Sathekge M., Maes A., Kgomo M., Stoltz A., Pottel H., Van De Wiele C.
Department of Nuclear Medicine, University of Pretoria, South Africa; Department of Nuclear Medicine, AZ Groeninge, Kortrijk, Belgium; Department of Morphology and Medical Imaging, University Hospital Leuven, Belgium; Department of Internal Medicine, Louis Pasture Hospital, Pretoria, South Africa; Department of Infectious Diseases, University of Pretoria, South Africa; Subfaculty of Medicine, Catholic University Leuven, Campus Kortrijk, Belgium; Department of Nuclear Medicine, University Hospital Ghent, Belgium
Sathekge, M., Department of Nuclear Medicine, University of Pretoria, South Africa; Maes, A., Department of Nuclear Medicine, AZ Groeninge, Kortrijk, Belgium, Department of Morphology and Medical Imaging, University Hospital Leuven, Belgium; Kgomo, M., Department of Internal Medicine, Louis Pasture Hospital, Pretoria, South Africa; Stoltz, A., Department of Infectious Diseases, University of Pretoria, South Africa; Pottel, H., Subfaculty of Medicine, Catholic University Leuven, Campus Kortrijk, Belgium; Van De Wiele, C., Department of Nuclear Medicine, University Hospital Ghent, Belgium
The aim of this study is to assess the potential impact of double-phase FDG PET versus routine staging in HIV-negative patients suffering from tuberculosis. Patients, methods: 16 consecutive patients suffering from tuberculosis underwent contrast-enhanced CT and double-phase FDG PET imaging (45 min, 120 min). Early (E) and delayed (D) SUVmax values were determined for all identified lesions and % change in SUV calculated (ΔSUV). Results: Seven patients presented with lung lesions on PET as well as CT (mean SUVmaxE 8.2, mean SUVmaxD 11.1, (p = 0.002), ΔSUV 35%. In two patients, lesions were judged as non-active on CT. In nine patients, 18 sites of LN involvement were identified on both early and delayed FDG PET images (mean SUVmaxE 6.3, mean SUVmaxD 7.9, (p = 0.0001), ΔSUV: 25%). 9 out of 18 sites of LN involvement, occurring in five patients, were missed on CT. In four of these five patients, sites of LN involvement were the only sites of extra-pulmonary involvement identified. In 6 out of 16 patients, pleural involvement was identified, respectively in 5 on FDG PET and in 6 on CT imaging (mean SUVmaxE 1.3, mean SUVmaxD 1.7, (p = 0.06), ΔSUV 21%). In 4 patients, osseous involvement was identified by both FDG PET and CT (mean SUVmaxE 7.2, mean SUVmaxD 10.7, (p = 0,06), ΔSUV 45%). Finally, in 3 patients, joint involvement was identified on both FDG PET as well as on CT imaging (mean SUVmaxE 4.7, mean SUVmaxD 5.2, ΔSUV 23%). FDG PET did not identify CTadditional sites of involvement that would have resulted in a prolonged treatment. Conclusion: In HIV-negative patients suffering from tuberculosis, FDG PET images suggested a more extensive involvement by Mycobacterium tuberculosis when compared to contrast enhanced CT. © Schattauer 2010.
corticosteroid; fluorodeoxyglucose f 18; adolescent; adult; aged; article; child; clinical article; computer assisted tomography; controlled study; extrapulmonary tuberculosis; female; gold standard; histology; human; Human immunodeficiency virus infection; male; miliary tuberculosis; positron emission tomography; preschool child; sputum cytodiagnosis; treatment planning; tuberculous meningitis; tuberculous pericarditis; Adolescent; Adult; Aged; Aged, 80 and over; Bone Diseases; Female; Fluorodeoxyglucose F18; Humans; Infant; Joint Diseases; Lung; Lymph Nodes; Male; Middle Aged; Pilot Projects; Pleural Effusion; Positron-Emission Tomography; Prospective Studies; Radiopharmaceuticals; Tomography, X-Ray Computed; Tuberculosis