Imaging characteristics of extrapulmonary tuberculosis lesions on dual time point imaging (DTPI) of FDG PET/CT

Razak, Hairil Rashmizal Abdul; Geso, Moshi; Rahim, Normaliza Abd; Nordin, Abdul Jalil

doi:10.1111/j.1754-9485.2011.02309.x

Cited by 17 publications

(6 citation statements)

References 22 publications

(64 reference statements)

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“…In summary, we have provided evidence that the spectrum of clinically defined LTBI, specifically that associated with inflammation detected by PET CT and the presence of extrapulmonary disease, is associated with reactivation risk. It is likely that this occurs in humans with LTBI and similar lung lesions have been described in LTBI humans by PET CT [ 16 , 23 – 25 ]. Importantly, this is the first assay that can functionally distinguish those at high and low risk for reactivation induced by TNF neutralization.…”

Section: Discussionmentioning

confidence: 76%

PET CT Identifies Reactivation Risk in Cynomolgus Macaques with Latent M. tuberculosis

et al. 2016

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Mycobacterium tuberculosis infection presents across a spectrum in humans, from latent infection to active tuberculosis. Among those with latent tuberculosis, it is now recognized that there is also a spectrum of infection and this likely contributes to the variable risk of reactivation tuberculosis. Here, functional imaging with 18F-fluorodeoxygluose positron emission tomography and computed tomography (PET CT) of cynomolgus macaques with latent M. tuberculosis infection was used to characterize the features of reactivation after tumor necrosis factor (TNF) neutralization and determine which imaging characteristics before TNF neutralization distinguish reactivation risk. PET CT was performed on latently infected macaques (n = 26) before and during the course of TNF neutralization and a separate set of latently infected controls (n = 25). Reactivation occurred in 50% of the latently infected animals receiving TNF neutralizing antibody defined as development of at least one new granuloma in adjacent or distant locations including extrapulmonary sites. Increased lung inflammation measured by PET and the presence of extrapulmonary involvement before TNF neutralization predicted reactivation with 92% sensitivity and specificity. To define the biologic features associated with risk of reactivation, we used these PET CT parameters to identify latently infected animals at high risk for reactivation. High risk animals had higher cumulative lung bacterial burden and higher maximum lesional bacterial burdens, and more T cells producing IL-2, IL-10 and IL-17 in lung granulomas as compared to low risk macaques. In total, these data support that risk of reactivation is associated with lung inflammation and higher bacterial burden in macaques with latent Mtb infection.

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Section: Discussionmentioning

confidence: 76%

PET CT Identifies Reactivation Risk in Cynomolgus Macaques with Latent M. tuberculosis

et al. 2016

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“…FDG uptake in inflammatory/infectious tissues was reported to reach its peak in about 60 min after the time of injection, but then it gradually decreased with time. Conversely, malignant lesions have been shown to keep increasing the FDG uptake up to several hours (34,35). However, Razak et al (35) suggested in their study that DTPI of PET/CT may not be a useful technique in differentiating between EPTB and non-EPTB lesions, so the value of DTP FDG PET/CT imaging remains controversial.…”

Section: Discussionmentioning

confidence: 99%

Lymph node tuberculosis mimicking malignancy on 18F-FDG PET/CT in two patients: A case report

Ding

Cao

et al. 2017

Experimental and Therapeutic Medicine

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18F-fluorodeoxyglucose positron emission/computed tomography (18F-FDG PET/CT) imaging, an established procedure for evaluation of malignancy, reports an increased 18F-FDG uptake in acute or chronic inflammatory condition. Lymph node tuberculosis (LNTB) is the most common form of extrapulmonary tuberculosis. However, the absence of clinical symptoms and bacteriological basis makes it difficult to diagnose. In the current case report, two patients with LNTB mimicking malignant lymphoma are presented by 18F-FDG PET/CT. The objective of the present report is to emphasize that LNTB should be considered as a noteworthy differential diagnosis in patients with enlarged lymph nodes, particularly in tuberculosis-endemic countries, and that lymph node biopsy serves a vital role in diagnosing LNTB.

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“…[14] A study undertaken to evaluate the diagnostic value of dual time point imaging (DTPI) of 18F-FDG PET/CT for detecting the infective lesions in patients with extrapulmonary TB revealed that early whole body PET/CT imaging may be sufficient for the detection of the EPTB lesions and DTPI of PET/CT may also not be a useful technique in differentiating between EPTB and non-EPTB lesions. [15]…”

Section: Discussionmentioning

confidence: 99%

Tuberculosis the great mimicker: 18F-fludeoxyglucose positron emission tomography/computed tomography in a case of atypical spinal tuberculosis

et al. 2014

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Tuberculosis (TB) has aptly been called the great mimicker. A 14-year-old boy, who had been treated for Hodgkin's Lymphoma 2 years back and had been in remission, underwent a whole body 18F-fludeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) scan, owing to a recent onset of backache and difficulty in walking. The study showed an FDG avid destructive lesion of the posterior elements of the sixth, seventh and eighth dorsal vertebrae along with a hypermetabolic collection in the adjacent paraspinal muscles with extension into the spinal canal, causing encasement of the thecal sac as well. Based on this constellation of findings, a diagnosis of atypical spinal TB was made, which was subsequently proven on histopathology. The present case illustrates that spinal TB, including the atypical form can be diagnosed on PET/CT even in clinically unsuspected cases.

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Imaging characteristics of extrapulmonary tuberculosis lesions on dual time point imaging (DTPI) of FDG PET/CT

Cited by 17 publications

References 22 publications

PET CT Identifies Reactivation Risk in Cynomolgus Macaques with Latent M. tuberculosis

PET CT Identifies Reactivation Risk in Cynomolgus Macaques with Latent M. tuberculosis

Lymph node tuberculosis mimicking malignancy on 18F-FDG PET/CT in two patients: A case report

Tuberculosis the great mimicker: 18F-fludeoxyglucose positron emission tomography/computed tomography in a case of atypical spinal tuberculosis

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