Skip to main content
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging 4/2009

01.04.2009 | Original Article

Usefulness of 18F-fluorodeoxyglucose positron emission tomography for diagnosing disease activity and monitoring therapeutic response in patients with pulmonary mycobacteriosis

verfasst von: Yoshiki Demura, Tatsuro Tsuchida, Daisuke Uesaka, Yukihiro Umeda, Miwa Morikawa, Shingo Ameshima, Takeshi Ishizaki, Yasuhisa Fujibayashi, Hidehiko Okazawa

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 4/2009

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To evaluate the usefulness of 18F-FDG PET in the imaging of pulmonary lesions related to disease activity and in monitoring responses to treatment in patients with pulmonary mycobacteriosis (PM).

Materials and methods

We used high-resolution computed tomography (HRCT) and 18F-FDG PET to evaluate 47 consecutive untreated patients with PM, 25 with tuberculosis (TB) and 22 with Mycobacterium avium-intracellulare complex (MAC), who presented with small peripheral pulmonary nodules ≤3 cm, and compared the findings. The diagnosis of mycobacteriosis was confirmed by bacteriological examinations of bronchoscopic or surgically resected specimens. PET scans were visually and quantitatively analysed using SUVmax. In addition, 14 patients with PM underwent repeat PET scanning during antimycobacterial therapy, and changes in 18F-FDG uptake were clinically evaluated (6 during treatment and 12 after treatment).

Results

Of all the lesions, 87.2% had SUVmax levels ranging from 3 to 7 (5.05 ± 1.56, range 2.5–7.6, n = 47). Further, SUV levels in patients with PM reflected disease activity as estimated by HRCT, but did not differ significantly between those with TB (4.96 ± 1.61, n = 25) and MAC (5.15 ± 1.53, n = 22). 18F-FDG uptake was significantly decreased in all 14 patients who received chemotherapy, indicating a positive response to treatment.

