scholarly journals Σχεδιασμός και ανάπτυξη συστήματος υπολογιστικής ευφυΐας για την εκτίμηση κινδύνου σε παθήσεις που σχετίζονται με το καρδιαγγειακό σύστημα

2021 ◽  
Author(s):  
Παύλος Καφούρης
Keyword(s):  
Computed Tomography ◽  
Myocardial Perfusion ◽  
Fdg Pet ◽  
Single Photon ◽  
Photon Emission ◽  
Standardized Uptake Value ◽  
Flow Reserve ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

Σύμφωνα με τον Παγκόσμιο Οργανισμό Υγείας οι καρδιαγγειακές παθήσεις, μεταξύ αυτών ιδιαίτερα η αθηρωματική στεφανιαία νόσος, είναι η συχνότερη αιτία θανάτου παγκοσμίως. Σκοπός αυτής της διδακτορικής διατριβής ήταν η ανάλυση ψηφιακών δεδομένων προερχομένων κυρίως από ιατρικές εικόνες, αλλά και από βιολογικά δείγματα, ασθενών με καρδιαγγειακές παθήσεις, με σκοπό την ανάδειξη σημαντικών βιοδεικτών για τις εν λόγω οντότητες. Κομβικό ρόλο στην επίλυση των ερευνητικών ερωτημάτων της παρούσας διατριβής κατέχει η μηχανική μάθηση, μέσω αλγορίθμων ταξινόμησης και παλινδρόμησης, αλλά και η αυτόνομη εφαρμογή που αναπτύχθηκε, ικανή να εκτελεί ανάγνωση και προσαρμοσμένη οπτικοποίηση των εικόνων τομογραφίας εκπομπής ποζιτρονίων (Positron Emission Tomography, PET)/αξονικής τομογραφίας (Computed Tomography, CT), μέσω της οποίας μελετήθηκαν και αναλύθηκαν τα ερωτήματα που πραγματεύθηκαν στη διατριβή. Αρχικά, μελετήθηκε η μεταβολή της πρόσληψης του ραδιοφαρμάκου στο αρτηριακό δίκτυο με την πάροδο του χρόνου και υλοποιήθηκαν προβλεπτικά μοντέλα εκτίμησης των μετρήσεων προτυποποιημένης τιμής πρόσληψης (standardized uptake value, SUV) σε διαφορετικές χρονικές στιγμές (Τ1, Τ2). Συλλέχτηκαν βιοϊατρικά δεδομένα 45 ατόμων που δεν είχαν κάποια ασθένεια όταν υποβλήθηκαν σε Φθοριοδεσοξυγλυκόζη (Fluorodeoxyglucose, 18F-FDG) PET/CT απεικόνιση. Αναπτύχθηκαν γραμμικά και μη γραμμικά μοντέλα παλινδρόμησης της διαφοράς του SUV (ΔSUV) και της χρονικής διαφοράς ΔΤ=Τ2-Τ1, βασιζόμενα στην ομάδα παραγωγής (30 ασθενείς) και ελέγχθηκαν σε μία ανεξάρτητη ομάδα επικύρωσης (15 ασθενείς). Τα μοντέλα παρουσίασαν πολύ καλή επαναληψιμότητα, με μικρές μη στατιστικώς σημαντικές διαφορές, πιθανώς περιορισμένης κλινικής σημασίας, μεταξύ του πραγματικού και του προβλεπόμενου SUV. Ένα άλλο επιστημονικό ερώτημα που προσεγγίστηκε στην παρούσα διατριβή, ήταν η ανάδειξη βιοδεικτών για την πρόβλεψη αθηρωματικής νόσου. Σε δύο διαφορετικά σύνολα ασθενών, με υψηλού βαθμού στένωση καρωτίδας και έχοντας υποβληθεί σε καρωτιδική ενδαρτηρεκτομή, μελετήθηκε η ανάλυση υφής για πρώτη φορά στη 18F-FDG PET/CT καρωτιδική απεικόνιση (1ο σύνολο) και η ανάλυση δεδομένων γονιδιακής έκφρασης από μικροσυστοιχίες δειγμάτων καρωτιδικής ενδαρτηρεκτομής μέσου και έξω χιτώνα του αγγειακού τοιχώματος από τον πυρήνα της αθηρωματικής πλάκας και από μακροσκοπικά υγιή ιστό (2ο σύνολο), τα οποία πάρθηκαν από τη διαδικτυακή βάση δεδομένων Gene Expression Omnibus (GEO). Σαν απεικονιστικοί βιοδείκτες εξήχθησαν 16 χαρακτηριστικά βάσει ιστογράμματος έντασης και 51 