18F-Fluorodeoxysorbitol PET for noninvasive detection of invasive mold infections: preclinical and first-in-human studies

Abstract Invasive mold infections are a major cause of mortality in immunosuppressed and cancer patients. Diagnosis is challenging, requiring invasive procedures or reliance on fungal biomarkers with limited sensitivity and an inability to detect non-Aspergillus molds. Here, we perform whole-body 18...

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Main Authors: Carlos E. Ruiz-Gonzalez, Oscar J. Nino-Meza, Medha Singh, Yuderleys Masias-Leon, Amy Kronenberg, Madelynn Shambles, Xueyi Chen, Elizabeth W. Tucker, Martin A. Lodge, Laurence S. Carroll, Kenneth R. Cooke, Olivia S. Kates, Shmuel Shoham, Sean X. Zhang, Sanjay K. Jain
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Nature Communications
Online Access:https://doi.org/10.1038/s41467-025-61700-6
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author Carlos E. Ruiz-Gonzalez
Oscar J. Nino-Meza
Medha Singh
Yuderleys Masias-Leon
Amy Kronenberg
Madelynn Shambles
Xueyi Chen
Elizabeth W. Tucker
Martin A. Lodge
Laurence S. Carroll
Kenneth R. Cooke
Olivia S. Kates
Shmuel Shoham
Sean X. Zhang
Sanjay K. Jain
author_facet Carlos E. Ruiz-Gonzalez
Oscar J. Nino-Meza
Medha Singh
Yuderleys Masias-Leon
Amy Kronenberg
Madelynn Shambles
Xueyi Chen
Elizabeth W. Tucker
Martin A. Lodge
Laurence S. Carroll
Kenneth R. Cooke
Olivia S. Kates
Shmuel Shoham
Sean X. Zhang
Sanjay K. Jain
author_sort Carlos E. Ruiz-Gonzalez
collection DOAJ
description Abstract Invasive mold infections are a major cause of mortality in immunosuppressed and cancer patients. Diagnosis is challenging, requiring invasive procedures or reliance on fungal biomarkers with limited sensitivity and an inability to detect non-Aspergillus molds. Here, we perform whole-body 18F-fluorodeoxysorbitol (18F-FDS) positron emission tomography (PET) in nine prospectively enrolled patients with high-suspicion of invasive mold infections (eventually confirmed using culture or molecular assays, n = 4) or other pathologies (n = 5) with localization of 18F-FDS PET signal to infection sites as the primary outcome (NCT05611892). 18F-FDS PET (120 or 180 min after injection), rapidly detects and localizes invasive pulmonary and cerebral infections due to Aspergillus, non-Aspergillus (galactomannan-negative), or azole-resistant molds, and differentiates them from sterile inflammation or cancer. Moreover, 18F-FDS selectively and rapidly accumulates intracellularly in a range of clinically relevant molds, including azole-resistant molds, via a saturable process. In animals, 18F-FDS PET is able to detect and localize pulmonary and cerebral aspergillosis, as well as rhinosinusal infections due to Aspergillus, Rhizopus, and Mucor, confirming the clinical data. 18F-FDS can be easily synthesized from 18F-fluorodeoxyglucose (18F-FDG), which is widely available, and represents a promising, noninvasive diagnostic tool for detecting, localizing and monitoring of invasive mold infections throughout the body.
