Comparison of 68Ga-DOTATOC and 18F-FDG Thoracic Lymph Node and Pulmonary Lesion Uptake Using PET/CT in Postprimary Tuberculosis

Paulo Henrique Rosado-de-Castro; Thiago Pereira-de-Carvalho; Miriam Menna Barreto; Afrânio Lineu Kritski; Rebecca de Oliveira Souza; Sergio Altino de Almeida; Valéria Cavalcanti Rolla; Walter Araujo Zin; Alysson Roncally Silva Carvalho; Rosana Souza Rodrigues

doi:10.4269/ajtmh.21-0416

Comparison of 68Ga-DOTATOC and 18F-FDG Thoracic Lymph Node and Pulmonary Lesion Uptake Using PET/CT in Postprimary Tuberculosis

Am J Trop Med Hyg. 2022 Apr 4;106(5):1340-1344. doi: 10.4269/ajtmh.21-0416. Online ahead of print.

Authors

Affiliations

¹ Department of Internal Medicine, D'Or Institute for Research and Education, Botafogo, Rio de Janeiro, Brazil.
² Department of Radiology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
³ Institute of Biomedical Sciences, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
⁴ Department of Internal Medicine, Petropolis School of Medicine/Arthur Sá Earp Neto Faculty, Petropolis, Brazil.
⁵ Academic Tuberculosis Program, School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
⁶ Department of Statistical Methods, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
⁷ Clinical Research Laboratory on Mycobacteria, Evandro Chagas National Institute of Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil.
⁸ Laboratory of Respiration Physiology, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
⁹ Cardiovascular R&D Centre (UnIC), Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal.
¹⁰ Laboratory of Pulmonary Engineering, Biomedical Engineering Program, Alberto Luiz Coimbra Institute of Post-Graduation and Research in Engineering, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.

Abstract

Tuberculosis (TB) remains one of the world's leading infectious cause of morbidity and mortality. Positron emission tomography (PET) associated with computed tomography (CT) allows a structural and metabolic evaluation of TB lesions, being an excellent noninvasive alternative for understanding its pathogenesis. DOTATOC labeled with gallium-68 (68Ga-DOTATOC) can bind to somatostatin receptors present in activated macrophages and lymphocytes, cells with a fundamental role in TB pathogenesis. We describe 68Ga-DOTATOC uptake distribution and patterns in thoracic lymph nodes (LN) and pulmonary lesions (PL) in immunocompetent patients with active postprimary TB, analyze the relative LN/PL uptake, and compare this two tracer's uptake. High uptake of both radiotracers in PL and LN was demonstrated, with higher LN/PL ratio on 68Ga-DOTATOC (P < 0.05). Considering that LN in immunocompetent patients are poorly studied, 68Ga-DOTATOC can contribute to the understanding of the complex immunopathogenesis of TB.