18F-fluorodeoxyglucose PET/CT scans for thoracic tuberculosis: current evidence and future perspectives

Ana Paula Santos; Rosana Souza Rodrigues; Erik H.J.G. Aarntzen; Paulo Henrique Rosado de Castro; Cecile Magis-Escurra; Fernanda Carvalho de Queiroz Mello

doi:10.1183/16000617.0289-2024

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18F-fluorodeoxyglucose PET/CT scans for thoracic tuberculosis: current evidence and future perspectives

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18F-fluorodeoxyglucose PET/CT scans for thoracic tuberculosis: current evidence and future perspectives

Ana Paula Santos, Rosana Souza Rodrigues, Erik H.J.G. Aarntzen, Paulo Henrique Rosado de Castro, Cecile Magis-Escurra and Fernanda Carvalho de Queiroz Mello

European respiratory review, Vol.34(176), 240289

06/25/2025

DOI: 10.1183/16000617.0289-2024

PMID: 40562440

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Abstract

The advent of positron emission tomography (PET) combined with computed tomography (CT) in the field of inflammatory/infectious diseases heralds an era of personalised disease management using these noninvasive technologies. This nuclear medicine technique can be a useful tool in tuberculosis (TB) for assessing the extent of extrapulmonary disease, evaluating treatment response and identifying patients at higher risk of disease relapse. The fusion of functional imaging provided by PET with the anatomical and morphological details captured by CT has enabled clinicians to better understand the dynamics of the pathophysiology and natural course of Mycobacterium tuberculosis infection. Using its whole-body field of view, host responses are most commonly visualised using 18F-fluorodeoxyglucose, which reflects the glycolytic activity of cells. The strict indications for PET/CT in TB are matched by the caution required in interpreting its qualitative, quantitative and volumetric imaging patterns. In this narrative review, we aim to summarise evidence supporting the use of this molecular imaging modality in thoracic presentations of TB, particularly pulmonary and lymph node involvement, together with concepts to aid in the reporting and interpretation of the tests. We will also explore future indications for PET/CT in TB and discuss challenges to its routine use. PET/CT can be considered a useful tool to assess the extent of extrapulmonary disease, evaluate treatment response and identify the risk of relapse in TB. There are pros and cons to a potential role for molecular imaging in TB. https://bit.ly/43ymbot

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Title: Subtitle: 18F-fluorodeoxyglucose PET/CT scans for thoracic tuberculosis: current evidence and future perspectives
Creators: Ana Paula Santos
Rosana Souza Rodrigues
Erik H.J.G. Aarntzen - Radboud University Medical Center
Paulo Henrique Rosado de Castro
Cecile Magis-Escurra
Fernanda Carvalho de Queiroz Mello
Resource Type: Journal article
Publication Details: European respiratory review, Vol.34(176), 240289
DOI: 10.1183/16000617.0289-2024
PMID: 40562440
NLM abbreviation: Eur Respir Rev
ISSN: 0905-9180
eISSN: 1600-0617
Publisher: European Respiratory Society; SHEFFIELD
Grant note: Grant support Postdoc Fellowship #200071/2024-6 / ; Grant call # E-26/200.533/2023 / ;
Language: English
Date published: 06/25/2025
Academic Unit: Radiology
Record Identifier: 9985143123002771

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