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ORIGINAL ARTICLE
The Quarterly Journal of Nuclear Medicine and Molecular Imaging 2019 March;63(1):48-55
DOI: 10.23736/S1824-4785.16.02680-7
Copyright © 2014 EDIZIONI MINERVA MEDICA
language: English
68Ga-citrate PET/CT in tuberculosis: a pilot study
Mariza VORSTER 1, Alex MAES 2, Christophe van de WIELE 3, Mike SATHEKGE 1 ✉
1 Department of Nuclear Medicine, Steve Biko Academic Hospital, University of Pretoria, Pretoria, South Africa; 2 Department of Nuclear Medicine AZ Groeninge, Reepkaai, Kortrijk, Belgium; 3 Department of Nuclear Medicine, University Hospital Ghent, Ghent, Belgium
BACKGROUND: Tuberculosis remains an important cause of morbidity and mortality worldwide, the diagnosis, staging and treatment response evaluation of which remains sub-optimal. 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 extra-pulmonary 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 extrapulmonary involvement, which included various lymph node groups, skeletal lesions, pleural-, splenic- and gastrointestinal tract involvement. Detection of extra-pulmonary involvement was higher on PET compared to CT (more lesions detected) in eight cases (80%).
CONCLUSIONS: 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 extrapulmonary involvement.
KEY WORDS: Positron-emission tomography - Infection - Diagnostic imaging - Tuberculosis