• Int. J. Tuberc. Lung Dis. · Sep 2012

    (18)F-FDG PET/CT in tuberculosis: an early non-invasive marker of therapeutic response.

    • V Martinez, M A Castilla-Lievre, C Guillet-Caruba, G Grenier, R Fior, S Desarnaud, F Doucet-Populaire, and F Boué.
    • Service de Médecine Interne et Immunologie Clinique, Unité Mixte de Recherche en Santé 996, Institut National de la Santé et de la Recherche Médicale, Paris, France. valerie.martinez@abc.aphp.fr
    • Int. J. Tuberc. Lung Dis. 2012 Sep 1;16(9):1180-5.

    ObjectiveTo evaluate the potential of (18)F-fluoro-deoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) for early therapeutic intervention in patients with probable or confirmed tuberculosis (TB).MethodsTwenty-one consecutive human immunodeficiency virus negative patients were prospectively included. All patients underwent (18)F-FDG PET/CT before and after 1 month of anti-tuberculosis treatment. The maximum standardised uptake value (SUV(max)) of the most (18)F-FDG avid lesions was recorded.ResultsThe median age of patients was 36 years (range 18-84); 33.3% were male, 80.9% were born in endemic countries, and 23.8% had a past history of TB. TB was confirmed on culture in 8, on histology in 9 and on the basis of clinical symptoms in 4 patients. (18)F-FDG PET/CT detected active pulmonary TB (n = 1), extra-pulmonary (n = 10) or both (n = 10). The second (18)F-FDG PET/CT showed reduced radiotracer uptake intensity in 19 of 21 patients, with a median percentage decrease of SUV(max) of 31% (range 2-84). Two patients showed no improvement. TB was ruled out in one patient during follow-up; the final diagnosis was a non-Hodgkin's lymphoma. The other patient was smear-positive for 3 months.Conclusion(18)F-FDG PET/CT allows an easy evaluation of early therapeutic response in patients with TB, particularly extra-pulmonary TB.

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