucl Med 29:1382–1386

    PubMed  Google Scholar 

  • Quinn MJ, Sheedy PF, Stephens DH, Hattery RR (1980) Computed tomography of the abdomen in evaluation of patients with fever of unknown origin. Radiology 136:407–411

    PubMed  Google Scholar 

  • Rodman CA, Keeffe EB, Leiberman DA, Krishnamurthy S, Kirshnamurthy GT, Gilbert S, Eklem MJ (1987) Diagnosis of sclerosing cholangitis with Technetium99m-labelled iminodiacetic acid, planar and computed tomographic scintigraphy. Gastroenterology 92:777–785

    PubMed  Google Scholar 

  • Rottenberg DA, Moeller JR, Strother SC, Sidtis JJ, Navia BA, Dhawan V, Ginos JZ, Price RW (1987) The metabolic pathology of the AIDS dementia complex. Ann Neurol 22:700–706

    Article  PubMed  Google Scholar 

  • Rubin RH, Needleman M, Wilkinson R, Callahan RJ, Khaw B-A, Strauss HW (1987) Effect of anti-inflammatory agents in radiolabelled immunoglobulin scans for focal inflammation. J Nucl Med 28:695

    Google Scholar 

  • Rubin RH, Young LS, Hansen WP (1988) Specific and nonspecific imaging of localized Fisher immunotype. 1.Pseudomonas aeroginosa infection with radiolabelled monoclonal antibody. J Nucl Med 29:651–656

    PubMed  Google Scholar 

  • Rubin RH, Fischman AJ, Needleman, Wilkinson R, Callahan RJ, Khaw B-A, Hansen WP, Kramer PB, Strauss HW (1989 a) Radiolabelled, nonspecific, polyclonal human immunoglobulin in the detection of focal inflammation by scintigraphy: comparison with gallium-67 citrate and Technetium-99m-labelled albumin. J Nucl Med 30:385–389

    PubMed  Google Scholar 

  • Rubin RH, Fischman AJ, Callahan RJ, Khaw B-A, Keech F, Ahmad M, Wilkinson R, Strauss HW (1989b)111In-labelled nonspecific immunoglobulin scanning in the detection of focal infection. N Engl J Med 321:935–940

    PubMed  Google Scholar 

  • Schiff RG, Kabat L, Kamani N (1987) Gallium scanning in lymphoid interstitial pneumonitis of children with AIDS. J Nucl Med 28:1915–1919

    PubMed  Google Scholar 

  • Scientific American: single topic tissue (1989). What science knowns about AIDS

  • Shaw RJ, Roussak C, Forster SM, Harris JRW, Punching AJ, Mitchell DM (1988) Lung function abnormalities in patients infected with human immunodeficiency virus and without overt pneumonitis. Thorax 43:436–440

    PubMed  Google Scholar 

  • Skarzynski JJ, Sherman W, Lee HK, Berger H (1987) Patchy uptake of gallium in the lungs of AIDS patients with atypical mycobacterial infection. Clin Nucl Med 12:507–509

    PubMed  Google Scholar 

  • Spies WG (1989) Gallium-67 citrate imaging in acquired immunodeficiency syndrome. J Nucl Med Technol 17:23–28

    Google Scholar 

  • Spies WG, Spies SM, Mintzer RA (1983) Radionuclide imaging in diseases of the chest (part 2). Chest 83:250–255

    PubMed  Google Scholar 

  • Stafanakis GN, Al-Skeikh W, Heal A, Rodman G, Zeppa R, Serafni A (1988) Comparisons of scintigraphy with In-III leukocytes and gallium-67 in the diagnosis of occult sepsis. J Nucl Med 29:23–25

    PubMed  Google Scholar 

  • Stafanakis GN, Jabir AM, Beach R, Szapocznik J, Fletcher MA, Fordyce-Baum MA, Millon C, Eisdorfer C (1989) Increased gallium-67 pulmonary activity in human immunodefciency virus (HIV) positive non-AIDS, non-ARC, non-iv drug abusers: correlation with tobacco smoking. J Nucl Med 29:829

    Google Scholar 

  • Stover DE, Greeno RA, Gagliardi AJ (1989) The use of a simple exercise test for the diagnosis ofPneumocystis carinii pneumonia in patients with AIDS. Am Rev Respir Dis 139:1343–1346

    PubMed  Google Scholar 

  • Tatsch K, Schielke E, Einhaupl KM, Bauer M, Markl AF, Kirsch CM (1989)99mTc-HMPAO-SPELT in patients with HIV infection: a comparison with neurological, CT and MRI fngings. Eur J Nucl Med 15:418

    Article  Google Scholar 

  • Tuazon CU, Delaney MD, Simon GL, Witorsh P, Varma VM (1985) Utility of gallium-67 scintigraphy and bronchial washings in the diagnosis and treatment ofPneumocystis carinii pneumonia in patients with acquired immunodefciency syndrome. Am Rev Respir Dis 132:1087–1092

    PubMed  Google Scholar 

  • Zamman HK, White DA (1988) Serum lactyate dehydragenase levels andPneumocystis carinii pneumonia. Am Rev Respir Dis 137:796–800

    PubMed  Google Scholar 

  • Ziegler JL, Beckstead JA, Volberding PA, (1984) Non-Hodgkin's lymphoma in 90 homosexual man. Relation to generalised lymphadenopathy an the acquired immunodeficiency syndrome. N Engl J Med 311:565–569

    PubMed  Google Scholar 

  • Zuckier LS, Ongseng F, Goldfarb CR (1988) Lymphocytic interstitial pneumonitis: a cause of pulmonary gallium-67 uptake in a child with acquired immunodeficiency syndrome. J Nucl Med 29:707–711

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Miller, R.F. Nuclear medicine and AIDS. Eur J Nucl Med 16, 103–118 (1990). https://doi.org/10.1007/BF01465919

Download citation

  • Received:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01465919

Key words

Navigation