Abstract
1153
Objectives: Tuberculosis (TB), caused by Mycobacterium tuberculosis is recognized as an infectious disease that can involve virtually any tissue/ organ from the head to toe. Lungs are the most commonly involved organs; however, a sizeable population has involvement of the extra-pulmonary tissue, with sparing of the lungs (Extra-pulmonary TB; EPTB). Because of the widely varying disease presentations and multi-tissue involvement, the clinical and imaging patterns are often difficult to interpret. 18F-FDG PET/CT forms a valuable modality in the diagnostic workup of these patients, especially those with EPTB by providing a whole-body assessment of the disease burden. The aim of this exhibit is to familiarize the readers with the multitudinous patterns of TB on 18F-FDG PET/CT whole-body imaging, which can improve diagnostic accuracy.
Methods: Records of patients with TB who underwent 18F-FDG PET/CT were retrospectively reviewed. Cases with classical as well as challenging imaging findings, were short-listed for the exhibit along with a brief review of the clinical findings. Classical presentations, being the most common should be promptly identified and point strongly towards the diagnosis. Uncommon presentations reinforce the diverse nature of the disease and require prior acquaintance for pattern recognition later on.
Results: System/ Organ wise involvement of TB on 18F-FDG PET/CT is presented, including pulmonary TB (lymphadenopathy, pleural and parenchymal involvement, military pattern), musculoskeletal TB (Potts’ spine, Poncet’s arthritis), gastro-intestinal TB (Tubercular cocoon, ileo-caecal TB), genito-urinary TB (adrenal, renal, genital TB), TB of the central nervous system (TB meningitis, tuberculomas, TB of the spinal cord), Ocular TB.
Conclusions: Tuberculosis is one of the leading infectious diseases in endemic nations with substantial disease morbidity and mortality. It was one of the top 10 causes of death worldwide in the year 2018. Prompt diagnosis and appropriate treatment are the key to achieving complete cure. 18F-FDG PET/CT is being increasing utilized for the assessment of disease burden in these patients and in several cases can provide a suspicion of TB in patients undergoing the study for a different indication. This exhibit illustrates the common and uncommon presentations of TB on 18F-FDG PET/CT to help the readers understand the spectrum of disease and have a high degree of suspicion while reading the scans, especially in a high-risk population.