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[68Ga]Ga-BP (gallium-68 buffered phosphate) is a novel, small-molecule positron emission tomography (PET) imaging radiotracer developed by the Mayo Clinic for the non-invasive detection and differentiation of bacterial infections (such as osteomyelitis) from sterile inflammation. The tracer is designed to exploit the bacterial requirement for iron; due to the similar size and charge of gallium (Ga3+) to iron (Fe3+), gallium-68 acts as an iron surrogate and is directly taken up by bacteria via membrane-bound transferrin receptors and siderophore-mediated transport systems. Preclinical studies in rat models of foreign body-associated osteomyelitis caused by MRSA, *Pseudomonas aeruginosa*, and *Klebsiella pneumoniae* have demonstrated that [68Ga]Ga-BP can successfully identify active bacterial infections with high specificity, outperforming conventional tracers like [18F]FDG and [68Ga]Ga-citrate.
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