Conclusion

18F-FDG PET is considered to be useful for the diagnosis and evaluation of disease activity along with HRCT findings, and in monitoring response to chemotherapy in patients with PM.
Literatur
1.
Zurück zum Zitat Lillington GA, Caskey CI. Evaluation and management of solitary and multiple pulmonary nodules. Clin Chest Med 1993;14:111–9.PubMed Lillington GA, Caskey CI. Evaluation and management of solitary and multiple pulmonary nodules. Clin Chest Med 1993;14:111–9.PubMed
2.
Zurück zum Zitat Swensen SJ, Jett JR, Payne WS, Viggiano RW, Pairolero PC, Trastek VF. An integrated approach to evaluation of the solitary pulmonary nodule. Mayo Clin Proc 1990;65:173–86.PubMed Swensen SJ, Jett JR, Payne WS, Viggiano RW, Pairolero PC, Trastek VF. An integrated approach to evaluation of the solitary pulmonary nodule. Mayo Clin Proc 1990;65:173–86.PubMed
3.
Zurück zum Zitat Nomori H, Horio H, Fuyuo G, Kobayashi R, Morinaga S, Suemasu K. Lung adenocarcinomas diagnosed by open lung or thoracoscopic vs. bronchoscopic biopsy. Chest 1998;114:40–4.PubMedCrossRef Nomori H, Horio H, Fuyuo G, Kobayashi R, Morinaga S, Suemasu K. Lung adenocarcinomas diagnosed by open lung or thoracoscopic vs. bronchoscopic biopsy. Chest 1998;114:40–4.PubMedCrossRef
5.
Zurück zum Zitat Liu SF, Liu JW, Lin MC, Lee CH, Huang HH, Lai YF. Monitoring treatment responses in patients with pulmonary TB using serial lung gallium-67 scintigraphy. AJR Am J Roentgenol 2007;188:W403–8.PubMedCrossRef Liu SF, Liu JW, Lin MC, Lee CH, Huang HH, Lai YF. Monitoring treatment responses in patients with pulmonary TB using serial lung gallium-67 scintigraphy. AJR Am J Roentgenol 2007;188:W403–8.PubMedCrossRef
6.
Zurück zum Zitat Goo JM, Im JG, Do KH, Yeo JS, Seo JB, Kim HY, et al. Pulmonary tuberculoma evaluated by means of FDG PET: findings in 10 cases. Radiology 2000;216:117–21.PubMed Goo JM, Im JG, Do KH, Yeo JS, Seo JB, Kim HY, et al. Pulmonary tuberculoma evaluated by means of FDG PET: findings in 10 cases. Radiology 2000;216:117–21.PubMed
7.
Zurück zum Zitat Patz EF, Lowe VJ, Hoffman JM, Paine SS, Burrowes P, Coleman RE, et al. Focal pulmonary abnormalities: evaluation with F-18-fluorodeoxyglucose PET scanning. Radiology 1993;188:487–90.PubMed Patz EF, Lowe VJ, Hoffman JM, Paine SS, Burrowes P, Coleman RE, et al. Focal pulmonary abnormalities: evaluation with F-18-fluorodeoxyglucose PET scanning. Radiology 1993;188:487–90.PubMed
8.
Zurück zum Zitat Hara T, Kosaka N, Suzuki T, 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;124:893–901.PubMedCrossRef Hara T, Kosaka N, Suzuki T, 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;124:893–901.PubMedCrossRef
9.
Zurück zum Zitat Demura Y, Tsuchida T, Ishizaki T, Mizuno S, Totani Y, Ameshima S, et al. 18F-FDG accumulation with PET for differentiation between benign and malignant lesions in the thorax. J Nucl Med 2003;44:540–8.PubMed Demura Y, Tsuchida T, Ishizaki T, Mizuno S, Totani Y, Ameshima S, et al. 18F-FDG accumulation with PET for differentiation between benign and malignant lesions in the thorax. J Nucl Med 2003;44:540–8.PubMed
10.
Zurück zum Zitat Kim IJ, Lee JS, Kim SJ, Kim YK, Jeong YJ, Jun S, et al. Double-phase 18F-FDG PET-CT for determination of pulmonary tuberculoma activity. Eur J Nucl Med Mol Imaging 2008;35:808–14.PubMedCrossRef Kim IJ, Lee JS, Kim SJ, Kim YK, Jeong YJ, Jun S, et al. Double-phase 18F-FDG PET-CT for determination of pulmonary tuberculoma activity. Eur J Nucl Med Mol Imaging 2008;35:808–14.PubMedCrossRef
11.
Zurück zum Zitat Lowe VJ, Hoffman JM, DeLong DM, Patz EF, Coleman RE. Semiquantitative and visual analysis of FDG-PET images in pulmonary abnormalities. J Nucl Med 1994;35:1771–6.PubMed Lowe VJ, Hoffman JM, DeLong DM, Patz EF, Coleman RE. Semiquantitative and visual analysis of FDG-PET images in pulmonary abnormalities. J Nucl Med 1994;35:1771–6.PubMed
12.
Zurück zum Zitat Higashi K, Ito K, Hiramatsu Y, Ishikawa T, Sakuma T, Matsunari I, et al. 18F-FDG uptake by primary tumor as a predictor of intratumoral lymphatic vessel invasion and lymph node involvement in non-small cell lung cancer: analysis of a multicenter study. J Nucl Med 2005;46:267–73.PubMed Higashi K, Ito K, Hiramatsu Y, Ishikawa T, Sakuma T, Matsunari I, et al. 18F-FDG uptake by primary tumor as a predictor of intratumoral lymphatic vessel invasion and lymph node involvement in non-small cell lung cancer: analysis of a multicenter study. J Nucl Med 2005;46:267–73.PubMed
13.
Zurück zum Zitat Im JG, Itoh H, Shim YS, Lee JH, Ahn J, Han MC, et al. Pulmonary tuberculosis: CT findings – early active disease and sequential change with antituberculous therapy. Radiology 1993;186:653–60.PubMed Im JG, Itoh H, Shim YS, Lee JH, Ahn J, Han MC, et al. Pulmonary tuberculosis: CT findings – early active disease and sequential change with antituberculous therapy. Radiology 1993;186:653–60.PubMed
14.
Zurück zum Zitat Primack SL, Logan PM, Hartman TE, Lee KS, Müller NL. Pulmonary tuberculosis and Mycobacterium avium-intracellulare: a comparison of CT findings. Radiology 1995;194:413–7.PubMed Primack SL, Logan PM, Hartman TE, Lee KS, Müller NL. Pulmonary tuberculosis and Mycobacterium avium-intracellulare: a comparison of CT findings. Radiology 1995;194:413–7.PubMed
