J Korean Med Sci.  2014 Mar;29(3):386-391. 10.3346/jkms.2014.29.3.386.

18F-FDG Positron-Emission Tomography/Computed Tomography Findings of Radiographic Lesions Suggesting Old Healed Tuberculosis

• Jeong YJ
• Paeng JC
• Nam HY
• Lee JS
• Lee SM
• Yoo CG
• Kim YW
• Han SK
• Yim JJ

• KMID: 1734926
• DOI: http://doi.org/10.3346/jkms.2014.29.3.386

Abstract

The presence of radiographic lesions suggesting old healed tuberculosis (TB) is one of the strongest risk factors for the subsequent development of active TB. We elucidated the metabolic activity of radiographic lesions suggesting old healed TB using 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT). This cross-sectional study included 63 participants with radiographic lesions suggesting old healed TB and with available 18F-FDG PET/CT scans. The maximum standardized uptake value (SUVmax) measured in the lesions, the clinical characteristics, results of the tuberculin skin test (TST) and interferon-gamma release assay (IGRA) were analyzed. The SUVmax in old healed TB was 1.5 or higher among nine (14.3%) participants. Age (adjusted odds ratio [aOR], 1.23; 95% CI, 1.03-1.46), history of previous TB (aOR, 60.43; 95% CI, 1.71-2131.65), and extent of the lesions (aOR, 1.34; 95% CI, 1.02-1.75) were associated with higher SUVmax. The positive rates for the TST and IGRA were not different between groups with and without increased FDG uptake. Increased FDG uptake on 18F-FDG PET/CT was observed in a subset of patients with radiographic lesions suggesting old healed TB. Given that the factors associated with increased FDG uptake are known risk factors for TB development, the possibility exists that participants with old healed TB lesions with higher SUV on 18F-FDG PET/CT scans might be at higher risk for active TB.

Keyword

Positron-Emission Tomography; Tomography, X-Ray Computed; Tuberculosis, Pulmonary; Latent Tuberculosis; Interferon-gamma Release Tests

MeSH Terms

Adult
Aged
Aged, 80 and over
Cross-Sectional Studies
Diagnosis, Differential
Female
Fluorodeoxyglucose F18/chemistry/*diagnostic use
Follow-Up Studies
Humans
Interferon-gamma Release Tests
Male
Middle Aged
Odds Ratio
Positron-Emission Tomography
Radiopharmaceuticals/chemistry/*diagnostic use
Risk Factors
Tomography, X-Ray Computed
Tuberculin Test
Tuberculosis/*diagnosis/radiography
Fluorodeoxyglucose F18
Radiopharmaceuticals

Figure

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  Fig. 1 Chest computed tomography (CT) and 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT findings of two participants with old healed tuberculosis (TB), showing increased FDG uptake. (A, B) Fibrotic scar and calcified nodules suggesting old healed TB in the right upper lobe was observed on the chest CT of a 76-yr-old man without a history of TB. The SUVmax of the lesions was measured as 4.0 by 18F-FDG PET/CT. Both the TST and IGRA were negative. (C, D) Fibrotic scar and nodules in the right upper lobe were observed on the chest CT of a 71-yr-old man. He had been treated for pulmonary TB 25 yr earlier. The SUVmax of the lesions was measured as 2.2 by 18F-FDG PET/CT. Both the TST and IGRA were positive.

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