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Home / The International Journal of Tuberculosis and Lung Disease, Volume 16, Number 9

18F-FDG PET/CT in tuberculosis: an early non-invasive marker of therapeutic response

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OBJECTIVE: To evaluate the potential of 18F-fluoro-deoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for early therapeutic intervention in patients with probable or confirmed tuberculosis (TB).

METHODS: Twenty-one consecutive human immunodeficiency virus negative patients were prospectively included. All patients underwent 18F-FDG PET/CT before and after 1 month of anti-tuberculosis treatment. The maximum standardised uptake value (SUVmax) of the most 18F-FDG avid lesions was recorded.

RESULTS: The median age of patients was 36 years (range 18–84); 33.3% were male, 80.9% were born in endemic countries, and 23.8% had a past history of TB. TB was confirmed on culture in 8, on histology in 9 and on the basis of clinical symptoms in 4 patients. 18F-FDG PET/CT detected active pulmonary TB (n = 1), extra-pulmonary (n = 10) or both (n = 10). The second 18F-FDG PET/CT showed reduced radiotracer uptake intensity in 19 of 21 patients, with a median percentage decrease of SUVmax of 31% (range 2–84). Two patients showed no improvement. TB was ruled out in one patient during follow-up; the final diagnosis was a non-Hodgkin's lymphoma. The other patient was smear-positive for 3 months.

CONCLUSION: 18F-FDG PET/CT allows an easy evaluation of early therapeutic response in patients with TB, particularly extra-pulmonary TB.

Keywords: 18F-FDG PET/CT; SUVmax; extra-pulmonary; therapy; tuberculosis

Document Type: Research Article

Affiliations: 1: Service de Médecine Interne et Immunologie Clinique, Unité Mixte de Recherche en Santé 996, Institut National de la Santé et de la Recherche Médicale, Paris, France 2: Service de Médecine Nucléaire, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Sud, Hôpital Antoine Béclère, Clamart, France 3: Service de Bactériologie-Hygiène, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Sud, Hôpital Antoine Béclère, Clamart, France 4: Service de Médecine Nucléaire, Centre Hospitalier Frédéric Jolliot, Commissariat à l'Energie Atomique et aux Energies Alternatives Orsay, Orsay, France

Publication date: 01 September 2012

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  • The International Journal of Tuberculosis and Lung Disease (IJTLD) is for clinical research and epidemiological studies on lung health, including articles on TB, TB-HIV and respiratory diseases such as COVID-19, asthma, COPD, child lung health and the hazards of tobacco and air pollution. Individuals and institutes can subscribe to the IJTLD online or in print – simply email us at [email protected] for details.

    The IJTLD is dedicated to understanding lung disease and to the dissemination of knowledge leading to better lung health. To allow us to share scientific research as rapidly as possible, the IJTLD is fast-tracking the publication of certain articles as preprints prior to their publication. Read fast-track articles.

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