• 1.

    Garg RK, 1999. Tuberculosis of the central nervous system. Postgrad Med J 75: 133140.

  • 2.

    Thao LTP et al., 2018. Prognostic models for 9-month mortality in tuberculous meningitis. Clin Infect Dis 66: 523532.

  • 3.

    Thwaites GE, van Toorn R, Schoeman J, 2013. Tuberculous meningitis: more questions, still too few answers. Lancet Neurol 12: 9991010.

  • 4.

    Garg RK, 2019. Microbiological diagnosis of tuberculous meningitis: phenotype to genotype. Indian J Med Res 150: 448.

  • 5.

    Kelloff GJ et al., 2005. Progress and promise of FDG-PET imaging for cancer patient management and oncologic drug development. Clin Cancer Res 11: 27852808.

    • Search Google Scholar
    • Export Citation
  • 6.

    Basu S, Alavi A, 2008. Role of FDG-PET in the clinical management of paraneoplastic neurological syndrome: detection of the underlying malignancy and the brain PET-MRI correlates. Mol Imaging Biol 10: 131137.

    • Search Google Scholar
    • Export Citation
  • 7.

    Eckert T, Barnes A, Dhawan V, Frucht S, Gordon MF, Feigin AS, Eidelberg D, 2005. FDG PET in the differential diagnosis of Parkinsonian disorders. Neuroimage 26: 912921.

    • Search Google Scholar
    • Export Citation
  • 8.

    Langer O et al., 2005. In vitro and in vivo evaluation of [18 F] ciprofloxacin for the imaging of bacterial infections with PET. Eur J Nucl Med Mol Imaging 32: 143150.

    • Search Google Scholar
    • Export Citation
  • 9.

    Goo JM, Im JG, Do KH, Yeo JS, Seo JB, Kim HY, Chung JK, 2000. Pulmonary tuberculoma evaluated by means of FDG PET: findings in 10 cases. Radiology 216: 117121.

    • Search Google Scholar
    • Export Citation
  • 10.

    Gambhir S, Kumar M, Ravina M, Bhoi SK, Kalita J, Misra UK, 2016. Role of 18F-FDG PET in demonstrating disease burden in patients with tuberculous meningitis. J Neurol Sci 370: 196200.

    • Search Google Scholar
    • Export Citation
  • 11.

    Jain A et al., 2020. 18FDG-PET is sensitive tool for detection of extracranial tuberculous foci in central nervous system tuberculosis—preliminary observations from a tertiary care center in northern India. J Neurol Sci 409: 116585.

    • Search Google Scholar
    • Export Citation
  • 12.

    Marais S, Thwaites G, Schoeman JF, Török ME, Misra UK, Prasad K, Donald PR, Wilkinson RJ, Marais BJ, 2010. Tuberculous meningitis: a uniform case definition for use in clinical research. Lancet Infect Dis 10: 803812.

    • Search Google Scholar
    • Export Citation
  • 13.

    Thwaites GE et al., 2004. Dexamethasone for the treatment of tuberculous meningitis in adolescents and adults. N Engl J Med 351: 17411751.

  • 14.

    World Health Organization , 2010. Guidelines for Treatment of Tuberculosis, 4th ed. Geneva, Switzerland: WHO. Available at: http://apps.who.int/iris/bitstream/10665/44165/1/9789241547833_eng.pdf?ua=1&a=1. Accessed January 17, 2021.

  • 15.

    Rangaraju S, Haussen D, Nogueira RG, Nahab F, Frankel M, 2017. Comparison of 3-month stroke disability and quality of life across modified Rankin scale categories. Intervent Neurol 6: 3641.

    • Search Google Scholar
    • Export Citation
  • 16.

    Uniyal R, Garg RK, Malhotra HS, Kumar N, Jain A, Kohli N, Kumar S, Pandey S, Rizvi I, 2019. Computed tomography thorax abnormalities in immunocompetent patients with tuberculous meningitis: an observational study. J Neurol Sci 397: 1115.

    • Search Google Scholar
    • Export Citation
  • 17.

    Modi M et al., 2017. Clinical and radiological predictors of outcome in tubercular meningitis: a prospective study of 209 patients. Clin Neurol Neurosurg 161: 2934.

    • Search Google Scholar
    • Export Citation
  • 18.

    Pratt PC, 1979. Pathology of tuberculosis. Semin Roentgenol 14: 196203.

  • 19.

    Louveau A, Harris TH, Kipnis J, 2015. Revisiting the mechanisms of CNS immune privilege. Trends Immunol 36: 569577.

