The purpose of this article is to demonstrate the appearance of active TB lymphadenitis using multimodality imaging apparatus. Multi-modality diagnostic imaging tools, including chest radiograph, Ultrasound (US), Computed Tomographic Scan (CT), Magnetic Resonance Imaging (MRI), and integrated 18F-FDG Positron Emission Tomography/CT examination, were performed to demonstrate TB lymphadenitis in the neck and superior mediastinum of a 26 year old female patient. There was widening of superior mediastinum on chest radiograph. Meanwhile, the ultrasound carried out detected superficial cystic lesions in the cervical region. The MRI found multiple gadolinium enhanced cervical and mediastinal lymphadenophaties. Contrast enhanced CT found heterogeneous enhancing lymphadenopathies in the same anatomical region. FDG PET/CT demonstrated a high metabolic activity in all lesions, as demonstrated by conventional imaging
modalities. Mycobacterium tuberculosis was isolated from 1ml aspirate using US guidance. Post treatment FDG PET CT scan demonstrated a complete metabolic remission of active lesions FDG PET CT can be used to demonstrate metabolic activity of active TB lesions in addition to guide clinicians in treating TB lesions.
Positron emission tomography (PET) combined with computed tomography (CT) is an established diagnostic modality that has become an essential imaging tool in oncological practice. However, thanks to its noninvasive nature and its capability to provide physiological information, the main applications of this technique have significantly expanded.(18)F-labelled fluorodeoxyglucose (FDG) is the most commonly used radiopharmaceutical for PET scanning and demonstrates metabolic activity in various tissues. Since activated inflammatory cells, like malignant cells, predominantly metabolise glucose as a source of energy and increase expression of glucose transporters when activated, FDG-PET/CT can be successfully used to detect and monitor a variety of lung diseases, such as infections and several inflammatory conditions.The added value of FDG-PET/CT as a molecular imaging technique relies on its capability to identify disease in very early stages, long before the appearance of structural changes detectable by conventional imaging. Furthermore, by detecting the active phase of infectious or inflammatory processes, disease progression and treatment efficacy can be monitored.This review will focus on the clinical use of FDG-PET/CT in nonmalignant pulmonary diseases.