15.
Zurück zum Zitat Elizabeth H, Moore MD. Atypical mycobacterial infection in the lung: CT appearance. Radiology 1993;187:777–82. Elizabeth H, Moore MD. Atypical mycobacterial infection in the lung: CT appearance. Radiology 1993;187:777–82.
16.
Zurück zum Zitat Chan W, Chia M, Lee LK, Macfadyen DM. Bacteriological measures for the detection of cases of pulmonary tuberculosis. Bull WHO 1971;45:551–8.PubMed Chan W, Chia M, Lee LK, Macfadyen DM. Bacteriological measures for the detection of cases of pulmonary tuberculosis. Bull WHO 1971;45:551–8.PubMed
17.
Zurück zum Zitat Bandoh S, Fujita J, Ueda Y, Tojo Y, Ishii T, Kubo A, et al. Uptake of fluorine-18-fluorodeoxyglucose in pulmonary Mycobacterium avium complex infection. Intern Med 2003;42:726–9.PubMedCrossRef Bandoh S, Fujita J, Ueda Y, Tojo Y, Ishii T, Kubo A, et al. Uptake of fluorine-18-fluorodeoxyglucose in pulmonary Mycobacterium avium complex infection. Intern Med 2003;42:726–9.PubMedCrossRef
18.
Zurück zum Zitat Pratt PC. Pathology of tuberculosis. Semin Roentgenol 1970;14:196–203.CrossRef Pratt PC. Pathology of tuberculosis. Semin Roentgenol 1970;14:196–203.CrossRef
19.
Zurück zum Zitat Sumartojo E. When tuberculosis treatment fails. A social behavioral account of patient adherence. Am Rev Respir Dis 1993;147:1311–20.PubMed Sumartojo E. When tuberculosis treatment fails. A social behavioral account of patient adherence. Am Rev Respir Dis 1993;147:1311–20.PubMed
20.
Zurück zum Zitat Lee HS, Oh JY, Lee JH, Yoo CG, Lee CT, Kim YW, et al. Response of pulmonary tuberculosis to anti-tuberculous treatment. Eur Respir J 2004;23:452–5.PubMedCrossRef Lee HS, Oh JY, Lee JH, Yoo CG, Lee CT, Kim YW, et al. Response of pulmonary tuberculosis to anti-tuberculous treatment. Eur Respir J 2004;23:452–5.PubMedCrossRef
21.
Zurück zum Zitat Hofmeyr A, Lau WF, Slavin MA. Mycobacterium tuberculosis infection in patients with cancer, the role of 18-fluorodeoxyglucose positron emission tomography for diagnosis and monitoring treatment response. Tuberculosis 2007;87:459–63.PubMedCrossRef Hofmeyr A, Lau WF, Slavin MA. Mycobacterium tuberculosis infection in patients with cancer, the role of 18-fluorodeoxyglucose positron emission tomography for diagnosis and monitoring treatment response. Tuberculosis 2007;87:459–63.PubMedCrossRef
22.
Zurück zum Zitat Park IN, Ryu JS, Shim TS. Evaluation of therapeutic response of tuberculoma using F-18 FDG positron emission tomography. Clin Nucl Med 2008;33:1–3.PubMedCrossRef Park IN, Ryu JS, Shim TS. Evaluation of therapeutic response of tuberculoma using F-18 FDG positron emission tomography. Clin Nucl Med 2008;33:1–3.PubMedCrossRef
23.
Zurück zum Zitat Kubota R, Yamada S, Kubota K, Ishiwata K, Tamahashi N, Ido T. Intratumoral distribution of fluorine-18-fluorodeoxyglucose in vivo: high accumulation in macrophages and granulation tissues studied by microautoradiography. J Nucl Med 1992;33:1972–80.PubMed Kubota R, Yamada S, Kubota K, Ishiwata K, Tamahashi N, Ido T. Intratumoral distribution of fluorine-18-fluorodeoxyglucose in vivo: high accumulation in macrophages and granulation tissues studied by microautoradiography. J Nucl Med 1992;33:1972–80.PubMed
24.
Zurück zum Zitat Kubota R, Kubota K, Yamada S, Tada M, Ido T, Tamahashi N. Microautoradiographic study for the differentiation of intratumoral macrophages, granulation tissues and cancer cells by the dynamics of fluorine-18-fluorodeoxyglucose uptake. J Nucl Med 1994;35:104–12.PubMed Kubota R, Kubota K, Yamada S, Tada M, Ido T, Tamahashi N. Microautoradiographic study for the differentiation of intratumoral macrophages, granulation tissues and cancer cells by the dynamics of fluorine-18-fluorodeoxyglucose uptake. J Nucl Med 1994;35:104–12.PubMed
25.
Zurück zum Zitat Miller WT. Spectrum of pulmonary nontuberculous mycobacterial infection. Radiology 1994;191:343–50.PubMed Miller WT. Spectrum of pulmonary nontuberculous mycobacterial infection. Radiology 1994;191:343–50.PubMed
26.
Zurück zum Zitat Kuhlman JE, Deutsch JH, Fishman EK, Siegelman SS. CT features of thoracic mycobacterial disease. Radiographics 1990;10:413–31.PubMed Kuhlman JE, Deutsch JH, Fishman EK, Siegelman SS. CT features of thoracic mycobacterial disease. Radiographics 1990;10:413–31.PubMed
Metadaten
Titel
Usefulness of 18F-fluorodeoxyglucose positron emission tomography for diagnosing disease activity and monitoring therapeutic response in patients with pulmonary mycobacteriosis
verfasst von
Yoshiki Demura
Tatsuro Tsuchida
Daisuke Uesaka
Yukihiro Umeda
Miwa Morikawa
Shingo Ameshima
Takeshi Ishizaki
Yasuhisa Fujibayashi
Hidehiko Okazawa
Publikationsdatum
01.04.2009
Verlag
Springer-Verlag
Erschienen in
European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 4/2009
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-008-1009-5

Weitere Artikel der Ausgabe 4/2009

European Journal of Nuclear Medicine and Molecular Imaging 4/2009 Zur Ausgabe