Molecular Imaging of Tuberculosis

Lawal, Ismaheel; Abubakar, Sofiullah; Ankrah, Alfred O.; Sathekge, Mike

doi:10.1053/j.semnuclmed.2022.07.001

Cited by 12 publications

(7 citation statements)

References 163 publications

(261 reference statements)

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“…Because FDG is significantly trapped by the activated inflammatory cells present in tuberculoma, avid FDG uptake is seen in tuberculous lesions, which increases the yield of FDG PET in the patient's diagnostic workup. 7 In the present case, FDG uptake was increased in the peripheral contrast-enhancing lesions, where inflammatory cells are abundant, and decreased in the abscess cavity, resulting in a ring-shaped uptake observed on FDG PET/MR. 18 F-FMISO is a well-known hypoxic PET tracer to visualize severe hypoxia in vivo, which has mainly been used to study tumor biology.…”

Section: Figurementioning

confidence: 44%

“…Recently, Peer et al 6 demonstrated that submarginal T2 hyperintense rim, possibly reflecting exudative fluid or inflammatory cells, may be another characteristic finding of tuberculoma. Because FDG is significantly trapped by the activated inflammatory cells present in tuberculoma, avid FDG uptake is seen in tuberculous lesions, which increases the yield of FDG PET in the patient’s diagnostic workup 7 . In the present case, FDG uptake was increased in the peripheral contrast-enhancing lesions, where inflammatory cells are abundant, and decreased in the abscess cavity, resulting in a ring-shaped uptake observed on FDG PET/MR.…”

mentioning

confidence: 99%

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18F-FMISO PET of an Intracranial Tuberculoma

et al. 2022

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Solitary intracranial tuberculomas are rare and frequently misdiagnosed as brain tumors. We report a case of intracranial tuberculous granuloma mimicking a high-grade glioma with avid uptake on 18 F-fluoromisonidazole PET/ CT. It has been believed that hypoxia exists within the tuberculosis granuloma, and that this hypoxic environment causes Mycobacterium tuberculosis to lie dormant and asymptomatic infection to occur. This hypoxic and necrotic condition inside tuberculous granuloma may lead to high accumulation of 18 F-fluoromisonidazole in this case.

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Section: Figurementioning

confidence: 44%

mentioning

confidence: 99%

18F-FMISO PET of an Intracranial Tuberculoma

et al. 2022

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“…It can be easily mistaken for malignancy in this condition. As with CT and MRI, ring-shaped uptake can also be observed on 18F-FDG PET/CT 14 …”

Section: Discussionmentioning

confidence: 78%

“…As with CT and MRI, ring-shaped uptake can also be observed on 18F-FDG PET/CT. 14 Lymphoma is the most important differential diagnosis for TL. Both TL and lymphoma have the same constitutional symptoms, such as malaise, low-grade fever and weight loss.…”

Section: Discussionmentioning

confidence: 99%

Porta Hepatis Tuberculous Lymphadenopathy: Clinical and Imaging Features of 10 Cases

Hu,

Xia

et al. 2023

Infect Microb Dis

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Porta hepatis tuberculous lymphadenopathy (TL) is rare, and the clinical and imaging manifestations often mimic tumors. To offer a better understanding of porta hepatis TL and thus improve its diagnosis and treatment, here, we retrospectively reviewed and analyzed 10 porta hepatis TL cases between May 2017 and November 2022. In this study, porta hepatis TL occurred predominantly in women (70%), with a mean age of 43.1 years (range: 16–70 years). Among the patients, 60% were initially suspected of malignancy (metastatic lymphadenopathy and lymphoma). The clinical manifestations were non-specific, such as fever and weight loss, without overt abdominal malaise. Many patients showed high concentrations of serum C-reactive protein, erythrocyte sedimentation rate, alkaline phosphatase, γ-glutamyl transpeptidase, and carbohydrate antigen 125. Peripheral rim-like enhancement was a characteristic finding on contrast-enhanced CT for all the patients. Pathological examination confirmed the diagnosis in 90% of patients with caseous granulomatous inflammation and positive results of Xpert MTB/RIF, quantitative real-time PCR and/or metagenomic next-generation sequencing assays. All patients underwent anti-tuberculosis therapy with a median treatment duration of 13.5 months (range, 1–43 months). They all showed satisfactory therapeutic responses with improved symptoms and resolution on imaging after treatment. Pathological examination by biopsy remains the primary diagnostic method. A combination of the characteristic epidemiologic, clinical, imaging features and lesion biopsy for histopathology are essential for the diagnosis and treatment of TL.

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“…The granuloma microenvironment, which includes necrosis, fibrosis, hypoxia, and pathological angiogenesis, is formed by the mutual shaping of the pathogen and the host. 6 …”

Section: Introductionmentioning

confidence: 99%

An Oxygen Supply Strategy for Sonodynamic Therapy in Tuberculous Granuloma Lesions Using a Catalase-Loaded Nanoplatform

Hu,

Qiu,

Guo

et al. 2023

IJN

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Purpose Tuberculosis (TB) is a chronic disease caused by Mycobacterium tuberculosis ( MTB ) that remains a major global health challenge. One of the main obstacles to effective treatment is the heterogeneous microenvironment of TB granulomas. This study aimed to investigate the potential of a hypoxic remission-based strategy to enhance the outcome of tuberculosis treatment when implemented in combination with ultrasound. Methods A PLGA nanoparticle (LEV@CAT-NPs) loaded with levofloxacin (LEV) and catalase (CAT) was fabricated by a double emulsification method, and its physical characteristics, oxygen production capacity, drug release capacity, and biosafety were thoroughly investigated. The synergistic therapeutic effects of ultrasound (US)-mediated LEV@CAT-NPs were evaluated using an experimental mouse model of subcutaneous tuberculosis granuloma induced by Bacille Calmette-Guérin ( BCG ) as a substitute for MTB . Results LEV@CAT-NPs exhibited excellent oxygen production capacity, biosafety, and biocompatibility. Histological analysis revealed that ultrasound-mediated LEV@CAT-NPs could effectively remove bacteria from tuberculous granulomas, significantly alleviate the hypoxia state, reduce the necrotic area and inflammatory cells within the granuloma, and increase the penetration of dyes in granuloma tissues. The combined treatment also reduced the serum levels of inflammatory cytokines (eg, TNF-α, IL-6, and IL-8), and significantly downregulated the expression of hypoxia-inducible factor 1α (HIF-1α) and vascular endothelial growth factor (VEGF). These results suggested that the synergistic treatment of ultrasound-mediated LEV@CAT-NPs effectively eradicated the bacterial infection and reversed the hypoxic microenvironment of tuberculous granulomas, further promoting tissue repair. Conclusion This study provides a non-invasive and new avenue for treating refractory tuberculosis infections. The potential role of regulating hypoxia within infected lesions as a therapeutic target for infection deserves further exploration in future studies.

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Molecular Imaging of Tuberculosis

Cited by 12 publications

References 163 publications

18F-FMISO PET of an Intracranial Tuberculoma

18F-FMISO PET of an Intracranial Tuberculoma

Porta Hepatis Tuberculous Lymphadenopathy: Clinical and Imaging Features of 10 Cases

An Oxygen Supply Strategy for Sonodynamic Therapy in Tuberculous Granuloma Lesions Using a Catalase-Loaded Nanoplatform

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