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Updated: Mar 28, 2026
Analysis of 18FDG PET/CT Imaging as a Tool for Studying Mycobacterium tuberculosis Infection and Treatment in Non-human Primates
Published on: September 5, 2017
18F-FDG PET/CT in the Initial Assessment and for Follow-up in Patients With Tuberculosis
Ingrid Stelzmueller1, Helmut Huber, Rainer Wunn
1From the Departments of *Pneumology, †Nuclear and Endocrinology, and ‡Radiology, Allgemeines Krankenhaus der Stadt Linz, Medical Faculty of the Johannes Kepler University, Linz; §Nuclear Medicine Research Department, IASON, Graz, Austria; ∥Médecine Nucléaire, Centre Hospitalier and Biophysique, Faculté Charles Mérieux, Lyon, France; ¶Department of Radiology, University of Southern California, Los Angeles, CA; **Department Nuclear Medicine, Santa Maria della Misericordia Hospital, Rovigo, Italy; and ††University Clinic of Nuclear Medicine, Medical University of Innsbruck, Innsbruck, Austria.
Purpose:
The aim of this retrospective study was to assess the value of 18F-FDG PET/CT in the initial evaluation and follow-up of patients with tuberculosis (TB).
Patients And Methods:
Thirty-five patients (18 men) with pulmonary or extrapulmonary TB were included. Diagnosis of TB was based either on histology or microbiological assessment in 32 patients and was based on typical morphological features of TB in CT and improvement on antimycobacterial medication in 3 patients. Eighty-eight 18F-FDG PET/CT scans were performed at initial assessment and during treatment, on a Siemens Biograph PET/CT. Diagnostic contrast-enhanced CT scans were performed on the 40-slice multidetector CT of the PET/CT scanner. Mean (SD) anti-TB treatment duration was 16.1 (8.9) months.
Results:
The initial 18F-FDG PET identified 64 affected regions in 34 among 35 patients, whereas CT identified 34 affected organs in 23 patients. Matching image results between PET and CT were observed at first visit in 11 patients (31.4%), with relevant differences in 23 (65.7%). In 1 patient, both modalities remained negative. During follow-up 18F-FDG PET scans, we recorded 15 cases with remission of disease, 16 with residual disease (2 patients with multidrug-resistant infection), and 4 cases with progressive disease or delayed onset of adequate immunological response. In only 3 patients, both modalities, PET and CT, showed completely equivalent results.
Conclusions:
Both components of 18F-FDG PET/CT provide complementary information at initial evaluation and during follow-up; however, 18F-FDG showed more abnormal findings than CT. 18F-FDG PET/CT might be useful for the establishment of individualized treatment regimes, but this requires further prospective studies.
Insights
18F-FDG PET/CT imaging offers valuable insights for tuberculosis (TB) diagnosis and monitoring. This study found 18F-FDG PET/CT detected more abnormalities than CT alone, aiding in treatment assessment.
Area of Science:
- Nuclear Medicine
- Radiology
- Infectious Disease Imaging
Background:
- Tuberculosis (TB) diagnosis and management require accurate imaging modalities.
- Evaluating the utility of 18F-FDG PET/CT in TB assessment is crucial for optimizing patient care.
Purpose of the Study:
- To retrospectively evaluate the effectiveness of 18F-FDG PET/CT in the initial diagnosis and follow-up of patients with tuberculosis.
- To compare the diagnostic performance of 18F-FDG PET/CT with conventional CT in TB patients.
Main Methods:
- Retrospective analysis of 88 18F-FDG PET/CT scans from 35 patients with confirmed pulmonary or extrapulmonary TB.
- Diagnosis of TB confirmed by histology or microbiology in most cases; CT and treatment response used in others.
- Scans were performed at initial assessment and during anti-TB treatment (mean duration 16.1 months).
Main Results:
- 18F-FDG PET identified significantly more affected regions (64) than CT (34) in initial evaluations.
- PET and CT findings were only matching in 31.4% of patients at the first visit, with discrepancies in 65.7%.
- Follow-up PET scans showed disease remission (15), residual disease (16, including multidrug-resistant TB), or progression (4).
Conclusions:
- 18F-FDG PET/CT provides complementary information to CT for initial TB evaluation and treatment monitoring.
- 18F-FDG PET/CT demonstrates a higher sensitivity for detecting abnormalities compared to CT alone.
- The findings suggest 18F-FDG PET/CT may aid in developing individualized TB treatment strategies, warranting further prospective research.
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