title: Imaging in tuberculosis.
abstract: Early diagnosis of tuberculosis (TB) is necessary for effective treatment. In primary pulmonary TB, chest radiography remains the mainstay for the diagnosis of parenchymal disease, while computed tomography (CT) is more sensitive in detecting lymphadenopathy. In post-primary pulmonary TB, CT is the method of choice to reveal early bronchogenic spread. Concerning characterization of the infection as active or not, CT is more sensitive than radiography, and (18)F-fluorodeoxyglucose positron emission tomography/CT ((18)F-FDG PET/CT) has yielded promising results that need further confirmation. The diagnosis of extrapulmonary TB sometimes remains difficult. Magnetic resonance imaging (MRI) is the preferred modality in the diagnosis and assessment of tuberculous spondylitis, while (18)F-FDG PET shows superior image resolution compared with single-photon-emitting tracers. MRI is considered superior to CT for the detection and assessment of central nervous system TB. Concerning abdominal TB, lymph nodes are best evaluated on CT, and there is no evidence that MRI offers added advantages in diagnosing hepatobiliary disease. As metabolic changes precede morphological ones, the application of (18)F-FDG PET/CT will likely play a major role in the assessment of the response to anti-TB treatment.
authors: Institute of Nuclear Medicine, University College Hospitals NHS Trust, London NW1 2BU, UK.
authors: Evangelia
authors: E
authors: Skoura
authors: Division of Infection and Immunity, Centre for Clinical Microbiology, University College London, and NIHR Biomedical Research Centre, University College London Hospitals, London, UK.
authors: Alimuddin
authors: A
authors: Zumla
authors: Institute of Nuclear Medicine, University College Hospitals NHS Trust, London NW1 2BU, UK. Electronic address: jamshed.bomanji@uclh.nhs.uk.
authors: Jamshed
authors: J
authors: Bomanji
mesh_terms: D042241:Early Diagnosis; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008279:Magnetic Resonance Imaging; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography / Q000379:methods; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014376:Tuberculosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000000981:diagnostic imaging
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Computed tomography; Extrapulmonary tuberculosis; Fluorodeoxyglucose; Magnetic resonance imaging; Positron emission tomography; Pulmonary tuberculosis