Quantitative 18F-FDG PET-CT scan characteristics correlate with tuberculosis treatment response. Malherbe, S. T.; Chen, R. Y.; Dupont, P.; Kant, I.; Kriel, M.; Loxton, A. G.; Smith, B.; Beltran, C. G.; van Zyl, S.; McAnda, S.; Abrahams, C.; Maasdorp, E.; Doruyter, A.; Via, L. E.; Barry, C. E.; Alland, D.; Richards, S. G.; Ellman, A.; Peppard, T.; Belisle, J.; Tromp, G.; Ronacher, K.; Warwick, J. M.; Winter, J.; and Walzl, G. EJNMMI Research, 10(1):8, Springer, dec, 2020.
Quantitative 18F-FDG PET-CT scan characteristics correlate with tuberculosis treatment response [link]Paper  doi  abstract   bibtex   
Background: There is a growing interest in the use of F-18 FDG PET-CT to monitor tuberculosis (TB) treatment response. Tuberculosis lung lesions are often complex and diffuse, with dynamic changes during treatment and persisting metabolic activity after apparent clinical cure. This poses a challenge in quantifying scan-based markers of burden of disease and disease activity. We used semi-automated, whole lung quantification of lung lesions to analyse serial FDG PET-CT scans from the Catalysis TB Treatment Response Cohort to identify characteristics that best correlated with clinical and microbiological outcomes. Results: Quantified scan metrics were already associated with clinical outcomes at diagnosis and 1 month after treatment, with further improved accuracy to differentiate clinical outcomes after standard treatment duration (month 6). A high cavity volume showed the strongest association with a risk of treatment failure (AUC 0.81 to predict failure at diagnosis), while a suboptimal reduction of the total glycolytic activity in lung lesions during treatment had the strongest association with recurrent disease (AUC 0.8 to predict pooled unfavourable outcomes). During the first year after TB treatment lesion burden reduced; but for many patients, there were continued dynamic changes of individual lesions. Conclusions: Quantification of FDG PET-CT images better characterised TB treatment outcomes than qualitative scan patterns and robustly measured the burden of disease. In future, validated metrics may be used to stratify patients and help evaluate the effectiveness of TB treatment modalities.
@article{Malherbe2020,
abstract = {Background: There is a growing interest in the use of F-18 FDG PET-CT to monitor tuberculosis (TB) treatment response. Tuberculosis lung lesions are often complex and diffuse, with dynamic changes during treatment and persisting metabolic activity after apparent clinical cure. This poses a challenge in quantifying scan-based markers of burden of disease and disease activity. We used semi-automated, whole lung quantification of lung lesions to analyse serial FDG PET-CT scans from the Catalysis TB Treatment Response Cohort to identify characteristics that best correlated with clinical and microbiological outcomes. Results: Quantified scan metrics were already associated with clinical outcomes at diagnosis and 1 month after treatment, with further improved accuracy to differentiate clinical outcomes after standard treatment duration (month 6). A high cavity volume showed the strongest association with a risk of treatment failure (AUC 0.81 to predict failure at diagnosis), while a suboptimal reduction of the total glycolytic activity in lung lesions during treatment had the strongest association with recurrent disease (AUC 0.8 to predict pooled unfavourable outcomes). During the first year after TB treatment lesion burden reduced; but for many patients, there were continued dynamic changes of individual lesions. Conclusions: Quantification of FDG PET-CT images better characterised TB treatment outcomes than qualitative scan patterns and robustly measured the burden of disease. In future, validated metrics may be used to stratify patients and help evaluate the effectiveness of TB treatment modalities.},
author = {Malherbe, Stephanus T. and Chen, Ray Y. and Dupont, Patrick and Kant, Ilse and Kriel, Magdalena and Loxton, Andr{\'{e}} G. and Smith, Bronwyn and Beltran, Caroline G.G. and van Zyl, Susan and McAnda, Shirely and Abrahams, Charmaine and Maasdorp, Elizna and Doruyter, Alex and Via, Laura E. and Barry, Clifton E. and Alland, David and Richards, Stephanie Griffith and Ellman, Annare and Peppard, Thomas and Belisle, John and Tromp, Gerard and Ronacher, Katharina and Warwick, James M. and Winter, Jill and Walzl, Gerhard},
doi = {10.1186/s13550-020-0591-9},
file = {:C$\backslash$:/Users/Claire/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Malherbe et al. - 2020 - Quantitative 18F-FDG PET-CT scan characteristics correlate with tuberculosis treatment response.pdf:pdf},
issn = {2191219X},
journal = {EJNMMI Research},
keywords = {18F-FDG,Mycobacterium tuberculosis,OA,PET-CT,Quantified lung analysis,Quantitative imaging analysis,Tuberculosis,Tuberculosis treatment response,fund{\_}not{\_}ack,original},
mendeley-tags = {OA,fund{\_}not{\_}ack,original},
month = {dec},
number = {1},
pages = {8},
publisher = {Springer},
title = {{Quantitative 18F-FDG PET-CT scan characteristics correlate with tuberculosis treatment response}},
url = {https://ejnmmires.springeropen.com/articles/10.1186/s13550-020-0591-9},
volume = {10},
year = {2020}
}
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