Technetium-99m-tetrofosmin scintigraphy in pulmonary tuberculosis

Area of Science:

• Nuclear Medicine
• Radiology
• Infectious Diseases

Background:

• Technetium-99m-tetrofosmin (99mTc-tetrofosmin) is primarily used for myocardial imaging.
• Its accumulation in malignancies is known, but its role in imaging infections like pulmonary tuberculosis is less understood.

Purpose of the Study:

• To evaluate the utility of 99mTc-tetrofosmin scintigraphy in diagnosing active and inactive pulmonary tuberculosis (TB).
• To compare scintigraphy findings with radiological and microbiological results.
• To assess the role of 99mTc-tetrofosmin scintigraphy in monitoring treatment response in pulmonary TB.

Main Methods:

• The study included 27 patients with active pulmonary TB (APTB) and 6 with inactive pulmonary TB (IPTB).
• 99mTc-tetrofosmin scintigraphy was performed, with images acquired at 20 and 60 minutes post-injection.
• Visual and semiquantitative analyses (lesion to nonlesion ratios) were conducted by nuclear medicine physicians.

Main Results:

• Significant 99mTc-tetrofosmin uptake was observed in 85% of APTB patients, with uptake absent in most IPTB patients.
• Post-treatment scans showed decreased or absent uptake, correlating with clinical and radiological improvements.
• Lesion-to-nonlesion ratios were calculated, indicating higher uptake in active disease.

Conclusions:

• 99mTc-tetrofosmin scintigraphy demonstrates increased uptake in active pulmonary TB lesions, reflecting disease activity.
• The imaging modality shows promise as a complementary tool for assessing APTB and evaluating treatment efficacy.
• Changes in 99mTc-tetrofosmin uptake post-therapy correlate well with treatment outcomes.