Evaluation of therapeutic response of tuberculoma using F-18FDG positron emission tomography

Background: Monitoring the response to antituberculosis (anti-TB) treatment can be difficult in patients with tuberculoma. We have retrospectively assessed the ability of F-18 fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) to evaluate the response to anti-TB treatment in patients with tuberculoma. Methods: Two patients with tuberculoma underwent repeat PET scans during anti-TB treatment. Changes in maximal standard uptake value (SUV) of the tuberculoma on PET images were analyzed between 2 scans. Initial PET scans were performed before the start of anti-TB treatment (T0), and later scans were performed after completion of treatment (T1). Results: In a 57-year-old female patient with clinical TB, maximal SUV of tuberculoma on PET scan decreased from 2.6 (at T0) to an undetectable value (at T1) at an interval of 187 days. In a 60-yearold woman with biopsy-proven TB, maximal SUV of tuberculoma on PET scan decreased from 4.8 (at T0) to 1.1 (at T1) at an interval of 192 days. Conclusion: PET scans may be useful for monitoring responses to anti-TB treatment in patients with tuberculoma.