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Open Access Case report

18-fluorodeoxyglucose positron emission tomography for tuberculosis diagnosis and management: a case series

Scott K Heysell1*, Tania A Thomas1, Costi D Sifri12, Patrice K Rehm3 and Eric R Houpt1

Author Affiliations

1 Division of Infectious Diseases and International Health, University of Virginia, PO Box 801337, Charlottesville, VA 29908-1337, USA

2 Office of Hospital Epidemiology/Infection Prevention and Control, University of Virginia Health System, Charlottesville, USA

3 Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, USA

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BMC Pulmonary Medicine 2013, 13:14  doi:10.1186/1471-2466-13-14

Published: 21 March 2013

Abstract

Background

F-fluorodeoxyglucose positron emission tomography (FDG-PET) is increasingly used to investigate for malignancy in the evaluation of pulmonary nodules, yet both active tuberculosis (TB) and malignancy have high uptake of FDG. Definitive diagnosis of TB can be further hindered in patients without growth of the organism from sputum.

Case presentations

We describe a series of four representative cases of TB in varying disease state originally imaged by FDG-PET during evaluation for malignancy. Decisions regarding treatment for active TB in the presence of negative cultures and the evolving understanding of the spectrum of the TB disease state are discussed.

Conclusions

FDG-PET may possess a role in the diagnosis of active TB infection in settings where conventional microbiological methods are unavaiable and holds particular promise for monitoring response to therapy in cases of unsettled treatment duration such as multidrug-resistant TB or in extrapulmonary TB.

Keywords:
Positron emission tomography; Tuberculosis; Multidrug-resistant tuberculosis; Pulmonary nodule