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J Nucl Med. 2008; 49 (Supplement 1):248P
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General Clinical Specialties: General Practice-Oncology

General Practice-Oncology Posters

Pictures of tuberculosis in 18F-FDG PET/CT scan at cancer patients

Chih Wu1, Chiang Lee2 and Jih Hsieh2

1 Division of Nuclear Medicine, Department of Medical Image, Chi Mei Medical Center, Liouying, Liouying Township, Taiwan; 2 Chi Mei Medical Center, Yungkang, Tainan, Taiwan

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Objectives: The 18F-FDG PET/CT scan has been powerfully used in the cancer patients. Owing to poor immunity of the cancer patients, unusual infection was occasionally occurred. Taiwan is an endemic area of tuberculosis (TB). The study is hope to understand the TB pictures in 18F-FDG PET/CT scan for getting correct diagnosis to decrease the false positive rate of cancer progression.

Methods: From Mar., 2005 through Dec., 2007, We performed 2850 FDG PET/CT scans for diagnosis or staging of cancer. We retrospectively reviewed 34 cases with TB infection and 42 scans and grouped the TB pictures. 20 cases are proved by culture or acid-fast stain of sputum or histopathologically by means of operation or CT-guided biopsy. The other 14 cases have the TB history and pictures with sequential clinically follow up.

Results: There are five patterns of TB infection. 5 cases of far-advanced pneumonia with complete and intensive FDG uptake are simultaneously positive in culture or acid-fast stain of sputum. 7 cases of pneumonia with obvious and uneven FDG uptake are with or without old TB appearance. 14 cases of TB lesions with only faint FDG uptake are negative in sequentially serial culture or acid-fast stain of sputum. 5 cases show nodular appearance with variable FDG uptake. 3 cases of cancer lesion combined with caseation necrosis are only diagnosed pathologically.

Conclusions: It is concluded that the more intensive FDG uptake is revealed, the more active or even open stage of TB infection is detected easily by culture or acid-fast stain of sputum. Nodular pattern is difficult to differentiate the nature only by FDG uptake. But the nodule with lower FDG uptake that is combined with old TB appearance has the higher probability to identify the nature of TB granuloma.





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