Estudo do metabolismo da glicose na tuberculose pulmonar ativa utilizando a tomografia por emissão de pósitrons (18F-FDG PET)

Bombarda, Sidney; Júnior, José Soares; Filho, Mário Terra

doi:10.1590/s0102-35862002000500005

Cited by 2 publications

(2 citation statements)

References 16 publications

(15 reference statements)

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“…Positron emission tomography, with or without CT, studies tissue metabolism, based on fluorine-18-deoxyglucose uptake, and is known to identify malignant neoplasms and some benign lesions, such as those secondary to tuberculosis. (30) However, pulmonary lesions and lymphadenomegaly resulting from silicosis also show accelerated metabolism on positron emission tomography scans (particularly in the form of massive fibrosis). (31,32) In addition, both diseases are accompanied by intense radiotracer uptake, which limits the correct differentiation of the lesions in terms of etiology.…”

Section: Chemoprophylaxis: Efficacy and Safetymentioning

confidence: 99%

Tuberculose e silicose: epidemiologia, diagnóstico e quimioprofilaxia

et al. 2008

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Silicosis, the most prevalent of the pneumoconioses, is caused by inhalation of crystalline silica particles. Silica-exposed workers, with or without silicosis, are at increased risk for tuberculosis and nontuberculous mycobacteria-related diseases. The risk of a patient with silicosis developing tuberculosis is higher (2.8 to 39 times higher, depending on the severity of the silicosis) than that found for healthy controls. Various regimens for tuberculosis chemoprophylaxis in patients with silicosis have been studied, all of which present similar efficacy and overall risk reduction to about one half of that obtained with placebo. Long-term regimens have potential side effects (particularly hepatotoxicity). In addition, the use of such regimens can jeopardize adherence to treatment. The current guidelines recommend that tuberculin skin tests be performed, and, if positive, that chemoprophylaxis be instituted. There are several possible regimens, varying in terms of the drugs prescribed, as well as in terms of treatment duration. We recommend the use of isoniazid at 300 mg/day (or 10 mg/kg/day) for six months for patients with silicosis, as well as for healthy patients with periods of exposure to silica longer than 10 years and strongly positive tuberculin skin test results (induration> or = 10 mm). Nevertheless, further studies are necessary so that indications, drugs, doses and duration of chemoprophylaxis regimens can be more properly defined.

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Section: Chemoprophylaxis: Efficacy and Safetymentioning

confidence: 99%

Tuberculose e silicose: epidemiologia, diagnóstico e quimioprofilaxia

et al. 2008

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“…It is known that the glycolytic metabolism and, consequently, uptake of the [18F]-FDG are increased in inflammatory and granulomatous lesions, (7)(8)(9)(10) especially in individuals with pulmonary tuberculosis, histoplasmosis or sarcoidosis.…”

Section: Introductionmentioning

confidence: 99%

Valor do FDG[18F]-PET/TC como preditor de câncer em nódulo pulmonar solitário

et al. 2008

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Objective: To determine the diagnostic accuracy of positron emission tomography/computed tomography (PET/CT) using fluorine-18-deoxyglucose ([18F]-FDG) for the evaluation of a solitary pulmonary nodule (SPN). Methods: Prospective analysis of 53 consecutive patients submitted to PET/CT between March 2005 and May 2007 for the evaluation of an SPN. Of those, 32 met the criteria for inclusion in the present study. The lesions were evaluated for location, size, radiotracer uptake and maximum standardized uptake value (SUV). The FDG-PET/CT results were correlated with other predictors of malignancy (age, gender, smoking status, nodule size and nodule location). The definitive diagnosis was established through histopathology or through clinical/radiological follow-up for at least one year. Results: Fourteen malignant SPNs were found. Through analysis of the receiver operating characteristic curve, we established an SUV of 2.5 as the most appropriate cut-off point, since it correctly identified 13 of the 14 malignant SPNs. The results below that point revealed one false positive for neoplasia out of a total of 14. The semiquantitative method presented a sensitivity of 92.9%, specificity of 72.2%, positive predictive value of 72.2%, negative predictive value of 92.9% and accuracy of 81.2%. The multivariate analysis showed a statistically significant association with SPN malignancy only for nodule location in the upper lobes (p = 0.048) and SUV (p = 0.007). Conclusions: The results obtained suggest that the SUV of [18F]-FDG is a useful predictor of neoplasia in SPN, with a high negative predictive value, which allows malignancy to be safely ruled out, showing its relevance in the diagnostic approach to pulmonary nodules.Keywords: Positron-emission tomography; Coin lesion, pulmonary; Lung neoplasms. ResumoObjetivo: Determinar a acurácia diagnóstica da positron emission tomography (tomografia por emissão de pósitrons)/tomografia computadorizada (PET/TC) com deoxiglicose marcada com flúor-18, conhecida como fluorodeoxiglicose (FDG[18F]), na avaliação de nódulo pulmonar solitário (NPS). Métodos: Análise prospectiva de 53 pacientes consecutivos que realizaram PET/TC para avaliação de NPS, entre março de 2005 e maio de 2007. Destes 32 preencheram os critérios de inclusão. As lesões foram avaliadas quanto a sua localização e tamanho, grau de captação do radiofármaco e o standardized uptake value (SUV, valor padronizado de captação) máximo das lesões. Os achados dos estudos de FDG-PET/TC foram correlacionados com outros preditores de malignidade (idade, sexo, tabagismo, tamanho e localização do nódulo). O diagnóstico definitivo foi estabelecido por confirmação histopatológica ou acompanhamento clínico-radiológico por um período mínimo de um ano. Resultados: Encontrados 14 NPS malignos. Após análise da curva ROC, o SUV de 2,5 foi considerado o melhor ponto de corte que identificou corretamente 13 dos 14 NPS malignos. Os resultados abaixo deste ponto de corte mostraram um exame falso positivo para neoplasia num total de 14....

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Estudo do metabolismo da glicose na tuberculose pulmonar ativa utilizando a tomografia por emissão de pósitrons (18F-FDG PET)

Cited by 2 publications

References 16 publications

Tuberculose e silicose: epidemiologia, diagnóstico e quimioprofilaxia

Tuberculose e silicose: epidemiologia, diagnóstico e quimioprofilaxia

Valor do FDG[18F]-PET/TC como preditor de câncer em nódulo pulmonar solitário

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