Skip to main content
Top
Published in: BMC Pulmonary Medicine 1/2013

Open Access 01-12-2013 | Case report

18-fluorodeoxyglucose positron emission tomography for tuberculosis diagnosis and management: a case series

Authors: Scott K Heysell, Tania A Thomas, Costi D Sifri, Patrice K Rehm, Eric R Houpt

Published in: BMC Pulmonary Medicine | Issue 1/2013

Login to get access

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.
Appendix
Available only for authorised users
Literature
1.
go back to reference Lillington GA, Caskey CI: Evaluation and management of solitary and multiple pulmonary nodules. Clin Chest Med. 1993, 14: 111-119.PubMed Lillington GA, Caskey CI: Evaluation and management of solitary and multiple pulmonary nodules. Clin Chest Med. 1993, 14: 111-119.PubMed
2.
go back to reference 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): 313-329. 10.1053/j.semnuclmed.2004.06.006.CrossRefPubMed 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): 313-329. 10.1053/j.semnuclmed.2004.06.006.CrossRefPubMed
3.
go back to reference Sathekge MM, 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: 598-601.CrossRefPubMed Sathekge MM, 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: 598-601.CrossRefPubMed
4.
go back to reference Malik K, Dedhia HV, Bishop H: Clinical utility of PET-FDG imaging in detecting malignancy in pulmonary lesions. Chest. 1996, 110 (suppl): 95S- Malik K, Dedhia HV, Bishop H: Clinical utility of PET-FDG imaging in detecting malignancy in pulmonary lesions. Chest. 1996, 110 (suppl): 95S-
5.
go back to reference Hara T, Kosaka N, Suzuki T, Kudo K, Niino H: Uptake rates of 18-Fluorodeoxyglucose and 11C-choline in lung cancer and pulmonary tuberculosis: a positron emission tomography study. Chest. 2003, 124: 893-901. 10.1378/chest.124.3.893.CrossRefPubMed Hara T, Kosaka N, Suzuki T, Kudo K, Niino H: Uptake rates of 18-Fluorodeoxyglucose and 11C-choline in lung cancer and pulmonary tuberculosis: a positron emission tomography study. Chest. 2003, 124: 893-901. 10.1378/chest.124.3.893.CrossRefPubMed
6.
go back to reference Goo JM, Im JG, Do KH, Yeo JS, Seo JB, Kim HY, Chung JK: Pulmonary tuberculoma evaluated by means of FDG PET: findings in 10 cases. Radiology. 2000, 216: 117-121.CrossRefPubMed Goo JM, Im JG, Do KH, Yeo JS, Seo JB, Kim HY, Chung JK: Pulmonary tuberculoma evaluated by means of FDG PET: findings in 10 cases. Radiology. 2000, 216: 117-121.CrossRefPubMed
7.
go back to reference Demura Y, Tsuchida T, Uesaka D, Umeda Y, Morikawa M, Ameshima S, Ishizaki T, Fujibayashi Y, Okazawa H: Usefulness of 18 F-fluorodeoxyglucose positron emission tomography for diagnosing disease activity and monitoring therapeutic response in patients with pulmonary mycobacteriosis. Eur J Nucl Med Mol Imaging. 2009, 36: 632-639. 10.1007/s00259-008-1009-5.CrossRefPubMed Demura Y, Tsuchida T, Uesaka D, Umeda Y, Morikawa M, Ameshima S, Ishizaki T, Fujibayashi Y, Okazawa H: Usefulness of 18 F-fluorodeoxyglucose positron emission tomography for diagnosing disease activity and monitoring therapeutic response in patients with pulmonary mycobacteriosis. Eur J Nucl Med Mol Imaging. 2009, 36: 632-639. 10.1007/s00259-008-1009-5.CrossRefPubMed
8.
go back to reference Martinez V, Castilla-Lievre MA, Guillet-Caruba C, Grenier G, Fior R, Desarnaud S, Doucet-Populaire F, Boué F: (18)F-FDG PET/CT in tuberculosis: an early non-invasive marker of therapeutic response. Int J Tuberc Lung Dis. 2012, 16 (9): 1180-1185. 10.5588/ijtld.12.0010.CrossRefPubMed Martinez V, Castilla-Lievre MA, Guillet-Caruba C, Grenier G, Fior R, Desarnaud S, Doucet-Populaire F, Boué F: (18)F-FDG PET/CT in tuberculosis: an early non-invasive marker of therapeutic response. Int J Tuberc Lung Dis. 2012, 16 (9): 1180-1185. 10.5588/ijtld.12.0010.CrossRefPubMed
9.
go back to reference Soussan M, Brillet PY, Mekinian A, Khafagy A, Nicolas P, Vessieres A, Brauner M: Patterns of pulmonary tuberculosis on FDG-PET/CT. Eur J Radiol. 2012, 81 (10): 2872-2876. 10.1016/j.ejrad.2011.09.002.CrossRefPubMed Soussan M, Brillet PY, Mekinian A, Khafagy A, Nicolas P, Vessieres A, Brauner M: Patterns of pulmonary tuberculosis on FDG-PET/CT. Eur J Radiol. 2012, 81 (10): 2872-2876. 10.1016/j.ejrad.2011.09.002.CrossRefPubMed
10.
go back to reference Treglia G, MD , Taralli S, Calcagni ML, Maggi F, Giordan 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: 387-393. 10.1097/RCT.0b013e318219f810.CrossRefPubMed Treglia G, MD , Taralli S, Calcagni ML, Maggi F, Giordan 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: 387-393. 10.1097/RCT.0b013e318219f810.CrossRefPubMed
