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Correlation Between CT Features of Active Tuberculosis and Residual Metabolic Activity on End-of-Treatment FDG PET/CT in Patients Treated for Pulmonary Tuberculosis

Patients who complete a standard course of anti-tuberculous treatment (ATT) for pulmonary tuberculosis and are declared cured according to the current standard of care commonly have residual metabolic activity (RMA) in their lungs on fluorine-18 fluorodeoxyglucose positron emission tomography/comput...

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Autores principales: Lawal, Ismaheel O., Mokoala, Kgomotso M. G., Mathebula, Matsontso, Moagi, Ingrid, Popoola, Gbenga O., Moeketsi, Nontando, Nchabeleng, Maphoshane, Hikuam, Chris, Ellner, Jerrold J., Hatherill, Mark, Fourie, Bernard P., Sathekge, Mike M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8920557/
https://www.ncbi.nlm.nih.gov/pubmed/35295606
http://dx.doi.org/10.3389/fmed.2022.791653
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author Lawal, Ismaheel O.
Mokoala, Kgomotso M. G.
Mathebula, Matsontso
Moagi, Ingrid
Popoola, Gbenga O.
Moeketsi, Nontando
Nchabeleng, Maphoshane
Hikuam, Chris
Ellner, Jerrold J.
Hatherill, Mark
Fourie, Bernard P.
Sathekge, Mike M.
author_facet Lawal, Ismaheel O.
Mokoala, Kgomotso M. G.
Mathebula, Matsontso
Moagi, Ingrid
Popoola, Gbenga O.
Moeketsi, Nontando
Nchabeleng, Maphoshane
Hikuam, Chris
Ellner, Jerrold J.
Hatherill, Mark
Fourie, Bernard P.
Sathekge, Mike M.
author_sort Lawal, Ismaheel O.
collection PubMed
description Patients who complete a standard course of anti-tuberculous treatment (ATT) for pulmonary tuberculosis and are declared cured according to the current standard of care commonly have residual metabolic activity (RMA) in their lungs on fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PER/CT) imaging. RMA seen in this setting has been shown to be associated with relapse of tuberculosis. The routine clinical use of FDG PET/CT imaging for treatment response assessment in tuberculosis is hindered by cost and availability. CT is a more readily available imaging modality. We sought to determine the association between CT features suggestive of active tuberculosis and RMA on FDG PET/CT obtained in patients who completed a standard course of ATT for pulmonary tuberculosis. We prospectively recruited patients who completed a standard course of ATT and declared cured based on negative sputum culture. All patients had FDG PET/CT within 2 weeks of completing ATT. We determined the presence of RMA on FDG PET images. Among the various lung changes seen on CT, we considered the presence of lung nodule, consolidation, micronodules in tree-in-bud pattern, FDG-avid chest nodes, and pleural effusion as suggestive of active tuberculosis. We determine the association between the presence of RMA on FDG PET and the CT features of active tuberculosis. We include 75 patients with a mean age of 36.09 ± 10.49 years. Forty-one patients (54.67%) had RMA on their FDG PET/CT while 34 patients (45.33%) achieved complete metabolic response to ATT. There was a significant association between four of the five CT features of active disease, p < 0.05 in all cases. Pleural effusion (seen in two patients) was the only CT feature of active disease without a significant association with the presence of RMA. This suggests that CT may be used in lieu of FDG PET/CT for treatment response assessment of pulmonary tuberculosis.
