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A Journal on Nuclear Medicine and Molecular Imaging
Affiliated to the and to the International Research Group of Immunoscintigraphy
Indexed/Abstracted in: Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index (SciSearch), Scopus
Impact Factor 2,413
Online ISSN 1827-1936
Vorster M. 1, Maes A. 2, Van de Wiele C. 3, Sathekge M.M. 1
1 University of Pretoria, Department of Nuclear Medicine, Steve Biko Academic Hospital;
2 Department of Nuclear Medicine AZ Groeninge, Reepkaai, Kortrijk, Belgium;
3 Department of Nuclear Medicine, University hospital Ghent, Ghent, Belgium
Aim: Tuberculosis remains an important cause of morbidity and mortality worldwide, the diagnosis, staging and treatment response evaluation of which remains suboptimal. We evaluated PET/CT imaging with a novel tracer,68Ga-citrate, in this setting.
Methods: Thirteen patients with tuberculosis underwent PET/CT imaging with 68Ga-citrate. Tuberculosis was diagnosed with bacteriological or histopathology studies (n=8) or based on a combination of clinical data, biochemistry and imaging (n=5). PET images were analyzed qualitatively and semi-quantitatively and compared to CT findings.
Results: All 13 patients demonstrated abnormal tracer accumulation in the lungs or extrapulmonary or both. 68Ga-citrate accumulated in every lung lesion noted on CT in six cases (46%). In seven cases (54%) some of the lung lesions noted on CT were not 68Ga-citrate avid, which is suggestive of non-active tuberculous lesions. Ten patients (77%) demonstrated extra-pulmonary involvement, which included various lymph node groups, skeletal lesions, pleural-, splenic- and gastro-intestinal tract involvement. Detection of extra-pulmonary involvement was higher on PET compared to CT (more lesions detected) in eight cases (80%).
Conclusion: 68Ga-citrate PET accumulates in both pulmonary and extra-pulmonary tuberculous lesions and may provide a way of distinguishing active from inactive lesions for treatment response evaluation. 68Ga-citrate PET may be superior to CT in the detection of extra-pulmonary involvement.