Role of [18F]FDG - PET/CT Scan in Cervical Tuberculosis.

Background: Distribution and quantification of extra-pulmonary tuberculosis and elicitation of response antitubercular therapy via F18-Fluorodeoxyglucose Positron Emission-based Tomography/ Computed Tomography(F18-FDG PET/CT).

Materials and methods: This was a prospective Pilot study. In this study 30 patients of age between 15 to 36 years(mean 26.8±6.13years) were included. PET/CT scan was performed at the time of presentation(baseline) and after 2 months of anti-tubercular therapy to evaluate bacterial activity in different levels of cervical lymph nodes and changes in various parameters of lymph nodes such as size, conglomeration and abscess formation were included in the evaluation.

Result: In this study, 18 patients were of 18 to 30 years(60.0%), 3 patients were below 18 years(10.0%) and 9 patients above 30 years(30%). The female proportion was higher in our study population(53.3%). Node-positive status, conglomeration, and abscess were evaluated clinically. Maximum percentages were found in level II and level V groups. While minimum percentage was found in level I and level VI. We also found that in all patients of tubercular cervical lymphadenopathy, tubercular bacterial activity was found at some distant sites also the common sites were the lung(56.7%), mediastinum(53.3%), abdomen(36.7%) and bone(23.3%). The response of antitubercular therapy by F18 - FDG PET/CT scan after 2 months of treatment was checked. There was a significant change in standardized uptake value(SUV-max) pre-treatment and post-treatment at all distant sites except the bony site.

Conclusion: F18-FDG PET/CT scan is a non-invasive tool in monitoring the response of antitubercular chemotherapy in patients of extrapulmonary and multiorgan lymphadenopathy.