title: 18F-FDG PET/CT in the Initial Assessment and for Follow-up in Patients With Tuberculosis.
abstract: OBJECTIVE
  The aim of this retrospective study was to assess the value of 18F-FDG PET/CT in the initial evaluation and follow-up of patients with tuberculosis (TB).
  
  
  METHODS
  Thirty-five patients (18 men) with pulmonary or extrapulmonary TB were included. Diagnosis of TB was based either on histology or microbiological assessment in 32 patients and was based on typical morphological features of TB in CT and improvement on antimycobacterial medication in 3 patients. Eighty-eight 18F-FDG PET/CT scans were performed at initial assessment and during treatment, on a Siemens Biograph PET/CT. Diagnostic contrast-enhanced CT scans were performed on the 40-slice multidetector CT of the PET/CT scanner. Mean (SD) anti-TB treatment duration was 16.1 (8.9) months.
  
  
  RESULTS
  The initial 18F-FDG PET identified 64 affected regions in 34 among 35 patients, whereas CT identified 34 affected organs in 23 patients. Matching image results between PET and CT were observed at first visit in 11 patients (31.4%), with relevant differences in 23 (65.7%). In 1 patient, both modalities remained negative. During follow-up 18F-FDG PET scans, we recorded 15 cases with remission of disease, 16 with residual disease (2 patients with multidrug-resistant infection), and 4 cases with progressive disease or delayed onset of adequate immunological response. In only 3 patients, both modalities, PET and CT, showed completely equivalent results.
  
  
  CONCLUSIONS
  Both components of 18F-FDG PET/CT provide complementary information at initial evaluation and during follow-up; however, 18F-FDG showed more abnormal findings than CT. 18F-FDG PET/CT might be useful for the establishment of individualized treatment regimes, but this requires further prospective studies.
authors.affiliation: From the Departments of *Pneumology, †Nuclear and Endocrinology, and ‡Radiology, Allgemeines Krankenhaus der Stadt Linz, Medical Faculty of the Johannes Kepler University, Linz; §Nuclear Medicine Research Department, IASON, Graz, Austria; ∥Médecine Nucléaire, Centre Hospitalier and Biophysique, Faculté Charles Mérieux, Lyon, France; ¶Department of Radiology, University of Southern California, Los Angeles, CA; **Department Nuclear Medicine, Santa Maria della Misericordia Hospital, Rovigo, Italy; and ††University Clinic of Nuclear Medicine, Medical University of Innsbruck, Innsbruck, Austria.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Stelzmueller
authors.forename: Helmut
authors.initials: H
authors.lastname: Huber
authors.forename: Rainer
authors.initials: R
authors.lastname: Wunn
authors.forename: Marina
authors.initials: M
authors.lastname: Hodolic
authors.forename: Michael
authors.initials: M
authors.lastname: Mandl
authors.forename: Bernd
authors.initials: B
authors.lastname: Lamprecht
authors.forename: Herwig
authors.initials: H
authors.lastname: Schinko
authors.forename: Franz
authors.initials: F
authors.lastname: Fellner
authors.forename: Andrea
authors.initials: A
authors.lastname: Skanjeti
authors.forename: Francesco
authors.initials: F
authors.lastname: Giammarile
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Colletti
authors.forename: Domenico
authors.initials: D
authors.lastname: Rubello
authors.forename: Michael
authors.initials: M
authors.lastname: Gabriel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed; D014376:Tuberculosis / Q000000981:diagnostic imaging*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18