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spelling doaj-art-ae44530f40c14af4b28daec8b136d9472025-08-20T03:42:55ZengNature PortfolioNature Communications2041-17232025-07-0116111210.1038/s41467-025-61700-618F-Fluorodeoxysorbitol PET for noninvasive detection of invasive mold infections: preclinical and first-in-human studiesCarlos E. Ruiz-Gonzalez0Oscar J. Nino-Meza1Medha Singh2Yuderleys Masias-Leon3Amy Kronenberg4Madelynn Shambles5Xueyi Chen6Elizabeth W. Tucker7Martin A. Lodge8Laurence S. Carroll9Kenneth R. Cooke10Olivia S. Kates11Shmuel Shoham12Sean X. Zhang13Sanjay K. Jain14Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of MedicineCenter for Infection and Inflammation Imaging Research, Johns Hopkins University School of MedicineCenter for Infection and Inflammation Imaging Research, Johns Hopkins University School of MedicineCenter for Infection and Inflammation Imaging Research, Johns Hopkins University School of MedicineCenter for Infection and Inflammation Imaging Research, Johns Hopkins University School of MedicineCenter for Infection and Inflammation Imaging Research, Johns Hopkins University School of MedicineCenter for Infection and Inflammation Imaging Research, Johns Hopkins University School of MedicineCenter for Infection and Inflammation Imaging Research, Johns Hopkins University School of MedicineRussell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of MedicineRussell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of MedicineDepartment of Oncology, Johns Hopkins University School of MedicineDepartment of Medicine, Johns Hopkins University School of MedicineDepartment of Medicine, Johns Hopkins University School of MedicineDepartment of Pathology, Johns Hopkins University School of MedicineCenter for Infection and Inflammation Imaging Research, Johns Hopkins University School of MedicineAbstract Invasive mold infections are a major cause of mortality in immunosuppressed and cancer patients. Diagnosis is challenging, requiring invasive procedures or reliance on fungal biomarkers with limited sensitivity and an inability to detect non-Aspergillus molds. Here, we perform whole-body 18F-fluorodeoxysorbitol (18F-FDS) positron emission tomography (PET) in nine prospectively enrolled patients with high-suspicion of invasive mold infections (eventually confirmed using culture or molecular assays, n = 4) or other pathologies (n = 5) with localization of 18F-FDS PET signal to infection sites as the primary outcome (NCT05611892). 18F-FDS PET (120 or 180 min after injection), rapidly detects and localizes invasive pulmonary and cerebral infections due to Aspergillus, non-Aspergillus (galactomannan-negative), or azole-resistant molds, and differentiates them from sterile inflammation or cancer. Moreover, 18F-FDS selectively and rapidly accumulates intracellularly in a range of clinically relevant molds, including azole-resistant molds, via a saturable process. In animals, 18F-FDS PET is able to detect and localize pulmonary and cerebral aspergillosis, as well as rhinosinusal infections due to Aspergillus, Rhizopus, and Mucor, confirming the clinical data. 18F-FDS can be easily synthesized from 18F-fluorodeoxyglucose (18F-FDG), which is widely available, and represents a promising, noninvasive diagnostic tool for detecting, localizing and monitoring of invasive mold infections throughout the body.https://doi.org/10.1038/s41467-025-61700-6
spellingShingle Carlos E. Ruiz-Gonzalez
Oscar J. Nino-Meza
Medha Singh
Yuderleys Masias-Leon
Amy Kronenberg
Madelynn Shambles
Xueyi Chen
Elizabeth W. Tucker
Martin A. Lodge
Laurence S. Carroll
Kenneth R. Cooke
Olivia S. Kates
Shmuel Shoham
Sean X. Zhang
Sanjay K. Jain
18F-Fluorodeoxysorbitol PET for noninvasive detection of invasive mold infections: preclinical and first-in-human studies
Nature Communications
title 18F-Fluorodeoxysorbitol PET for noninvasive detection of invasive mold infections: preclinical and first-in-human studies
title_full 18F-Fluorodeoxysorbitol PET for noninvasive detection of invasive mold infections: preclinical and first-in-human studies
title_fullStr 18F-Fluorodeoxysorbitol PET for noninvasive detection of invasive mold infections: preclinical and first-in-human studies
title_full_unstemmed 18F-Fluorodeoxysorbitol PET for noninvasive detection of invasive mold infections: preclinical and first-in-human studies
title_short 18F-Fluorodeoxysorbitol PET for noninvasive detection of invasive mold infections: preclinical and first-in-human studies
title_sort 18f fluorodeoxysorbitol pet for noninvasive detection of invasive mold infections preclinical and first in human studies
url https://doi.org/10.1038/s41467-025-61700-6
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