Usefulness of FDG PET/CT in the management of tuberculosis

Adrián Sánchez-Montalvá, Marta Barios, Fernando Salvador, Ana Villar, Teresa Tórtola, Daniel Molina-Morant, Carles Lorenzo-Bosquet, Juan Espinosa-Pereiro, Israel Molina

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    Abstract

    © 2019 Sánchez-Montalvá et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Background The aim of our study is to describe the FDG-PET/CT findings in patients with tuberculosis and to correlate them with the patient’s prognosis. Methods We retrospectively collected data from patients with tuberculosis, who had an FDG-PET/CT performed prior to treatment initiation from 2010 to 2015. Results Forty-seven out of 504 patients with active tuberculosis diagnosis (9.33%) underwent an FDG-PET/CT. The reasons for performing the FDG-PET/CT were: characterization of a pulmonary nodule (24; 51.1%), study of fever of unknown origin (12; 25.5%), study of lymph node enlargement (5; 10.6%) and others (6; 12.8%). Median age was 64 (IQR 50–74) years and 31 (66%) patients were male. Twenty-six (55.3%) patients had an immunosuppressant condition. According to the FDG-PET/CT, 48.6% of the patients had more than 1 organ affected and 46.8% had lymph node involvement. Median SUVmax of the main lesion was 5 (IQR 0.28–11.85). We found an association between the FDG accumulation and the size of the main lesion with a correlation coefficient of 0.54 (p<0.002). Patients with an unsuccessful outcome had a higher ratio SUVmax main lesion / SUVmean liver (1.92 vs 7.67, p<0.02). Conclusions In our cohort, almost half of the patients had more than 1 organ affected and 46.8% of them had lymph node involvement. FDG uptake was associated with the size of the main lesion and seems to be related to the treatment outcome. The extent of its potential to be used as an early predictor of treatment success still needs to be defined.
    Original languageEnglish
    Article numbere0221516
    JournalPLoS ONE
    Volume14
    DOIs
    Publication statusPublished - 1 Jan 2019

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