18-Fluorodeoxyglucose Positron Emission Tomography for Tuberculosis Diagnosis and Management: a Case Series

Overview

Journal BMC Pulm Med

Publisher Biomed Central

Specialty Pulmonary Medicine

Date 2013 Mar 22

PMID 23514625

Citations 16

Authors

Scott K Heysell

Tania A Thomas

Costi D Sifri

Patrice K Rehm

Eric R Houpt

Affiliations

Soon will be listed here.

Abstract

Background: F-fluorodeoxyglucose positron emission tomography (FDG-PET) is increasingly used to investigate for malignancy in the evaluation of pulmonary nodules, yet both active tuberculosis (TB) and malignancy have high uptake of FDG. Definitive diagnosis of TB can be further hindered in patients without growth of the organism from sputum.

Case Presentations: We describe a series of four representative cases of TB in varying disease state originally imaged by FDG-PET during evaluation for malignancy. Decisions regarding treatment for active TB in the presence of negative cultures and the evolving understanding of the spectrum of the TB disease state are discussed.

Conclusions: FDG-PET may possess a role in the diagnosis of active TB infection in settings where conventional microbiological methods are unavaiable and holds particular promise for monitoring response to therapy in cases of unsettled treatment duration such as multidrug-resistant TB or in extrapulmonary TB.

Citing Articles

Immunologic and imaging signatures in post tuberculosis lung disease.

Singh S, Allwood B, Chiyaka T, Kleyhans L, Naidoo C, Moodley S Tuberculosis (Edinb). 2022; 136:102244.

PMID: 36007338 PMC: 10061373. DOI: 10.1016/j.tube.2022.102244.

The Value of 18F-FDG PET/CT in the Diagnosis of Tuberculous Pleurisy and in the Differential Diagnosis between Tuberculous Pleurisy and Pleural Metastasis from Lung Adenocarcinoma.

Du X, Zhu F, Yu C Contrast Media Mol Imaging. 2022; 2022:4082291.

PMID: 35965614 PMC: 9357728. DOI: 10.1155/2022/4082291.

A Case of Premenopausal Uterine Leiomyoma, Non-cirrhotic Portal Fibrosis, Hepatic Koch's, a PET Gone Astray-Morphology Antidotes a Confounding Concoction.

Gaur K, Shukla S, Choudhury S, Raj P, Patra S Iran J Pathol. 2022; 17(2):229-233.

PMID: 35463736 PMC: 9013869. DOI: 10.30699/IJP.2022.540258.2743.

The Peripheral Blood Transcriptome Is Correlated With PET Measures of Lung Inflammation During Successful Tuberculosis Treatment.

Odia T, Malherbe S, Meier S, Maasdorp E, Kleynhans L, Plessis N Front Immunol. 2021; 11:596173.

PMID: 33643286 PMC: 7902901. DOI: 10.3389/fimmu.2020.596173.

Molecular Imaging of Pulmonary Inflammation and Infection.

Giraudo C, Evangelista L, Fraia A, Lupi A, Quaia E, Cecchin D Int J Mol Sci. 2020; 21(3).

PMID: 32019142 PMC: 7037834. DOI: 10.3390/ijms21030894.

References

Hara T, Kosaka N, Suzuki T, Kudo K, Niino H . Uptake rates of 18F-fluorodeoxyglucose and 11C-choline in lung cancer and pulmonary tuberculosis: a positron emission tomography study. Chest. 2003; 124(3):893-901. DOI: 10.1378/chest.124.3.893. View

Kim I, Lee J, Kim S, Kim Y, Jeong Y, Jun S . Double-phase 18F-FDG PET-CT for determination of pulmonary tuberculoma activity. Eur J Nucl Med Mol Imaging. 2007; 35(4):808-14. DOI: 10.1007/s00259-007-0585-0. View

Lin P, Flynn J . Understanding latent tuberculosis: a moving target. J Immunol. 2010; 185(1):15-22. PMC: 3311959. DOI: 10.4049/jimmunol.0903856. View

Demura Y, Tsuchida T, Uesaka D, Umeda Y, Morikawa M, Ameshima S . Usefulness of 18F-fluorodeoxyglucose positron emission tomography for diagnosing disease activity and monitoring therapeutic response in patients with pulmonary mycobacteriosis. Eur J Nucl Med Mol Imaging. 2008; 36(4):632-9. DOI: 10.1007/s00259-008-1009-5. View

