Positron Emission Tomography and Magnetic Resonance Imaging in Experimental Human Malaria to Identify Organ-Specific Changes in Morphology and Glucose Metabolism: A Prospective Cohort Study

The tissue distribution of P. falciparum on autopsy has been well described. In a seminal publication by Marchiafava and Bignami, the greatest concentration of schizonts was found in the brain, followed by the lungs, spleen, bone marrow, liver, and intestines. Magnetic resonance imaging and functional imaging using nuclear medicine such as positron emission tomography may be useful noninvasive methods to study deep tissue processes and organ-specific tropism, particularly in early and non-severe infection. Changes in splenic imaging metrics may be associated with either increased parasite or host activity, or a combination of both. To date, the ability to localize the pathology of malaria in life has been limited, and direct evaluation of sequestration and organ-specific parasite tropism has relied upon animal models and postmortem studies.