Microbial culture is the gold standard for determining the effectiveness of tuberculosis treatment. End-of-treatment (EOT) ¹⁸F-FDG PET/CT findings are variable among patients with negative microbial culture results after completing a standard regimen of antituberculous treatment (ATT), with some patients having a complete metabolic response to treatment whereas others have residual metabolic activity (RMA). We herein determine the impact of findings on EOT ¹⁸F-FDG PET/CT on tuberculosis relapse in patients treated with a standard regimen of ATT for drug-sensitive pulmonary tuberculosis (DS-PTB). Methods: Patients who completed a standard regimen of ATT for DS-PTB and were declared cured based on a negative clinical and bacteriologic examination were prospectively recruited to undergo EOT ¹⁸F-FDG PET/CT. Images were assessed for the presence of RMA. Patients were subsequently followed up for 6 mo looking for symptoms of tuberculosis relapse. When new symptoms developed, relapse was confirmed with bacteriologic testing. Repeat ¹⁸F-FDG PET/CT was done in patients who relapsed. Results: Fifty-three patients were included (mean age, 37.81 ± 11.29 y), with 62% being male and 75% HIV-infected. RMA was demonstrated in 33 patients (RMA group), whereas 20 patients had a complete metabolic response to ATT (non-RMA group). There was a higher prevalence of lung cavitation in the RMA group (P = 0.035). The groups did not significantly differ in age, sex, presence of HIV infection, body mass index, or hemoglobin level (P > 0.05). On follow-up, no patients in the non-RMA group developed tuberculosis relapse. Three patients in the RMA group developed relapse. All patients who developed tuberculosis relapse had bilateral disease with lung cavitation. Conclusion: A negative EOT ¹⁸F-FDG PET/CT result is protective against tuberculosis relapse. Nine percent of patients with RMA after ATT may experience tuberculosis relapse within 6 mo of completing ATT. Bilateral disease with lung cavitation is prevalent among patients with tuberculosis relapse.

微生物培养是确定结核病治疗效果的金标准。治疗结束（EOT）¹⁸ F-FDG PET / CT结果在完成抗结核治疗（ATT）标准方案的微生物培养结果为阴性的患者中各不相同，其中一些患者对治疗具有完全的代谢反应，而另一些患者残留代谢活性（RMA）。我们在本文中确定研究结果对药物敏感型肺结核（ATT）的标准ATT疗法治疗的患者中EOT ¹⁸ F-FDG PET / CT对结核复发的影响。方法：前瞻性招募了完成DS-PTB ATT标准治疗方案并根据临床和细菌学检查阴性宣布治愈的患者，进行EOT ¹⁸ F-FDG PET / CT。评估图像中是否存在RMA。随后对患者进行了6个月的随访，以寻找结核复发的症状。当出现新症状时，通过细菌学检查确认复发。复发患者重复^18次F-FDG PET / CT检查。结果：纳入53例患者（平均年龄37.81±11.29岁），其中62％为男性，75％为HIV感染者。RMA在33例患者（RMA组）中得到证实，而20例对ATT有完全代谢反应（非RMA组）。RMA组肺空化发生率较高（P = 0.035）。各组在年龄，性别，是否存在HIV感染，体重指数或血红蛋白水平方面无显着差异（P > 0.05）。在随访中，非RMA组中没有患者出现结核病复发。RMA组中的三名患者出现了复发。所有发生结核病复发的患者均伴有肺空化的双侧疾病。结论： EOT为负¹⁸F-FDG PET / CT结果可预防结核病复发。ATT后9％的RMA患者可能在ATT完成后6个月内出现结核病复发。在肺结核复发患者中，伴有肺空化的双侧疾病普遍存在。