Quantitative 18F-FDG PET-CT scan characteristics correlate with tuberculosis treatment response

dc.contributor.authorMalherbe, Stephanus T
dc.contributor.authorChen, Ray Y
dc.contributor.authorDupont, Patrick
dc.contributor.authorKant, Ilse
dc.contributor.authorKriel, Magdalena
dc.contributor.authorLoxton, André G
dc.contributor.authorSmith, Bronwyn
dc.contributor.authorBeltran, Caroline G G
dc.contributor.authorvan Zyl, Susan
dc.contributor.authorMcAnda, Shirely
dc.contributor.authorAbrahams, Charmaine
dc.contributor.authorMaasdorp, Elizna
dc.contributor.authorDoruyter, Alex
dc.contributor.authorVia, Laura E
dc.contributor.authorBarry, Clifton E
dc.contributor.authorAlland, David
dc.contributor.authorRichards, Stephanie G
dc.contributor.authorEllman, Annare
dc.contributor.authorPeppard, Thomas
dc.contributor.authorBelisle, John
dc.contributor.authorTromp, Gerard
dc.contributor.authorRonacher, Katharina
dc.contributor.authorWarwick, James M
dc.contributor.authorWinter, Jill
dc.contributor.authorWalzl, Gerhard
dc.date.accessioned2020-04-15T10:00:16Z
dc.date.available2020-04-15T10:00:16Z
dc.date.issued2020-02-10
dc.date.updated2020-02-18T10:55:22Z
dc.description.abstractAbstract 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.en_US
dc.identifier.apacitationMalherbe, S. T., Chen, R. Y., Dupont, P., Kant, I., Kriel, M., Loxton, A. G., ... Walzl, G. (2020). Quantitative 18F-FDG PET-CT scan characteristics correlate with tuberculosis treatment response. <i>EJNMMI Research</i>, 10(1), 8. en_ZA
dc.identifier.chicagocitationMalherbe, Stephanus T, Ray Y Chen, Patrick Dupont, Ilse Kant, Magdalena Kriel, André G Loxton, Bronwyn Smith, et al "Quantitative 18F-FDG PET-CT scan characteristics correlate with tuberculosis treatment response." <i>EJNMMI Research</i> 10, 1. (2020): 8. en_ZA
dc.identifier.citationMalherbe, S.T., Chen, R.Y., Dupont, P., Kant, I., Kriel, M., Loxton, A.G., Smith, B. & Beltran, C.G.G. et al. 2020. Quantitative 18F-FDG PET-CT scan characteristics correlate with tuberculosis treatment response. <i>EJNMMI Research.</i> 10(1):8. en_ZA
dc.identifier.issn2191-219X
dc.identifier.ris TY - Journal Article AU - Malherbe, Stephanus T AU - Chen, Ray Y AU - Dupont, Patrick AU - Kant, Ilse AU - Kriel, Magdalena AU - Loxton, André G AU - Smith, Bronwyn AU - Beltran, Caroline G G AU - van Zyl, Susan AU - McAnda, Shirely AU - Abrahams, Charmaine AU - Maasdorp, Elizna AU - Doruyter, Alex AU - Via, Laura E AU - Barry, Clifton E AU - Alland, David AU - Richards, Stephanie G AU - Ellman, Annare AU - Peppard, Thomas AU - Belisle, John AU - Tromp, Gerard AU - Ronacher, Katharina AU - Warwick, James M AU - Winter, Jill AU - Walzl, Gerhard AB - 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. DA - 2020-02-10 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - EJNMMI Research KW - Tuberculosis KW - 18F-FDG KW - PET-CT KW - Tuberculosis treatment response KW - Mycobacterium tuberculosis KW - Quantitative imaging analysis KW - Quantified lung analysis LK - https://open.uct.ac.za PY - 2020 SM - 2191-219X T1 - Quantitative 18F-FDG PET-CT scan characteristics correlate with tuberculosis treatment response TI - Quantitative 18F-FDG PET-CT scan characteristics correlate with tuberculosis treatment response UR - ER - en_ZA
dc.identifier.urihttps://doi.org/10.1186/s13550-020-0591-9
dc.identifier.urihttps://hdl.handle.net/11427/31635
dc.identifier.vancouvercitationMalherbe ST, Chen RY, Dupont P, Kant I, Kriel M, Loxton AG, et al. Quantitative 18F-FDG PET-CT scan characteristics correlate with tuberculosis treatment response. EJNMMI Research. 2020;10(1):8. .en_ZA
dc.language.isoenen_US
dc.language.rfc3066en
dc.publisher.departmentDivision of Human Geneticsen_US
dc.publisher.facultyFaculty of Health Sciencesen_US
dc.rights.holderThe Author(s).
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_US
dc.sourceEJNMMI Researchen_US
dc.source.journalissue1en_US
dc.source.journalvolume10en_US
dc.source.pagination8en_US
dc.source.urihttps://ejnmmires.springeropen.com/
dc.subjectTuberculosisen_US
dc.subject18F-FDGen_US
dc.subjectPET-CTen_US
dc.subjectTuberculosis treatment responseen_US
dc.subjectMycobacterium tuberculosisen_US
dc.subjectQuantitative imaging analysisen_US
dc.subjectQuantified lung analysisen_US
dc.titleQuantitative 18F-FDG PET-CT scan characteristics correlate with tuberculosis treatment responseen_US
dc.typeJournal Articleen_US
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