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Sequential 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) scan findings in patients with extrapulmonary tuberculosis during the course of treatment-a prospective observational study.
Bomanji, Jamshed; Sharma, Rajnish; Mittal, Bhagwant R; Gambhir, Sanjay; Qureshy, Ahmad; Begum, Shamim M F; Paez, Diana; Sathekge, Mike; Vorster, Mariza; Sobic Saranovic, Dragana; Pusuwan, Pawana; Mann, Vera; Vinjamuri, Sobhan; Zumla, Alimuddin; Pascual, Thomas N B.
Afiliação
  • Bomanji J; Institute of Nuclear Medicine, 5th Floor, UCLH NHS Foundation Trust, 235 Euston Road, London, NW1 2BU, UK. jamshed.bomanji@nhs.net.
  • Sharma R; Division of Nuclear Medicine & PET Imaging, Specialist in Nuclear Medicine &Thyroid diseases, Molecular Imaging & Research Center (MIRC), INMAS, Delhi, India.
  • Mittal BR; Department of Nuclear Medicine & PET, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India.
  • Gambhir S; Department of Nuclear Medicine, SGPGIMS, Rae Bareli Road, Lucknow, 226014, India.
  • Qureshy A; Institute of Nuclear Medicine and Oncology (INMOL) Hospital, New Campus Road, Lahore, 54600, Pakistan.
  • Begum SMF; National Institute of Nuclear Medicine & Allied Sciences (NINMAS), BSM Medical University Campus, 7th-10th Floor, Block-D, Shahbag, Dhaka, 1000, Bangladesh.
  • Paez D; Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, IAEA, Vienna, Austria.
  • Sathekge M; Department of Nuclear Medicine, Steve Biko Academic Hospital, University of Pretoria, Pretoria, South Africa.
  • Vorster M; Department of Nuclear Medicine, Steve Biko Academic Hospital, University of Pretoria, Pretoria, South Africa.
  • Sobic Saranovic D; Faculty of Medicine University of Belgrade and Center of Nuclear Medicine Clinical Center of Serbia, Belgrade, Serbia.
  • Pusuwan P; Division of Nuclear Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok-noi, Bangkok, 10700, Thailand.
  • Mann V; Institute of Nuclear Medicine, 5th Floor, UCLH NHS Foundation Trust, 235 Euston Road, London, NW1 2BU, UK.
  • Vinjamuri S; Royal Liverpool University Hospital, Liverpool, L7 8XP, UK.
  • Zumla A; Center for Clinical Microbiology, Division of Infection and Immunity, University College London, and the National Institute of Health Research Biomedical Research Centre at UCL Hospitals, London, UK.
  • Pascual TNB; Section of Nuclear Medicine and Diagnostic Imaging, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna International Centre, PO Box 100, 1400, Vienna, Austria.
Eur J Nucl Med Mol Imaging ; 47(13): 3118-3129, 2020 12.
Article em En | MEDLINE | ID: mdl-32483653
BACKGROUND: Initial studies of tuberculosis (TB) in macaques and humans using 18F-FDG positron emission tomography (PET) imaging as a research tool suggest its usefulness in localising disease sites and as a clinical biomarker. Sequential serial scans in patients with extrapulmonary TB (EPTB) could inform on the value of PET-CT for monitoring response to treatment and defining cure. PATIENTS AND METHODS: HIV-negative adults with EPTB from eight sites across six countries had three 18F-FDG PET/CT scans: (i) within 2 weeks of enrolment, (ii) at 2 months into TB treatment and (iii) at end of ATT treatment. Scanning was performed according to the EANM guidelines. 18F-FDG PET/CT scans were performed 60 ± 10 min after intravenous injection of 2.5-5.0 MBq/kg of 18F-FDG. FINDINGS: One hundred and forty-seven patients with EPTB underwent 3 sequential scans. A progressive reduction over time of both the number of active sites and the uptake level (SUVmax) at these sites was seen. At the end of WHO recommended treatment, 53/147 (36.0%) patients had negative PET/CT scans, and 94/147 (63.9%) patients remained PET/CT positive, of which 12 patients had developed MDR TB. One died of brain tuberculoma. INTERPRETATION: Current 18F-FDG PET/CT imaging technology cannot be used clinically as a biomarker of treatment response, cure or for decision-making on when to stop EPTB treatment. PET/CT remains a research tool for TB and further development of PET/CT is required using new Mycobacterium tuberculosis-specific radiopharmaceuticals targeting high-density surface epitopes, gene targets or metabolic pathways.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Tuberculose / Fluordesoxiglucose F18 Tipo de estudo: Diagnostic_studies / Guideline / Observational_studies / Prognostic_studies Limite: Adult / Humans Idioma: En Ano de publicação: 2020 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Tuberculose / Fluordesoxiglucose F18 Tipo de estudo: Diagnostic_studies / Guideline / Observational_studies / Prognostic_studies Limite: Adult / Humans Idioma: En Ano de publicação: 2020 Tipo de documento: Article