Bhattacharya Bisakh, Damle Nishikant, Ranjan Piyush, Arora Geetanjali, Prakash Sneha, Nischal Neeraj, Jorwal Pankaj, Kumar Arvind, Tyagi Apoorva, Wig Naveet
Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.
Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India.
Indian J Nucl Med. 2022 Oct-Dec;37(4):323-328. doi: 10.4103/ijnm.ijnm_207_21. Epub 2022 Dec 2.
The purpose of the study is to evaluate Tc-labeled ethambutol (Tc-EMB) as a potential diagnostic agent in lymph node tuberculosis (LNTB).
A prospective pilot study was done at All India Institute of Medical Sciences, New Delhi. We included adult consenting patients who were diagnosed with LNTB and were either treatment naïve or had just started treatment. Patients were injected with 10-15 mCi of Tc-EMB. Whole-body anteroposterior planar imaging was done from 15 min after injection at serial intervals till 4-6 h along with one single-photon emission computed tomography-computed tomography (SPECT-CT) imaging with the help of a dual-head SPECT-CT gamma camera. The uptake of Tc-EMB was analyzed and corroborated with clinicoradiological findings.
Between January 2019 and November 2020, we recruited 23 patients who underwent Tc-EMB, and 19 scans were interpretable and considered for analysis. Cervical lymphadenopathy was the most common presentation (13, 68.42%), followed by mediastinal (9, 47.36%) and abdominal (4, 21.05%) nodes. Other involvement included pulmonary (8, 42.1%), gastrointestinal (3, 15.78%), and chest wall abscess and bone marrow deposits in 1 patient each. A positive scan was noted in 7 (53.84%) patients with cervical lymphadenopathy, whereas uptake in abdominal and mediastinal lymph nodes was seen in 1 (25%) and 2 (22.22%) cases, respectively. Uptake in pulmonary lesions was noted in 3 (37.5%), but uptake in hepatic and splenic lesions was not seen.
Tc-EMB scan can demonstrate drug penetrance in some patients with LNTB and should be explored further with a larger sample size.
本研究旨在评估锝标记乙胺丁醇（Tc-EMB）作为淋巴结结核（LNTB）潜在诊断剂的价值。
在新德里全印度医学科学研究所进行了一项前瞻性初步研究。我们纳入了成年自愿参与的患者，这些患者被诊断为LNTB，要么是初治患者，要么是刚开始治疗的患者。给患者注射10 - 15毫居里的Tc-EMB。注射后15分钟开始，每隔一段时间进行全身前后位平面成像，直至4 - 6小时，同时借助双头SPECT-CT伽马相机进行一次单光子发射计算机断层扫描-计算机断层扫描（SPECT-CT）成像。分析Tc-EMB的摄取情况，并与临床放射学结果进行对照。
在2019年1月至2020年11月期间，我们招募了23例接受Tc-EMB检查的患者，其中19次扫描结果可解读并纳入分析。颈部淋巴结肿大是最常见的表现（13例，68.42%），其次是纵隔淋巴结（9例，47.36%）和腹部淋巴结（4例，21.05%）。其他受累部位包括肺部（8例，42.1%）、胃肠道（3例，15.78%），还有1例患者出现胸壁脓肿和骨髓沉积。7例（53.84%）颈部淋巴结肿大患者扫描结果呈阳性，而腹部和纵隔淋巴结摄取分别见于1例（25%）和2例（22.22%）。3例（37.5%）肺部病变有摄取，但肝脏和脾脏病变未见摄取。
Tc-EMB扫描可在部分LNTB患者中显示药物渗透情况，应通过更大样本量进一步探索。
