Sarda-Mantel Laure, Kaoutar Jidar, Alfaiate Toni, Lopes Amanda, Paycha Frédéric, Benali Khadija, Mikail Nidaa, Soussan Michael, Lemarignier Charles, Méchaï Frédéric, Nagat Sophie Le, Montravers Françoise, Deradji Ouda, Durand Emmanuel, Goulenok Tiphaine, Ponscarme Diane, Yéni Patrick, Laouénan Cédric, Rioux Christophe
Nuclear Medicine Department, Lariboisière Hospital, APHP, Paris, France.
Infectious Diseases Department, Bichat Hospital, APHP, Paris, France.
Front Med (Lausanne). 2021 Aug 17;8:715115. doi: 10.3389/fmed.2021.715115. eCollection 2021.
In extra-pulmonary tuberculosis, therapeutic management is difficult in the absence of reliable tool to affirm healing at the end of treatment. In this prospective multicenter study, we evaluated [F]FDG-PET for this purpose. Forty-two patients out of 55 included patients could be analyzed. Additionally to usual biological, histological and morphological explorations, [F]FDG-PET was performed at diagnosis (PET1), at the end of treatment (PET2), indeed 6 months later. Then patients were followed until 12 months after end of prescribed treatment. PET1 was positive in 97.6% of patients and discovered unknown injured sites in 52.7% of cases. PET2 was positive in 83.3% of uncured patients, and in 82.3% of cured patients. The sum and mean value of SUV measured in PET/CT lesions decreased between PET1 and PET2 in all patients. Mean value of SUV (MSUV) and sum value of SUVmax on PET2 showed the highest AUC on ROC curves for the diagnosis of healing at the end of prescribed treatment; MSUV 3.5 on PET2 had a sensitivity of 76.5% and a specificity of 80.0% to affirm healing at the end of prescribed treatment. [F]FDG-PET/CT was useful at diagnosis, discovering unknown lesions in 52.7% of cases. MSUV on PET2 was the best criteria to affirm healing at the end of prescribed treatment.
在肺外结核病中，由于缺乏可靠的工具来确认治疗结束时的治愈情况，治疗管理存在困难。在这项前瞻性多中心研究中，我们为此评估了[F]FDG-PET。纳入研究的55例患者中有42例可进行分析。除了常规的生物学、组织学和形态学检查外，在诊断时（PET1）、治疗结束时（PET2）以及治疗结束6个月后均进行了[F]FDG-PET检查。然后对患者进行随访，直至规定治疗结束后12个月。PET1在97.6%的患者中呈阳性，在52.7%的病例中发现了未知的损伤部位。PET2在83.3%未治愈的患者和82.3%治愈的患者中呈阳性。在所有患者中，PET/CT病变中测量的SUV总和及平均值在PET1和PET2之间有所下降。PET2上的SUV平均值（MSUV）和SUVmax总和值在规定治疗结束时诊断治愈的ROC曲线上显示出最高的AUC；PET2上MSUV为3.5时，确认规定治疗结束时治愈的敏感性为76.5%，特异性为80.0%。[F]FDG-PET/CT在诊断时很有用，在52.7%的病例中发现了未知病变。PET2上的MSUV是确认规定治疗结束时治愈的最佳标准。
