Ingrid Stelzmueller1, Helmut Huber, Rainer Wunn, Marina Hodolic, Michael Mandl, Bernd Lamprecht, Herwig Schinko, Franz Fellner, Andrea Skanjeti, Francesco Giammarile, Patrick M Colletti, Domenico Rubello, Michael Gabriel. 1. From the Departments of *Pneumology, †Nuclear and Endocrinology, and ‡Radiology, Allgemeines Krankenhaus der Stadt Linz, Medical Faculty of the Johannes Kepler University, Linz; §Nuclear Medicine Research Department, IASON, Graz, Austria; ∥Médecine Nucléaire, Centre Hospitalier and Biophysique, Faculté Charles Mérieux, Lyon, France; ¶Department of Radiology, University of Southern California, Los Angeles, CA; **Department Nuclear Medicine, Santa Maria della Misericordia Hospital, Rovigo, Italy; and ††University Clinic of Nuclear Medicine, Medical University of Innsbruck, Innsbruck, Austria.
Abstract
PURPOSE: The aim of this retrospective study was to assess the value of 18F-FDG PET/CT in the initial evaluation and follow-up of patients with tuberculosis (TB). PATIENTS AND METHODS: Thirty-five patients (18 men) with pulmonary or extrapulmonary TB were included. Diagnosis of TB was based either on histology or microbiological assessment in 32 patients and was based on typical morphological features of TB in CT and improvement on antimycobacterial medication in 3 patients. Eighty-eight 18F-FDG PET/CT scans were performed at initial assessment and during treatment, on a Siemens Biograph PET/CT. Diagnostic contrast-enhanced CT scans were performed on the 40-slice multidetector CT of the PET/CT scanner. Mean (SD) anti-TB treatment duration was 16.1 (8.9) months. RESULTS: The initial 18F-FDG PET identified 64 affected regions in 34 among 35 patients, whereas CT identified 34 affected organs in 23 patients. Matching image results between PET and CT were observed at first visit in 11 patients (31.4%), with relevant differences in 23 (65.7%). In 1 patient, both modalities remained negative. During follow-up 18F-FDG PET scans, we recorded 15 cases with remission of disease, 16 with residual disease (2 patients with multidrug-resistant infection), and 4 cases with progressive disease or delayed onset of adequate immunological response. In only 3 patients, both modalities, PET and CT, showed completely equivalent results. CONCLUSIONS: Both components of 18F-FDG PET/CT provide complementary information at initial evaluation and during follow-up; however, 18F-FDG showed more abnormal findings than CT. 18F-FDG PET/CT might be useful for the establishment of individualized treatment regimes, but this requires further prospective studies.
PURPOSE: The aim of this retrospective study was to assess the value of 18F-FDG PET/CT in the initial evaluation and follow-up of patients with tuberculosis (TB). PATIENTS AND METHODS: Thirty-five patients (18 men) with pulmonary or extrapulmonary TB were included. Diagnosis of TB was based either on histology or microbiological assessment in 32 patients and was based on typical morphological features of TB in CT and improvement on antimycobacterial medication in 3 patients. Eighty-eight 18F-FDG PET/CT scans were performed at initial assessment and during treatment, on a Siemens Biograph PET/CT. Diagnostic contrast-enhanced CT scans were performed on the 40-slice multidetector CT of the PET/CT scanner. Mean (SD) anti-TB treatment duration was 16.1 (8.9) months. RESULTS: The initial 18F-FDG PET identified 64 affected regions in 34 among 35 patients, whereas CT identified 34 affected organs in 23 patients. Matching image results between PET and CT were observed at first visit in 11 patients (31.4%), with relevant differences in 23 (65.7%). In 1 patient, both modalities remained negative. During follow-up 18F-FDG PET scans, we recorded 15 cases with remission of disease, 16 with residual disease (2 patients with multidrug-resistant infection), and 4 cases with progressive disease or delayed onset of adequate immunological response. In only 3 patients, both modalities, PET and CT, showed completely equivalent results. CONCLUSIONS: Both components of 18F-FDG PET/CT provide complementary information at initial evaluation and during follow-up; however, 18F-FDG showed more abnormal findings than CT. 18F-FDG PET/CT might be useful for the establishment of individualized treatment regimes, but this requires further prospective studies.
Authors: Jan Heyckendorf; Sophia B Georghiou; Nicole Frahm; Norbert Heinrich; Irina Kontsevaya; Maja Reimann; David Holtzman; Marjorie Imperial; Daniela M Cirillo; Stephen H Gillespie; Morten Ruhwald Journal: Clin Microbiol Rev Date: 2022-03-21 Impact factor: 50.129
Authors: Stephanus T Malherbe; Shubhada Shenai; Katharina Ronacher; Andre G Loxton; Gregory Dolganov; Magdalena Kriel; Tran Van; Ray Y Chen; James Warwick; Laura E Via; Taeksun Song; Myungsun Lee; Gary Schoolnik; Gerard Tromp; David Alland; Clifton E Barry; Jill Winter; Gerhard Walzl; Lance Lucas; Gian van der Spuy; Kim Stanley; Lani Thiart; Bronwyn Smith; Nelita Du Plessis; Caroline G G Beltran; Elizna Maasdorp; Annare Ellmann; Hongjo Choi; Joonsung Joh; Lori E Dodd; Brian Allwood; Coenie Koegelenberg; Morné Vorster; Stephanie Griffith-Richards Journal: Nat Med Date: 2016-09-05 Impact factor: 53.440
Authors: E Guirao Arrabal; M J Pérez Sola; M Montes Ruiz-Cabello; J Rodríguez Granger; G Egea Journal: Rev Esp Quimioter Date: 2018-06-27 Impact factor: 1.553
Authors: Stephanus T Malherbe; Ray Y Chen; Patrick Dupont; Ilse Kant; Magdalena Kriel; André G Loxton; Bronwyn Smith; Caroline G G Beltran; Susan van Zyl; Shirely McAnda; Charmaine Abrahams; Elizna Maasdorp; Alex Doruyter; Laura E Via; Clifton E Barry; David Alland; Stephanie Griffith- Richards; Annare Ellman; Thomas Peppard; John Belisle; Gerard Tromp; Katharina Ronacher; James M Warwick; Jill Winter; Gerhard Walzl Journal: EJNMMI Res Date: 2020-02-10 Impact factor: 3.138