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68Ga-citrate PET/CT in tuberculosis: a pilot study.

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The Quarterly Journal of Nuclear Medicine and Molecular Imaging : Official Publication of the Italian Association of Nuclear Medicine (AIMN) [And] the International Association of Radiopharmacology (IAR), [And] Section of the Society Of
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Positron emission tomography/computed tomography (PET/CT) with 68Ga-citrate shows promise in diagnosing tuberculosis. This novel tracer aids in identifying active pulmonary and extrapulmonary lesions, potentially improving treatment response evaluation.

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Area of Science:

  • Nuclear medicine
  • Radiopharmacology
  • Infectious disease imaging

Background:

  • Tuberculosis (TB) diagnosis, staging, and treatment monitoring require improvement.
  • Current diagnostic methods for TB are suboptimal.
  • Novel imaging tracers are needed for better TB management.

Purpose of the Study:

  • To evaluate the utility of 68Ga-citrate positron emission tomography/computed tomography (PET/CT) for diagnosing tuberculosis.
  • To assess the tracer's ability to detect pulmonary and extrapulmonary lesions.
  • To compare PET/CT findings with CT alone for TB staging.

Main Methods:

  • Thirteen patients with tuberculosis underwent PET/CT imaging using 68Ga-citrate.
  • Tuberculosis diagnosis was confirmed via bacteriological, histopathological, or clinical criteria.
  • PET/CT images were analyzed qualitatively and semi-quantitatively, with comparisons to CT findings.

Main Results:

  • All patients showed abnormal 68Ga-citrate uptake in pulmonary and/or extrapulmonary sites.
  • 68Ga-citrate PET/CT detected extrapulmonary involvement in 77% of patients, exceeding CT detection in 80% of cases.
  • The tracer's avidity potentially differentiates active from inactive tuberculous lesions.

Conclusions:

  • 68Ga-citrate PET/CT effectively visualizes both pulmonary and extrapulmonary tuberculosis lesions.
  • This imaging modality may aid in distinguishing active from inactive disease, crucial for treatment evaluation.
  • 68Ga-citrate PET/CT demonstrates superiority over CT in detecting extrapulmonary tuberculous involvement.