χαρακτηριστικά που βασίζονται σε διάφορους αναλυτικούς πίνακες που ήδη κωδικοποιούν συγκεκριμένες χωρικές σχέσεις μεταξύ των εικονοστοιχείων και χαρακτηρίζουν τη χωρική ετερογένεια. Τα διαφορικώς εκφρασμένα γονίδια (Differentially Expressed Genes, DEGs) ταξινομήθηκαν βάσει της απόλυτης τιμής του log Fold Change (logFC) και χρησιμοποιήθηκαν μεμονωμένα ως είσοδοι σε ταξινομητές με σκοπό την ανάδειξή τους σε πιθανούς βιοδείκτες. Μετά την ανάλυση των δεδομένων, μέσω αλγορίθμων μηχανικής μάθησης, αποδείχθηκε ότι η ανάλυση υφής μπορεί να χρησιμοποιηθεί σε συνδυασμό με την αγγειακή απεικόνιση ΡΕΤ και ενδεχομένως να παρέχει πολύτιμες συμπληρωματικές πληροφορίες σε σύγκριση με το λόγο πρόσληψης 18F-FDG της υπό εξέτασης ανατομικής δομής προς το αίμα (target to background ratio, TBR) σχετικά με τα βιολογικά χαρακτηριστικά της πλάκας που ενδέχεται να μη διακρίνονται από το ανθρώπινο μάτι. Παράλληλα, εντοπίστηκαν κρίσιμα γονίδια που εμπλέκονται στην ανάπτυξη της αθηροσκλήρωσης της καρωτίδας και μπορεί να αποτελούν πολύτιμοι θεραπευτικοί στόχοι και δείκτες πρόβλεψης για την αθηροσκλήρωσή της. Στη συνέχεια, διερευνήθηκε η ικανότητα αλγορίθμων μηχανικής μάθησης στην πρόβλεψη μεταβολών μυοκαρδιακής αιμάτωσης (myocardial perfusion) μέσω PET και τομογραφίας μονοφωτονιακής εκπομπής (Single Photon Emission Computer Tomography, SPECT) απεικόνισης, ενσωματώνοντας παραμέτρους που εξάγονται από τις εικόνες υπολογιστικής τομογραφίας στεφανιαίων αγγείων (Computed Tomography Coronary Angiography, CTCA), όπως την υπολογιστική δυναμική ρευστού, το φορτίο αθηρωματικής πλάκας, τη μορφολογία και τα ανατομικά χαρακτηριστικά αυτής, καθώς και χαρακτηριστικά υφής, εκτιμώμενης ως εφεδρεία στεφανιαίας ροής μυοκαρδίου (myocardial flow reserve, MFR) ή ως ροή αίματος μυοκαρδίου (myocardial blood flow, MBF). Τα αποτελέσματα έδειξαν ότι η μηχανική μάθηση φαίνεται να είναι αποτελεσματική στην πρόβλεψη παθολογικής μυοκαρδιακής αιμάτωσης. Μεταξύ των καλύτερων συνδυασμών χαρακτηριστικών, η ενδοθηλιακή διατμητική τάση (endothelial shear stress, ESS) στο εγγύς τμήμα ήταν το χαρακτηριστικό που εμφανίστηκε στις πρώτες θέσεις σε όλα τα σχήματα ταξινόμησης. Επιπλέον, η ανατομία της πλάκας και οι συνακόλουθες αλλαγές στη δυναμική του υγρού, όπως καταγράφονται από τo ESS, φαίνεται να είναι σημαντικοί πληροφοριακοί δείκτες για τη λειτουργική σημασία μιας στεφανιαίας βλάβης. Επιπλέον, τo ESS μπορεί να προσθέσει αξία στη σοβαρότητα της στένωσης, βελτιώνοντας την πρόβλεψη της εξασθενημένης αγγειοδιασταλτικής ικανότητας που αξιολογείται από το ΡΕΤ-ΜΡΙ (Myocardial Perfusion Imaging – απεικόνιση αιμάτωσης του μυοκαρδίου). Η ανάλυση υφής μπορεί να χρησιμοποιηθεί σε συνδυασμό με την απεικόνιση CTCA και ενδεχομένως να παρέχει πολύτιμες συμπληρωματικές πληροφορίες σε συνδυασμό με ανατομικά και μορφολογικά χαρακτηριστικά για την πρόβλεψη επαγώγιμων ανωμαλιών αιμάτωσης στο SPECT-MPI, οι οποίες ενδέχεται να μην συλλαμβάνονται από το ανθρώπινο μάτι.