11.
go back to reference Kim IJ, Lee JS, Kim SJ, Kim YK, Jeong YJ, Jun S, Nam HY, Kim JS: Double phase 18 F-FDG PET-CT for determination of pulmonary tuberculoma activity. Eur J Nucl Med Mol Imaging. 2008, 35: 808-814. 10.1007/s00259-007-0585-0.CrossRefPubMed Kim IJ, Lee JS, Kim SJ, Kim YK, Jeong YJ, Jun S, Nam HY, Kim JS: Double phase 18 F-FDG PET-CT for determination of pulmonary tuberculoma activity. Eur J Nucl Med Mol Imaging. 2008, 35: 808-814. 10.1007/s00259-007-0585-0.CrossRefPubMed
12.
go back to reference Barry CE, Boshoff HI, Dartois V, Dick T, Ehrt S, Flynn J, Schnappinger D, Wilkinson RJ, Young D: The spectrum of latent tuberculosis: rethinking the biology and intervention strategies. Nature Reviews. 2009, 7: 845-855.PubMedPubMedCentral Barry CE, Boshoff HI, Dartois V, Dick T, Ehrt S, Flynn J, Schnappinger D, Wilkinson RJ, Young D: The spectrum of latent tuberculosis: rethinking the biology and intervention strategies. Nature Reviews. 2009, 7: 845-855.PubMedPubMedCentral
14.
go back to reference Via LE, Schimel D, Weiner DM: Infection dynamics and response to chemotherapy in a rabbit model of tuberculosis using [18 F]2-Fluoro-Deoxy-D-Glucose Positron Emission Tomography and Computed Tomography. Antimicrob Agents Chemother. 2012, 56 (8): 4391-10.1128/AAC.00531-12.CrossRefPubMedPubMedCentral Via LE, Schimel D, Weiner DM: Infection dynamics and response to chemotherapy in a rabbit model of tuberculosis using [18 F]2-Fluoro-Deoxy-D-Glucose Positron Emission Tomography and Computed Tomography. Antimicrob Agents Chemother. 2012, 56 (8): 4391-10.1128/AAC.00531-12.CrossRefPubMedPubMedCentral
15.
go back to reference Gandhi NR, Nunn P, Dheda K, Schaaf HS, Zignol M, van Soolingen D, Jensen P, Bayona J: Multidrug-resistant and extensively drug-resistant tuberculosis: a threat to global control of tuberculosis. Lancet. 2010, 375: 1830-1843. 10.1016/S0140-6736(10)60410-2.CrossRefPubMed Gandhi NR, Nunn P, Dheda K, Schaaf HS, Zignol M, van Soolingen D, Jensen P, Bayona J: Multidrug-resistant and extensively drug-resistant tuberculosis: a threat to global control of tuberculosis. Lancet. 2010, 375: 1830-1843. 10.1016/S0140-6736(10)60410-2.CrossRefPubMed
16.
go back to reference 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 Radiologica. 2010, 9: 1002-1006.CrossRef 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 Radiologica. 2010, 9: 1002-1006.CrossRef
17.
go back to reference Kim SJ, Kim IJ, Suh KT, Kim YK, Lee JS: Prediction of residual disease of spine infection using F-18 FDG PET/CT. Spine. 2009, 34: 2424-2430. 10.1097/BRS.0b013e3181b1fd33.CrossRefPubMed Kim SJ, Kim IJ, Suh KT, Kim YK, Lee JS: Prediction of residual disease of spine infection using F-18 FDG PET/CT. Spine. 2009, 34: 2424-2430. 10.1097/BRS.0b013e3181b1fd33.CrossRefPubMed
18.
go back to reference Sathekge M, Maes A, Kgomo M, Stoltz A, Van de Wiele C: Use of 18 F-FDG PET to predict response to first-line tuberculostatics in HIV-associated tuberculosis. J Nucl Med. 2011, 52: 880-885. 10.2967/jnumed.110.083709.CrossRefPubMed Sathekge M, Maes A, Kgomo M, Stoltz A, Van de Wiele C: Use of 18 F-FDG PET to predict response to first-line tuberculostatics in HIV-associated tuberculosis. J Nucl Med. 2011, 52: 880-885. 10.2967/jnumed.110.083709.CrossRefPubMed
19.
go back to reference Davis SL, Nuermberger EL, Um PK, Vidal C, Jedynak B, Pomper MG, Bishai WR, Jain SK: Noninvasive pulmonary [18 F]-2-fluoro-deoxy-D-glucose positron emission tomography correlates with bactericidal activity of tuberculosis drug treatment. Antimicrob Agents Chemother. 2009, 53: 4879-4884. 10.1128/AAC.00789-09.CrossRefPubMedPubMedCentral Davis SL, Nuermberger EL, Um PK, Vidal C, Jedynak B, Pomper MG, Bishai WR, Jain SK: Noninvasive pulmonary [18 F]-2-fluoro-deoxy-D-glucose positron emission tomography correlates with bactericidal activity of tuberculosis drug treatment. Antimicrob Agents Chemother. 2009, 53: 4879-4884. 10.1128/AAC.00789-09.CrossRefPubMedPubMedCentral
Metadata
Title
18-fluorodeoxyglucose positron emission tomography for tuberculosis diagnosis and management: a case series
Authors
Scott K Heysell
Tania A Thomas
Costi D Sifri
Patrice K Rehm
Eric R Houpt
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Pulmonary Medicine / Issue 1/2013
Electronic ISSN: 1471-2466
DOI
https://doi.org/10.1186/1471-2466-13-14

Other articles of this Issue 1/2013

BMC Pulmonary Medicine 1/2013 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.