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Fluoromannitol (specifically [18F]fluoromannitol or [18F]FMtl) is a novel, pathogen-specific radiopharmaceutical PET tracer developed by St. Jude Children's Research Hospital. It is designed to noninvasively detect and differentiate active bacterial infections from viral infections and sterile inflammation. The tracer exploits the bacterial-specific mannitol transport and metabolism pathway (mediated by the mannitol-specific phosphotransferase system), which is minimal or absent in mammalian cells. This allows [18F]fluoromannitol to rapidly and selectively accumulate in both Gram-positive and Gram-negative bacteria at infection sites. It is being evaluated in clinical trials for safety, biodistribution, and its potential to diagnose deep-seated infections such as osteomyelitis and prosthetic joint infections, particularly in patients with sickle cell disease or cancer.
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