Open AccessUpdates on 18F-FDG-PET/CT as a clinical tool for tuberculosis evaluation and therapeutic monitoring
Author(s) -
Yu Wang,
Pu-Xuan Lu,
Majid Assadi,
Xiuzhen Huang,
Aliaksandr Skrahin,
Alex Rosenthal,
Andrei Gabrielian,
Michael Tartakovsky,
Yì Xiáng J. Wáng
Publication year - 2019
Publication title -
quantitative imaging in medicine and surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.766
H-Index - 21
eISSN - 2223-4292
pISSN - 2223-4306
DOI - 10.21037/qims.2019.05.24
Subject(s) - medicine , tuberculosis , positron emission tomography , radiology , mycobacterium tuberculosis , pet ct , lymph node , lesion , biopsy , disease , pathology
Tuberculosis (TB) is currently the world's leading cause of infectious mortality. The complex immune response of the human body to Mycobacterium tuberculosis ( M.tb ) results in a wide array of clinical manifestations, thus the clinical and radiological diagnosis can be challenging. 18 F-fluorodeoxyglucose positron emission tomography ( 18 F-FDG-PET) scan with/without computed tomography (CT) component images the whole body and provides a metabolic map of the infection, enabling clinicians to assess the disease burden. 18 F-FDG-PET/CT scan is particularly useful in detecting the disease in previously unknown sites, and allows the most appropriate site of biopsy to be selected. 18 F-FDG-PET/CT is also very valuable in assessing early disease response to therapy, and plays an important role in cases where conventional microbiological methods are unavailable and for monitoring response to therapy in cases of multidrug-resistant TB or extrapulmonary TB. 18 F-FDG-PET/CT cannot reliably differentiate active TB lesion from malignant lesions and false positives can also be due to other infective or inflammatory conditions. 18 F-FDG PET is also unable to distinguish tuberculous lymphadenitis from metastatic lymph node involvement. The lack of specificity is a limitation for 18 F-FDG-PET/CT in TB management.