title: 68Ga-citrate PET/CT in tuberculosis: a pilot study.
abstract: BACKGROUND
  Tuberculosis remains an important cause of morbidity and mortality worldwide, the diagnosis, staging and treatment response evaluation of which remains sub-optimal. We evaluated PET/CT imaging with a novel tracer, 68Ga-citrate, in this setting.
  
  
  METHODS
  Thirteen patients with tuberculosis underwent PET/CT imaging with 68Ga-citrate. Tuberculosis was diagnosed with bacteriological or histopathology studies (N.=8) or based on a combination of clinical data, biochemistry and imaging (N.=5). PET images were analyzed qualitatively and semi-quantitatively and compared to CT findings.
  
  
  RESULTS
  All 13 patients demonstrated abnormal tracer accumulation in the lungs or extra-pulmonary or both. 68Ga-citrate accumulated in every lung lesion noted on CT in six cases (46%). In seven cases (54%) some of the lung lesions noted on CT were not 68Ga-citrate avid, which is suggestive of non-active tuberculous lesions. Ten patients (77%) demonstrated extrapulmonary involvement, which included various lymph node groups, skeletal lesions, pleural-, splenic- and gastrointestinal tract involvement. Detection of extra-pulmonary involvement was higher on PET compared to CT (more lesions detected) in eight cases (80%).
  
  
  CONCLUSIONS
  68Ga-citrate PET accumulates in both pulmonary and extra-pulmonary tuberculous lesions and may provide a way of distinguishing active from inactive lesions for treatment response evaluation. 68Ga-citrate PET may be superior to CT in the detection of extrapulmonary involvement.
authors.affiliation: Department of Nuclear Medicine, Steve Biko Academic Hospital, University of Pretoria, Pretoria, South Africa.
authors.forename: Mariza
authors.initials: M
authors.lastname: Vorster
authors.affiliation: Department of Nuclear Medicine AZ Groeninge, Reepkaai, Kortrijk, Belgium.
authors.forename: Alex
authors.initials: A
authors.lastname: Maes
authors.affiliation: Department of Nuclear Medicine, University Hospital Ghent, Ghent, Belgium.
authors.forename: Christophe
authors.initials: C
authors.lastname: van de Wiele
authors.affiliation: Department of Nuclear Medicine, Steve Biko Academic Hospital, University of Pretoria, Pretoria, South Africa - mike.sathekge@up.ac.za.
authors.forename: Mike
authors.initials: M
authors.lastname: Sathekge
mesh_terms: D000328:Adult; D002951:Citrates; D005260:Female; D005708:Gallium; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D000072078:Positron Emission Tomography Computed Tomography; D014376:Tuberculosis / Q000000981:diagnostic imaging*
chemical_list: D002951:Citrates; D005708:Gallium; C103850:gallium citrate