The study find that the molecular imaging with 18F-FDG positron emission tomography/computed tomography (PET/CT) can evaluate tuberculosis at the molecular level; because effectively identifying diseased areas and guiding treatment for patients. but According to the World Health Association; tuberculosis is one of the top 10 causes of death worldwide.
Computed tomography (PET/CT)
Although the disease is curable and preventable, in areas with high rates of tuberculosis, therefore it contributes to significant morbidity, mortality and an increased risk of transmission from infected individuals. but Tuberculosis most frequently involves the lungs; however involvement of tissues and organs other than the lungs is refer to as extra-pulmonary tuberculosis.
Extra-pulmonary tuberculosis presents a particular challenge as the disease site is often not accessible for performing an invasive diagnosis. The physician thus relies on the clinical diagnosis for initiating treatment as well as deciding the duration of therapy; because which can be difficult. In our study; we aimed to evaluate the utility of 18F-FDG PET/CT in the initial diagnosis and response assessment of patients with extra-pulmonary tuberculosis.”
The clinical diagnosis
Bhagwant R. Mittal, MD, DNB, professor and department head of nuclear medicine at the Postgraduate Institute of Medical Education and Research in Chandigarh; therefore India Ninety-three patients with extra-pulmonary tuberculosis are prospectively enroll in the study prior to the initiation of treatment. Therefore The patients underwent 18F-FDG PET/CT imaging as a baseline; and then received follow-up imaging after two months and after treatment completion.
Follow-up scans are categorize into three groups: complete metabolic response (no abnormal lesions), residual disease (persistent lesions; but no new lesions) and disease progression (new lesions compared to the baseline scan). In the baseline scans; 176 lesion sites are detect among the 93 study participants. The most common sites included the lymph nodes and central nervous system.
Complete metabolic response
Two month follow-up scans were performed on 47 patients; and 21.2% were classified as having complete metabolic response; 72.3% had residual disease and 6.4% were characterized as having disease progression. A final scan was conducted post-treatment and, of the 28 patients imaged; 28.6%t had complete metabolic response, 53.6% of patients showed residual disease and 17.8% had disease progression. During the course of the study; 12.9% of patients died. Of these deaths, the patients who fell in the disease progression category had the highest mortality rate 60%t.
“This study has the potential to change the way we manage tuberculosis patients. Our results show that 18F-FDG PET/CT provides a whole-body survey and identifies the disease sites in various organs and tissues in a single study. Because This helps to provide an early estimation of disease extent, and in suspect cases; helps to identify accessible biopsy sites for obtaining tissue diagnosis;” Mittal said. But “Further, follow-up scans can point towards response to treatment and thus suggest predict a more accurate outcome.”