¹⁸F-fluorodeoxyglucose PET/CT scans for thoracic tuberculosis: current evidence and future perspectives

Area of Science:

• Nuclear Medicine
• Radiology
• Infectious Diseases

Background:

• Positron emission tomography/computed tomography (PET/CT) is a noninvasive nuclear medicine technique increasingly used for inflammatory and infectious diseases.
• In tuberculosis (TB), PET/CT helps assess extrapulmonary disease extent, treatment response, and predict relapse risk.
• The combination of PET's functional imaging with CT's anatomical detail enhances understanding of Mycobacterium tuberculosis infection pathophysiology.

Purpose of the Study:

• To review the evidence supporting PET/CT use in thoracic TB presentations, including pulmonary and lymph node involvement.
• To provide guidance on interpreting PET/CT findings in TB.
• To explore future applications and challenges of routine PET/CT use in TB management.

Main Methods:

• Narrative review of existing literature on PET/CT in TB.
• Focus on thoracic manifestations like pulmonary and lymph node TB.
• Discussion of imaging patterns, interpretation, and reporting.

Main Results:

• PET/CT, particularly using 18F-fluorodeoxyglucose, visualizes host responses reflecting glycolytic activity.
• The technique is valuable for assessing disease extent, treatment efficacy, and identifying high-risk patients.
• Interpretation requires caution due to qualitative, quantitative, and volumetric imaging patterns.

Conclusions:

• PET/CT is a valuable tool in managing TB, especially thoracic forms.
• Standardized interpretation and reporting are crucial for optimal use.
• Further research is needed to address challenges and expand routine applications of PET/CT in TB.