Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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$^{18}F-FDG$ Positron Emission Tomography in Patients with Concomitant Malignancy and Tuberculoma

  • Lee, Jung-Cheol (Division of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Ryu, Jin-Sook (Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Park, I-Nae (Division of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Choi, Chang-Min (Division of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Oh, Yeon-Mok (Division of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee, Sang-Do (Division of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Woo-Sung (Division of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Dong-Soon (Division of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Shim, Tae-Sun (Division of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine)
  • Received : 2010.01.02
  • Accepted : 2010.01.06
  • Published : 2010.01.30
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Abstract

Background: To analyze the result of $^{18}F-FDG$ positron emission tomography (PET) in patients with a concomitant malignancy and tuberculoma in a tuberculosis (TB)-endemic area. Methods: Twelve patients with a concomitant malignancy and tuberculoma, who underwent whole-body $^{18}F-FDG$ PET, were evaluated retrospectively. The maximal standardized uptake values (SUVmax) of the malignancy and tuberculoma were compared. In 6 patients, $^{18}F-FDG$ PET was repeated during the anti-TB treatment and the changes in SUVmax were analyzed. Results: Of the 12 patients, 10 were male. The mean age was $67.2{\pm}7.9$ years. Tuberculomas were located in the lung (n=10) and lymph nodes (n=2), and tumors were located in the lung (n=6), colon (n=3), stomach (n=1), ovary (n=1) and liver (n=1). Although the mean SUVmax of malignant lesions was higher than that of tuberculomas ($5.2{\pm}3.2$ vs $3.5{\pm}2.0$), the difference was not significant. In 4 patients, the SUVmax was higher in the tuberculoma than the tumor. After anti-TB treatment in 6 patients, the mean SUVmax of the tuberculomas decreased significantly, from $3.5{\pm}2.0$ to $1.6{\pm}0.9$ (p=0.028). Conclusion: In patients with a concomitant malignancy and tuberculoma, SUVmax alone could not differentiate between them. However, $^{18}F-FDG$ PET may be useful in monitoring the response to anti-TB treatment.

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References

  1. Reske SN, Kotzerke J. FDG-PET for clinical use: results of the 3rd German Interdisciplinary Consensus Conference, "Onko-PET III", 21 July and 19 September 2000. Eur J Nucl Med 2001;28:1707-23. https://doi.org/10.1007/s002590100626
  2. Chang JM, Lee HJ, Goo JM, Lee HY, Lee JJ, Chung JK, et al. False positive and false negative FDG-PET scans in various thoracic diseases. Korean J Radiol 2006;7:57-69. https://doi.org/10.3348/kjr.2006.7.1.57
  3. Sochocky S. Tuberculoma of the lung. Am Rev Tuberc 1958;78:403-10.
  4. Goo JM, Im JG, Do KH, Yeo JS, Seo JB, Kim HY, et al. Pulmonary tuberculoma evaluated by means of FDG PET: findings in 10 cases. Radiology 2000;216:117-21.
  5. Hofmeyr A, Lau WF, Slavin MA. Mycobacterium tuberculosis infection in patients with cancer, the role of 18-fluorodeoxyglucose positron emission tomography for diagnosis and monitoring treatment response. Tuberculosis (Edinb) 2007;87:459-63. https://doi.org/10.1016/j.tube.2007.05.013
  6. Yen RF, Chen KC, Lee JM, Chang YC, Wang J, Cheng MF, et al. $^{18}F-FDG$ PET for the lymph node staging of non-small cell lung cancer in a tuberculosis-endemic country: is dual time point imaging worth the effort? Eur J Nucl Med Mol Imaging 2008;35:1305-15. https://doi.org/10.1007/s00259-008-0733-1
  7. An YS, Sun JS, Park KJ, Hwang SC, Park KJ, Sheen SS, et al. Diagnostic performance of $^{18}F-FDG$ PET/CT for lymph node staging in patients with operable non-smallcell lung cancer and inflammatory lung disease. Lung 2008;186:327-36. https://doi.org/10.1007/s00408-008-9109-3
  8. Low SY, Eng P, Keng GH, Ng DC. Positron emission tomography with CT in the evaluation of non-small cell lung cancer in populations with a high prevalence of tuberculosis. Respirology 2006;1:84-9.
  9. Hara T, Kosaka N, Suzuki T, Kudo K, Niino H. Uptake rates of $^{18}F$-fluorodeoxyglucose and $^{11}C-$-choline in lung cancer and pulmonary tuberculosis: a positron emission tomography study. Chest 2003;124:893-901. https://doi.org/10.1378/chest.124.3.893
  10. Park IN, Ryu JS, Shim TS. Evaluation of therapeutic response of tuberculoma using F-18 FDG positron emission tomography. Clin Nucl Med 2008;33:1-3. https://doi.org/10.1097/RLU.0b013e31815c5128
  11. Demura Y, Tsuchida T, Uesaka D, Umeda Y, Morikawa M, Ameshima S, et al. Usefulness of $^{18}F$-fluorodeoxyglucose positron emission tomography for diagnosing disease activity and monitoring therapeutic response in patients with pulmonary mycobacteriosis. Eur J Nucl Med Mol Imaging 2009;36:632-9. https://doi.org/10.1007/s00259-008-1009-5
  12. Davis SL, Nuermberger EL, Um PK, Vidal C, Jedynak B, Pomper MG, et al. Noninvasive pulmonary [18F]-2-fluoro-deoxy-D-glucose positron emission tomography correlates with bactericidal activity of tuberculosis drug treatment. Antimicrob Agents Chemother 2009;53:4879-84. https://doi.org/10.1128/AAC.00789-09
  13. Lee HS, Oh JY, Lee JH, Yoo CG, Lee CT, Kim YW, et al. Response of pulmonary tuberculomas to anti-tuberculous treatment. Eur Respir J 2004;23:452-5. https://doi.org/10.1183/09031936.04.00087304