Background A large proportion of the huge global burden of extrapulmonary tuberculosis (EPTB) cases are treated empirically without accurate definition of disease sites and extent of multi-organ disease involvement. Positron emission tomography (PET) imaging using 2-deoxy-2-(fluorine-18) fluoro-d-glucose (18F-FDG) in tuberculosis could be a useful imaging technique for localising disease sites and extent of disease. Methods We conducted a study of HIV-negative adult patients with a new clinical diagnosis of EPTB across eight centres located in six countries: India, Pakistan, Thailand, South Africa, Serbia and Bangladesh, to assess the extent of disease and common sites involved at first presentation. 18F-FDG PET/computed tomography (CT) scans were performed within 2 weeks of presentation. Findings 358 patients with EPTB (189 females; 169 males) were recruited over 45 months, with an age range of 18–83 years (females median 30 years; males median 38 years). 350 (98%) out of 358 patients (183 female, 167 male) had positive scans. 118 (33.7%) out of 350 had a single extrapulmonary site and 232 (66.3%) out of 350 had more than one site (organ) affected. Lymph nodes, skeleton, pleura and brain were common sites. 100 (28%) out of 358 EPTB patients had 18F-FDG PET/CT-positive sites in the lung. 110 patients were 18F-FDG PET/CT-positive in more body sites than were noted clinically at first presentation and 160 patients had the same number of positive body sites. Interpretation 18F-FDG PET/CT scan has potential for further elucidating the spectrum of disease, pathogenesis of EPTB and monitoring the effects of treatment on active lesions over time, and requires longitudinal cohort studies, twinned with biopsy and molecular studies. 18F-FDG PET/CT can localise EPTB disease sites not clinically detected. It may serve a useful tool for research studies defining pathogenetic mechanisms and cure, relapse and recurrence. http://bit.ly/2CKSH9a

中文翻译：

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肺外结核首次临床表现的 PET/CT 特征 - 六个国家的横断面观察性 18F-FDG 成像研究

背景 肺外结核 (EPTB) 病例的巨大全球负担中有很大一部分是在没有准确定义疾病部位和多器官疾病受累程度的情况下进行的。使用 2-deoxy-2-(fluorine-18) fluoro-d-glucose (18F-FDG) 在结核病中的正电子发射断层扫描 (PET) 成像可能是用于定位疾病部位和疾病范围的有用成像技术。方法 我们对位于印度、巴基斯坦、泰国、南非、塞尔维亚和孟加拉国这六个国家的八个中心进行了一项新的临床诊断为 EPTB 的 HIV 阴性成年患者的研究，以评估疾病的范围和常见部位。第一次介绍。18F-FDG PET/计算机断层扫描 (CT) 扫描在就诊后 2 周内进行。结果 358 名 EPTB 患者（189 名女性；169 名男性）在 45 个月内被招募，年龄范围为 18-83 岁（女性中位数为 30 岁；男性中位数为 38 岁）。358 名患者（183 名女性，167 名男性）中有 350 名（98%）扫描呈阳性。350 人中有 118 人（33.7%）有一个肺外部位，350 人中有 232 人（66.3%）有多个部位（器官）受累。淋巴结、骨骼、胸膜和脑是常见部位。358 名 EPTB 患者中有 100 名（28%）在肺部有 18F-FDG PET/CT 阳性部位。110 名患者 18F-FDG PET/CT 阳性的身体部位多于首次就诊时临床发现的部位，160 名患者的身体部位阳性数量相同。解释 18F-FDG PET/CT 扫描有可能进一步阐明疾病谱、EPTB 的发病机制，并随着时间的推移监测治疗对活动性病变的影响，并且需要与活检和分子研究相结合的纵向队列研究。18F-FDG PET/CT 可以定位临床上未检测到的 EPTB 疾病部位。它可以作为研究定义致病机制和治愈、复发和复发的有用工具。http://bit.ly/2CKSH9a