title: Patterns of pulmonary tuberculosis on FDG-PET/CT.
abstract: OBJECTIVE
  This study aims to describe patterns of pulmonary tuberculosis (TB) on FDG-PET/CT.
  
  
  METHODS
  All patients with a diagnosis of TB and who underwent FDG-PET/CT between January 2009 and June 2010 were included. Clinical, biological and imaging data were reviewed. TB was proven either on bacteriological or histopathological studies (n=13) or on a clinical and imaging basis (n=3).
  
  
  RESULTS
  Sixteen patients (11 men; median age 56, range 22-84 years) were included. Two distinct patterns were identified. In the lung pattern (9/16), patients had predominantly pulmonary symptoms (6/9 patients, 67%) with a parenchymal involvement: uptakes on lung consolidation ± cavitation surrounded by micronodules. Mediastino-hilar lymph nodes were slightly enlarged (15 mm, 10-27) with moderate uptake (3.9, 2.5-13.4). In the lymphatic pattern (7/16), patients had predominantly systemic symptoms (5/7 cases, 71%) and all had extra-thoracic involvement. Mediastino-hilar lymph nodes were more enlarged (30 mm, 18-35, p=0.03) and with higher uptake (6.8, 5.7-16.8, p=0.034) than in the lung pattern.
  
  
  CONCLUSIONS
  We identified two distinct patterns of pulmonary TB on FDG-PET/CT. The lung pattern related to a restricted and slight hypermetabolic infection and the lymphatic pattern related to a systemic and intense infection. Combined interpretation of PET and CT findings improves the specificity of images, especially for the lung pattern.
authors.affiliation: Université Paris 13, Faculté de médecine SMBH, Department of Nuclear Medicine, CHU Avicenne, 125 rue de Stalingrad, 93000 Bobigny, France. michael.soussan@avc.aphp.fr
authors.forename: Michael
authors.initials: M
authors.lastname: Soussan
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Brillet
authors.forename: Arsène
authors.initials: A
authors.lastname: Mekinian
authors.forename: Abrahim
authors.initials: A
authors.lastname: Khafagy
authors.forename: Patrick
authors.initials: P
authors.lastname: Nicolas
authors.forename: Annie
authors.initials: A
authors.lastname: Vessieres
authors.forename: Michel
authors.initials: M
authors.lastname: Brauner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18