scholarly journals Role of 18F-PET-CT to predict pathological response after neoadjuvant treatment of rectal cancer

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Riccardo Caruso ◽  
Emilio Vicente ◽  
Yolanda Quijano ◽  
Hipolito Duran ◽  
Isabel Fabra ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Fdg Pet ◽  
Locally Advanced ◽  
Neoadjuvant Treatment ◽  
Standardized Uptake Value ◽  
Tumour Regression Grade ◽  
Pet Ct ◽  
Significant Difference ◽  
18F Fdg ◽  
Fdg Pet Ct

Abstract Objectives Neoadjuvant chemoradiation (nCRT) is universally considered to be a valid treatment to achieve downstaging, to improve local disease control and to obtain better resectability in locally advanced rectal cancer (LARC). The aim of this study is to correlate the change in the tumour 18F-FDG PET-CT standardized uptake value (SUV) before and after nCRT, in order to obtain an early prediction of the pathologic response (pR) achieved in patients with LARC. Data description We performed a retrospective analysis of patients with LARC diagnosis who underwent curative resection. All patients underwent a baseline 18F-FDG PET-CT scan within the week prior to the initiation of the treatment (PET-CT SUV1) and a second scan (PET-CT SUV2) within 6 weeks of the completion of nCRT. We evaluated the prognostic value of 18F-FDG PET-CT in terms of disease-free survival (DFS) and overall survival (OS) in patients with LARC.A total of 133 patients with LARC were included in the study. Patients were divided in two groups according to the TRG (tumour regression grade): 107 (80%) as the responders group (TRG0-TRG1) and 26 (25%) as the no-responders group (TRG2-TRG3). We obtained a significant difference in Δ%SUV between the two different groups; responders versus no-responders (p < 0.012). The results of this analysis show that 18F-FDG PET-CT may be an indicator to evaluate the pR to nCRT in patients with LARC. The decrease in 18F-FDG PET-CT uptake in the primary tumour may offer important information in order for an early identification of those patients more likely to obtain a pCR to nCRT and to predict those who are unlikely to significantly regress.

scholarly journals Pulmonary Findings of [18F]FDG PET/CT Images on Asymptomatic COVID-19 Patients

Pathogens ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 839
Author(s):  
Tzu-Chuan Ho ◽  
Chin-Chuan Chang ◽  
Hung-Pin Chan ◽  
Ying-Fong Huang ◽  
Yi-Ming Arthur Chen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Fdg Pet ◽  
Standardized Uptake Value ◽  
Fdg Uptake ◽  
Asymptomatic Patients ◽  
Positron Emission ◽  
Pet Ct ◽  
18F Fdg ◽  
Maximal Standardized Uptake Value ◽  
Fdg Pet Ct

During the coronavirus disease 2019 (COVID-19) pandemic, several case studies demonstrated that many asymptomatic patients with COVID-19 underwent fluorine-18 fluorodeoxyglucose ([18F]FDG) positron emission tomography/computed tomography (PET/CT) examination for various indications. However, there is a lack of literature to characterize the pattern of [18F]FDG PET/CT imaging on asymptomatic COVID-19 patients. Therefore, a systematic review to analyze the pulmonary findings of [18F]FDG PET/CT on asymptomatic COVID-19 patients was conducted. This systematic review was performed under the guidelines of PRISMA. PubMed, Medline, and Web of Science were used to search for articles for this review. Articles with the key words: “asymptomatic”, “COVID-19”, “[18F]FDG PET/CT”, and “nuclear medicine” were searched for from 1 January 2020 to 20 May 2021. Thirty asymptomatic patients with COVID-19 were included in the eighteen articles. These patients had a mean age of 62.25 ± 14.85 years (male: 67.71 ± 12.00; female: 56.79 ± 15.81). [18F]FDG-avid lung lesions were found in 93.33% (28/30) of total patients. The major lesion was [18F]FDG-avid multiple ground-glass opacities (GGOs) in the peripheral or subpleural region in bilateral lungs, followed by the consolidation. The intensity of [18F]FDG uptake in multiple GGOs was 5.605 ± 2.914 (range from 2 to 12) for maximal standardized uptake value (SUVmax). [18F]FDG-avid thoracic lymph nodes (LN) were observed in 40% (12/40) of the patients. They mostly appeared in both mediastinal and hilar regions with an SUVmax of 5.8 ± 2.93 (range from 2.5 to 9.6). The [18F]FDG uptake was observed in multiple GGOs, as well as in the mediastinal and hilar LNs. These are common patterns in PET/CT of asymptomatic patients with COVID-19.