Sathekge M, Maes A, Pottel H, Stoltz A, Van de Wiele C . Dual time-point FDG PET-CT for differentiating benign from malignant solitary pulmonary nodules in a TB endemic area. S Afr Med J. 2010; 100(9):598-601. DOI: 10.7196/samj.4082. View

El-Haddad G, Zhuang H, Gupta N, Alavi A . Evolving role of positron emission tomography in the management of patients with inflammatory and other benign disorders. Semin Nucl Med. 2004; 34(4):313-29. DOI: 10.1053/j.semnuclmed.2004.06.006. View

Martinez V, Castilla-Lievre M, Guillet-Caruba C, Grenier G, Fior R, Desarnaud S . (18)F-FDG PET/CT in tuberculosis: an early non-invasive marker of therapeutic response. Int J Tuberc Lung Dis. 2012; 16(9):1180-5. DOI: 10.5588/ijtld.12.0010. View

Barry 3rd C, Boshoff H, Dartois V, Dick T, Ehrt S, Flynn J . The spectrum of latent tuberculosis: rethinking the biology and intervention strategies. Nat Rev Microbiol. 2009; 7(12):845-55. PMC: 4144869. DOI: 10.1038/nrmicro2236. View

Via L, Schimel D, Weiner D, Dartois V, Dayao E, Cai Y . Infection dynamics and response to chemotherapy in a rabbit model of tuberculosis using [¹⁸F]2-fluoro-deoxy-D-glucose positron emission tomography and computed tomography. Antimicrob Agents Chemother. 2012; 56(8):4391-402. PMC: 3421588. DOI: 10.1128/AAC.00531-12. View

10.

Tian G, Xiao Y, Chen B, Xia J, Guan H, Deng Q . FDG PET/CT for therapeutic response monitoring in multi-site non-respiratory tuberculosis. Acta Radiol. 2010; 51(9):1002-6. DOI: 10.3109/02841851.2010.504744. View

11.

Soussan M, Brillet P, Mekinian A, Khafagy A, Nicolas P, Vessieres A . Patterns of pulmonary tuberculosis on FDG-PET/CT. Eur J Radiol. 2011; 81(10):2872-6. DOI: 10.1016/j.ejrad.2011.09.002. View

12.

Davis S, Nuermberger E, Um P, Vidal C, Jedynak B, Pomper M . Noninvasive pulmonary [18F]-2-fluoro-deoxy-D-glucose positron emission tomography correlates with bactericidal activity of tuberculosis drug treatment. Antimicrob Agents Chemother. 2009; 53(11):4879-84. PMC: 2772305. DOI: 10.1128/AAC.00789-09. View

13.

Sathekge M, Maes A, Kgomo M, Stoltz A, Van de Wiele C . Use of 18F-FDG PET to predict response to first-line tuberculostatics in HIV-associated tuberculosis. J Nucl Med. 2011; 52(6):880-5. DOI: 10.2967/jnumed.110.083709. View

14.

Lillington G, Caskey C . Evaluation and management of solitary and multiple pulmonary nodules. Clin Chest Med. 1993; 14(1):111-9. View

15.

Kim S, Kim I, Suh K, Kim Y, Lee J . Prediction of residual disease of spine infection using F-18 FDG PET/CT. Spine (Phila Pa 1976). 2009; 34(22):2424-30. DOI: 10.1097/BRS.0b013e3181b1fd33. View

16.

Treglia G, Taralli S, Calcagni M, Maggi F, Giordano A, Bonomo L . Is there a role for fluorine 18 fluorodeoxyglucose-positron emission tomography and positron emission tomography/computed tomography in evaluating patients with mycobacteriosis? A systematic review. J Comput Assist Tomogr. 2011; 35(3):387-93. DOI: 10.1097/RCT.0b013e318219f810. View

17.

Goo J, Im J, Do K, Yeo J, Seo J, Kim H . Pulmonary tuberculoma evaluated by means of FDG PET: findings in 10 cases. Radiology. 2000; 216(1):117-21. DOI: 10.1148/radiology.216.1.r00jl19117. View

18.

Gandhi N, Nunn P, Dheda K, Schaaf H, Zignol M, van Soolingen D . Multidrug-resistant and extensively drug-resistant tuberculosis: a threat to global control of tuberculosis. Lancet. 2010; 375(9728):1830-43. DOI: 10.1016/S0140-6736(10)60410-2. View