Biomarkers to predict FDG PET/CT activity after the standard duration of treatment for spinal tuberculosis: An exploratory study,Tuberculosis

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Biomarkers to predict FDG PET/CT activity after the standard duration of treatment for spinal tuberculosis: An exploratory study
Tuberculosis ( IF 2.8 ) Pub Date : 2021-07-08 , DOI: 10.1016/j.tube.2021.102107
Theresa N Mann ₁ , James Warwick ₂ , Novel N Chegou ₃ , Johan H Davis ₁ , Caroline G G Beltran ₃ , Stephanie Griffith-Richards ₄ , Martin Kidd ₅ , Jacques du Toit ₆ , Robert P Lamberts ₆ , Gerhard Walzl ₃

Affiliation

Division of Orthopaedic Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg, 7505, Cape Town, South Africa; Institute of Orthopaedics and Rheumatology, Mediclinic Winelands Orthopaedic Hospital, Cnr Rokewood & Saffraan Ave, Die Boord, Stellenbosch, 7600, South Africa.
Division of Nuclear Medicine, Department of Medical Imaging and Clinical Oncology, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg, 7505, Cape Town, South Africa.
DST/NRF Centre of Excellence for Biomedical TB Research and SAMRC Centre for TB Research, Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg, 7505, Cape Town, South Africa.
Division of Radiodiagnosis, Department of Medical Imaging and Clinical Oncology, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg, 7505, Cape Town, South Africa.
Centre for Statistical Consultation, Department of Statistics and Actuarial Sciences, Faculty of Economic and Management Sciences, Stellenbosch University, Van Der Sterr Building, Bosman St, Stellenbosch, 7599, South Africa.
Division of Orthopaedic Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg, 7505, Cape Town, South Africa.

Objectives

18F-Fluorodeoxyglucose (FDG) Positron Emission Tomography- Computed Tomography (PET/CT) scans can be used to assess healing following treatment for spinal tuberculosis (TB) but have limited accessibility and high cost. This study investigated the association between immune biomarkers and FDG-PET/CT activity after ≥9 months of treatment for spinal TB.

Methods

Patients who had completed ≥9 months of treatment for spinal TB were recruited from a major hospital in the Western Cape, South Africa. Participants underwent a FDG-PET/CT scan and FDG- PET/CT activity was quantified for all spinal and extra-spinal sites. Participants also provided a blood sample, which was evaluated for 19 cytokines along with erythrocyte sedimentation rate (ESR). Correlations and multiple regression analyses were used to investigate the association between biomarkers and PET/CT measures.

Results

Twenty-eight patients were recruited, of whom 24 (86%) had spinal and/or extra-spinal FDG-PET/CT activity. In the strongest multiple regression model, CXCL10/IP-10, VEGFA, IFN-γ, CRP and Factor D/Adipsin explained 52% of the variation in overall maximal FDG uptake. Conventional monitoring marker ESR showed no significant association with PET/CT measures.

Conclusions

The current findings offered encouragement that biomarkers to predict FDG-PET/CT activity may show some promise and identified candidate biomarkers for further investigation in this regard.

中文翻译：

预测脊柱结核标准治疗持续时间后 FDG PET/CT 活动的生物标志物：一项探索性研究

目标

18F-氟脱氧葡萄糖 (FDG) 正电子发射断层扫描 - 计算机断层扫描 (PET/CT) 扫描可用于评估脊柱结核 (TB) 治疗后的愈合情况，但可获得性有限且成本高。本研究调查了脊柱结核治疗≥9 个月后免疫生物标志物与 FDG-PET/CT 活性之间的关联。

方法

从南非西开普省的一家大医院招募了完成 ≥9 个月脊柱结核治疗的患者。参与者接受了 FDG-PET/CT 扫描，并对所有脊柱和脊柱外部位的 FDG-PET/CT 活动进行了量化。参与者还提供了血液样本，评估了 19 种细胞因子以及红细胞沉降率 (ESR)。相关性和多元回归分析用于研究生物标志物与 PET/CT 测量之间的关联。

结果

招募了 28 名患者，其中 24 名 (86%) 有脊髓和/或脊髓外 FDG-PET/CT 活动。在最强的多元回归模型中，CXCL10/IP-10、VEGFA、IFN-γ、CRP 和因子 D/Adipsin 解释了总体最大 FDG 摄取量变化的 52%。常规监测标志物 ESR 与 PET/CT 测量没有显着相关性。