POSITRON EMISSION TOMOGRAPHY WITH 18F -FDG IN THE DIAGNOSIS OF PROSTHETIC HEART VALVE ENDOCARDITIS

2021 ◽  
Vol 5 (1) ◽  
pp. 1151-1160
Author(s):  
A.S. Lukashevich ◽  
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Fdg Pet ◽  
Prosthetic Heart Valve ◽  
Emission Tomography ◽  
Whole Body ◽  
Positron Emission ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

Purpose. The purpose of the article is to evaluate the diagnostic significance of positron emission tomography / computed tomography with 18F -fluorodeoxyglucose (18F -FDG PET/CT) for the diagnosis of prosthetic endocarditis. Methods of research. The study included 82 patients with suspected prosthetic endocarditis in accordance with the criteria proposed by Duke University [1-5]. The patients received hospital treatment at the State Institution RSPC "Cardiology" from January 2016 to March 2021. The study was of a prospective, non-randomized, single-center cohort design. The duration of the monitor period was 12 months from the moment of patients’ inclusion in the study. Whole-body positron emission tomography / computed tomography (PET/CT) examinations were performed in 82 patients. 27 patients were selected for surgical treatment. Conservative treatment group included 16 patients. 27 patients were selected into the observation group, they were suspected to have prosthetic heart valve infection in the primary referral and underwent PET/CT scanning, according to which the diagnosis of prosthetic endocarditis was excluded. The event under the study did not develop in this group during the year of observation. Results and conclusion. The history of infective endocarditis was not statistically significant and did not increase the risk of developing prosthetic endocarditis in the sample presented. The Duke criteria are less reliable in establishing the diagnosis of prosthetic endocarditis. The median number of days from the date of the first prosthesis implantation to the onset of prosthetic endocarditis was about 4 years. This study revealed that the development of the infectious process in the area of the prosthesis was noted in a more distant postoperative period compared to literature data. Histological confirmation of infection was noted in 100% (27 patients) of cases in reoperated patients. The presence of a more formidable complication such as valve ring abscess located mainly in the projection of the aortic valve ring was quite common in both groups. Presepsin and Interleukin-6 have a statistically significant (U = 394,50 p = 0,01 and U = 94,50 p = 0.004) value in the prognosis of prosthetic endocarditis. Considering the data obtained from ROC analysis, it can be said that the cut-off point at which it is possible to diagnose prosthetic endocarditis based on PETCT is 2.85. The presented methods for the interpretation of whole-body FDG-PET/CT images of patients with suspected infectious complications after cardiac surgery, as well as with the presence of prosthetic endocarditis, show high sensitivity and specificity.

scholarly journals The Value of 18 Fluorine-fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Imaging in Breast Cancer Staging

2020 ◽  
Vol 8 (A) ◽  
pp. 970-975
Author(s):  
Ahmed Tawakol ◽  
Maha Khalil ◽  
Yasser G. Abdelhafez ◽  
Mai Hussein ◽  
Mohamed Fouad Osman
Keyword(s):  
Breast Cancer ◽  
Computed Tomography ◽  
Fdg Pet ◽  
Cancer Staging ◽  
Emission Tomography ◽  
Breast Cancer Staging ◽  
Positron Emission ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

