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

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  • 1 Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India;
  • | 2 Department of Nuclear Medicine, SGPGIMS, Lucknow, Uttar Pradesh, India;
  • | 3 Department of Neurology, SGPGIMS, Lucknow, Uttar Pradesh, India;
  • | 4 Department of Microbiology, King George Medical University, Lucknow, Uttar Pradesh, India;
  • | 5 Department of Radiodiagnosis, King George Medical University, Lucknow, Uttar Pradesh, India

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, SGPGI, Lucknow, India, E-mails: gaambhir@yahoo.com and vivekkumarcsmmu@gmail.com. Vimal Kumar Paliwal, Department of Neurology, SGPGIMS, Lucknow, India, E-mail: dr_vimalkpaliwal@rediffmail.com; Amita Jain, Professor and Head, Department of microbiology, KGMU, Lucknow, India, E-mail: amita602002@yahoo.com.

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