Past two years Past Year Past 30 Days
Abstract Views 441 305 32
Full Text Views 127 41 0
PDF Downloads 113 37 0
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 

 

 

18FDG-Positron Emission Tomography in patients with Tuberculous Meningitis: A Prospective Evaluation

Harish NigamDepartment of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India;

Search for other papers by Harish Nigam in
Current site
Google Scholar
PubMed
Close
,
Sanjay GambhirDepartment of Nuclear Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India;

Search for other papers by Sanjay Gambhir in
Current site
Google Scholar
PubMed
Close
,
Shweta PandeyDepartment of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India;

Search for other papers by Shweta Pandey in
Current site
Google Scholar
PubMed
Close
,
Ravindra Kumar GargDepartment of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India;

Search for other papers by Ravindra Kumar Garg in
Current site
Google Scholar
PubMed
Close
,
Rajesh VermaDepartment of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India;

Search for other papers by Rajesh Verma in
Current site
Google Scholar
PubMed
Close
,
Vimal Kumar PaliwalDepartment of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India;

Search for other papers by Vimal Kumar Paliwal in
Current site
Google Scholar
PubMed
Close
,
Hardeep Singh MalhotraDepartment of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India;

Search for other papers by Hardeep Singh Malhotra in
Current site
Google Scholar
PubMed
Close
,
Praveen Kumar SharmaDepartment of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India;

Search for other papers by Praveen Kumar Sharma in
Current site
Google Scholar
PubMed
Close
,
Neeraj KumarDepartment of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India;

Search for other papers by Neeraj Kumar in
Current site
Google Scholar
PubMed
Close
,
Imran RizviDepartment of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India;

Search for other papers by Imran Rizvi in
Current site
Google Scholar
PubMed
Close
,
Amita JainDepartment of Microbiology, King George Medical University, Lucknow, Uttar Pradesh, India;

Search for other papers by Amita Jain in
Current site
Google Scholar
PubMed
Close
,
Neera KohliDepartment of Radiodiagnosis, King George Medical University, Lucknow, Uttar Pradesh, India

Search for other papers by Neera Kohli in
Current site
Google Scholar
PubMed
Close
,
Vivek Kumar SainiDepartment of Nuclear Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India;

Search for other papers by Vivek Kumar Saini in
Current site
Google Scholar
PubMed
Close
, and
Ravi UniyalDepartment of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India;

Search for other papers by Ravi Uniyal in
Current site
Google Scholar
PubMed
Close
Restricted access

ABSTRACT.

Lower yield of available diagnostic tests for tuberculous meningitis (TBM) frequently causes delay in diagnosis. Recently, 18F-fluorodeoxyglucose positron emission tomography (FDG PET) has been used in infectious disorders such as pulmonary tuberculosis; however, it is rarely used in TBM. This study was aimed to ascertain the role of FDG PET in the diagnosis and determination of the extent of disease and prognosis in patients with TBM. After excluding unsuitable patients, 25 patients were subjected to whole-body PET–computed tomography (CT) image acquisition along with separate brain protocol with an integrated PET-CT device. FDG PET was found to be abnormal in 92% patients. Extracranial FDG uptake was observed in 80% patients. Most common extracranial site of involvement was lymph nodes (60%), followed by lung (56%), vertebral body (8%), genitourinary organs (8%), and spleen (4%). FDG PET observed extracranial involvement had 80% sensitivity and 20% specificity in detecting definite TBM cases. In conclusion, FDG PET may be a useful test in TBM evaluation.

Author Notes

Address correspondence to Ravi Uniyal, Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India 226003. E-mail: ravi.sun.uniyal@gmail.com

Authors’ addresses: Harish Nigam, Shweta Pandey, Ravindra Kumar Garg, Rajesh Verma, Hardeep Singh Malhotra, Praveen Kumar Sharma, Neeraj Kumar, Imran Rizvi, Neera Kohli, and Ravi Uniyal, Department of Neurology, King George Medical University, Lucknow, India, E-mails: harish.nigam007@gmail.com, dr.shweta.md@gmail.com, garg50@yahoo.com, drrajeshverma32@gmail.com, drhsmalhotra@gmail.com, pspgimer@gmail.com, neerajkumar@kgmcindia.edu, imranrizvi09@gmail.com, drneerakohli@gmail.com, and ravi.sun.uniyal@gmail.com. Sanjay Gambhir and Vivek Kumar Saini, Department of Nuclear Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India, E-mails: gaambhir@yahoo.com and vivekkumarcsmmu@gmail.com. Vimal Kumar Paliwal, Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India, E-mail: dr_vimalkpaliwal@rediffmail.com; Amita Jain, Professor and Head, Department of microbiology, KGMU, Lucknow, India, E-mail: amita602002@yahoo.com.

Save