BACKGROUND: Accurate staging is important for management decisions in patients with newly diagnosed breast cancer. AIM: This study was conducted to evaluate the value of 18 fluorine-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) imaging in breast cancer staging.. METHODS: A prospective study of 80 patients (1 male and 79 female) mean age 51.13 years with histologically confirmed breast cancer. The staging procedures included history, physical examination, mammography, and CT of neck, chest, abdomen, and pelvis; then, PET/CT was performed in a time interval <30 days. The findings of PET/CT were compared with those of the other conventional methods. RESULTS: The agreement between conventional methods (mammography, breast ultrasound, contrast-enhanced CT of the neck, chest, abdomen, and pelvis) and 18F FDG-PET/CT was 0.6 for assessing the T stage, 0.39 for N stage, and 0.75 for M stage. There was moderate agreement between CT and 18F FDG-PET/CT in the detection of nodal lesions (K=0.6) and pulmonary lesions (K=0.51), while a perfect agreement was noted for detecting osseous (K=0.82) and liver lesions (K=0.81). In total, 50 patients (62.5%) were concordantly staged between the conventional imaging and 18F-FDG PET/CT, while 30 patients (37.5%) showed a different tumor, node, and metastasis stage. The changes were driven by the detection of additional findings (n=26) or exclusion of findings (n=4), mainly at the lymph nodes (LNs) and/or distant sites. Regarding N status, 18F FDG-PET/CT revealed previously unknown regional lymphatic spread in supraclavicular (n=4; 5%), infraclavicular (n=11; 13.7%), and internal mammary (n=12; 15%) lymph node groups. 18F-FDG PET/CT changed M status in a total of four patients (5%); three of them were upstaged by detecting distant metastases, while osseous deposits were excluded in one patient leading to downstaging. CONCLUSION: 18F-FDG-PET/CT is considered a valuable imaging tool in the initial staging of breast cancer, which significantly impacts the overall American Joint Committee on Cancer staging in 37.5% of our study population.

scholarly journals Nuclear Imaging in Infective Endocarditis

2021 ◽  
Vol 15 (1) ◽  
pp. 14
Author(s):  
Nidaa Mikail ◽  
Fabien Hyafil
Keyword(s):  
Computed Tomography ◽  
Infective Endocarditis ◽  
Fdg Pet ◽  
Imaging Techniques ◽  
Nuclear Imaging ◽  
Emission Tomography ◽  
Cardiac Devices ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

Infective endocarditis (IE) is a life-threatening disease with stable prevalence despite prophylactic, diagnostic, and therapeutic advances. In parallel to the growing number of cardiac devices implanted, the number of patients developing IE on prosthetic valves and cardiac implanted electronic device (CIED) is increasing at a rapid pace. The diagnosis of IE is particularly challenging, and currently relies on the Duke-Li modified classification, which include clinical, microbiological, and imaging criteria. While echocardiography remains the first line imaging technique, especially in native valve endocarditis, the incremental value of two nuclear imaging techniques, 18F-fluorodeoxyglucose positron emission tomography with computed tomography (18F-FDG-PET/CT) and white blood cells single photon emission tomography with computed tomography (WBC-SPECT), has emerged for the management of prosthetic valve and CIED IE. In this review, we will summarize the procedures for image acquisition, discuss the role of 18F-FDG-PET/CT and WBC-SPECT imaging in different clinical situations of IE, and review the respective diagnostic performance of these nuclear imaging techniques and their integration into the diagnostic algorithm for patients with a suspicion of IE.

Role of 18F-PET-CT to Predict Pathological Response After Neoadjuvant Treatment of Rectal Cancer

2021 ◽  
Author(s):  
Riccardo Caruso ◽  
Emilio Vicente ◽  
Yolanda Quijano ◽  
Hipolito Duran ◽  
Isabel Fabra ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Fdg Pet ◽  
Locally Advanced ◽  
Neoadjuvant Treatment ◽  
Standardized Uptake Value ◽  
Disease Free Survival ◽  
Pet Ct ◽  
Significant Difference ◽  
18F Fdg ◽  
Fdg Pet Ct

Abstract Objectives: Neoadjuvant radiochemotherapy (nCRT) is universally considered to be a valid treatment to achieve downstaging, improve local disease control and obtain better resectability in locally advanced rectal cancer (LARC). The aim of this study is to correlate the change in tumor 18F -FDG PET-CT standardized uptake value (SUV) before and after nCRT, in order to obtain an early prediction of pathologic response (pR) achieved in patients with LARC.Data description: We performed a retrospective analysis of patients with LARC diagnosis who underwent curative resection. All patients received nCRT and surgical treatment was carried after 8/12th. All patients underwent a baseline 18F -FDG PET-CT scan within the week prior to the initiation of the treatment (PET-CT SUV1) and a second scan (PET-C T SUV2) within six weeks of the completion of nCRT. Furthermore, we evaluated the prognostic value of 18F -FDG PET-CT in terms of disease free survival (DFS) and overall survival (OS) in patients with LARC.A total of 133 patients with LARC were included in the study. Patients were divided in two groups according to the TRG (tumor regression grade): 107 (80%) as Responders group (TRG0-TRG1) and 26 (25%) as the No-Responders group (TRG2-TRG3). We obtained a significant difference in Δ%SUV between the two different groups responders vs no responders (p<0.012).The results of this analysis have shown that 18F-FDG PET-CT may be an indicator in order to evaluate the pR to nCRT in patients with LARC. The decrease in 18F-FDG PET-CT uptake in the primary tumor may offer primary information in order to early identify those patients more likely to obtain a pCR to nCRT and predict those unlikely to regress significantly.