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spelling pubmed-89205572022-03-15 Correlation Between CT Features of Active Tuberculosis and Residual Metabolic Activity on End-of-Treatment FDG PET/CT in Patients Treated for Pulmonary Tuberculosis Lawal, Ismaheel O. Mokoala, Kgomotso M. G. Mathebula, Matsontso Moagi, Ingrid Popoola, Gbenga O. Moeketsi, Nontando Nchabeleng, Maphoshane Hikuam, Chris Ellner, Jerrold J. Hatherill, Mark Fourie, Bernard P. Sathekge, Mike M. Front Med (Lausanne) Medicine Patients who complete a standard course of anti-tuberculous treatment (ATT) for pulmonary tuberculosis and are declared cured according to the current standard of care commonly have residual metabolic activity (RMA) in their lungs on fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PER/CT) imaging. RMA seen in this setting has been shown to be associated with relapse of tuberculosis. The routine clinical use of FDG PET/CT imaging for treatment response assessment in tuberculosis is hindered by cost and availability. CT is a more readily available imaging modality. We sought to determine the association between CT features suggestive of active tuberculosis and RMA on FDG PET/CT obtained in patients who completed a standard course of ATT for pulmonary tuberculosis. We prospectively recruited patients who completed a standard course of ATT and declared cured based on negative sputum culture. All patients had FDG PET/CT within 2 weeks of completing ATT. We determined the presence of RMA on FDG PET images. Among the various lung changes seen on CT, we considered the presence of lung nodule, consolidation, micronodules in tree-in-bud pattern, FDG-avid chest nodes, and pleural effusion as suggestive of active tuberculosis. We determine the association between the presence of RMA on FDG PET and the CT features of active tuberculosis. We include 75 patients with a mean age of 36.09 ± 10.49 years. Forty-one patients (54.67%) had RMA on their FDG PET/CT while 34 patients (45.33%) achieved complete metabolic response to ATT. There was a significant association between four of the five CT features of active disease, p < 0.05 in all cases. Pleural effusion (seen in two patients) was the only CT feature of active disease without a significant association with the presence of RMA. This suggests that CT may be used in lieu of FDG PET/CT for treatment response assessment of pulmonary tuberculosis. Frontiers Media S.A. 2022-02-22 /pmc/articles/PMC8920557/ /pubmed/35295606 http://dx.doi.org/10.3389/fmed.2022.791653 Text en Copyright © 2022 Lawal, Mokoala, Mathebula, Moagi, Popoola, Moeketsi, Nchabeleng, Hikuam, Ellner, Hatherill, Fourie and Sathekge. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Lawal, Ismaheel O.
Mokoala, Kgomotso M. G.
Mathebula, Matsontso
Moagi, Ingrid
Popoola, Gbenga O.
Moeketsi, Nontando
Nchabeleng, Maphoshane
Hikuam, Chris
Ellner, Jerrold J.
Hatherill, Mark
Fourie, Bernard P.
Sathekge, Mike M.
Correlation Between CT Features of Active Tuberculosis and Residual Metabolic Activity on End-of-Treatment FDG PET/CT in Patients Treated for Pulmonary Tuberculosis
title Correlation Between CT Features of Active Tuberculosis and Residual Metabolic Activity on End-of-Treatment FDG PET/CT in Patients Treated for Pulmonary Tuberculosis
title_full Correlation Between CT Features of Active Tuberculosis and Residual Metabolic Activity on End-of-Treatment FDG PET/CT in Patients Treated for Pulmonary Tuberculosis
title_fullStr Correlation Between CT Features of Active Tuberculosis and Residual Metabolic Activity on End-of-Treatment FDG PET/CT in Patients Treated for Pulmonary Tuberculosis
title_full_unstemmed Correlation Between CT Features of Active Tuberculosis and Residual Metabolic Activity on End-of-Treatment FDG PET/CT in Patients Treated for Pulmonary Tuberculosis
title_short Correlation Between CT Features of Active Tuberculosis and Residual Metabolic Activity on End-of-Treatment FDG PET/CT in Patients Treated for Pulmonary Tuberculosis
title_sort correlation between ct features of active tuberculosis and residual metabolic activity on end-of-treatment fdg pet/ct in patients treated for pulmonary tuberculosis
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8920557/
https://www.ncbi.nlm.nih.gov/pubmed/35295606
http://dx.doi.org/10.3389/fmed.2022.791653
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