scholarly journals Clinical Impact of 18F-FDG PET/CT in the Diagnostic Workup of Pancreatic Ductal Adenocarcinoma: A Systematic Review

Diagnostics ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 1042
Author(s):  
Annachiara Arnone ◽  
Riccardo Laudicella ◽  
Federico Caobelli ◽  
Priscilla Guglielmo ◽  
Marianna Spallino ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Pancreatic Ductal Adenocarcinoma ◽  
Fdg Pet ◽  
Emission Tomography ◽  
Ductal Adenocarcinoma ◽  
Positron Emission ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

In this review, the performance of fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) in the diagnostic workup of pancreatic ductal adenocarcinoma (PDAC) is evaluated. A comprehensive literature search up to September 2020 was performed, selecting studies with the presence of: sample size ≥10 patients and index test (i.e., “FDG” or “18F-FDG” AND “pancreatic adenocarcinoma” or “pancreas cancer” AND “PET” or “positron emission tomography”). The methodological quality was evaluated using the revised quality assessment of diagnostic accuracy studies (QUADAS-2) tool and presented according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Basic data (authors, year of publication, country and study design), patients’ characteristics (number of enrolled subjects and age), disease phase, type of treatment and grading were retrieved. Forty-six articles met the adopted research criteria. The articles were divided according to the considered clinical context. Namely, besides conventional anatomical imaging, such as computed tomography (CT) and magnetic resonance imaging (MRI), molecular imaging with FDG PET/CT is an important tool in PDAC, for all disease stages. Further prospective studies will be necessary to confirm the cost-effectiveness of such imaging techniques by testing its real potential improvement in the clinical management of PDAC.

scholarly journals 18F FDG PET-CT Imaging in Tuberculosis

2018 ◽  
Vol 19 (2) ◽  
pp. 135
Author(s):  
Shamim MF Begum ◽  
Md Abdus Shakur Khan
Keyword(s):  
Computed Tomography ◽  
Fdg Pet ◽  
Ct Imaging ◽  
Medical Emergency ◽  
Imaging Features ◽  
Conventional Imaging ◽  
Imaging Tool ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

<p>Tuberculosis (TB) is the second highest infective cause of death worldwide and the global impact of TB is very important. Among all the TB burden WHO regions, 40% TB cases accounts in the South East Asian region. It has become a medical emergency not only in developing countries but also in some high-income countries. The rising incidence of multidrug resistance (MDR) TB and HIV co-infection has increased the morbidity and mortality of TB despite the availability of cheap and effective treatment. The diagnosis of active TB is almost similar over the world. Conventional radiography and Computed Tomography (CT) imaging play a crucial role in the diagnosis of TB. But these conventional imaging are often nonspecific and unable to provide a definitive diagnosis in cases of atypical and heterogeneous presentation. The signs of TB may mimic other diseases in conventional imaging. The introduction of new imaging tool Fluorine18 Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography (18F FDG PET-CT) opens the door to evaluate its potentiality application in TB. The role of this new imaging tool in TB imaging has been well documented. 18F FDG PET-CT may assist in early diagnosis, facilitate differentiation between malignancies and TB, identification of extrapulmonary TB, staging of TB, and in assessment of treatment response. Therefore, familiarity with the spectrum of imaging features and understanding the use of 18F FDG PET-CT in diagnosis and management of TB is important, especially for referring clinicians and the reporting nuclear medicine specialists in TB burden country like Bangladesh. This article reviews the main applications, pattern of imaging spectrum with limitations of 18F FDG PET-CT in TB.</p><p>Bangladesh J. Nuclear Med. 19(2): 135-140, July 2016</p>

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