Utility of preoperative 18F-flurodeoxyglucose PET/CT scanning in preoperative evaluation and surgical planning for pulmonary tuberculosis

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OBJECTIVE: The objective of this study was to investigate the utility of preoperative 18F-FDG PET/CT scanning in preoperative evaluation and surgical planning for pulmonary tuberculosis. METHODS: The study involved a retrospective analysis of clinical data and preoperative chest 18F-FDG PET/CT data of 24 patients with pulmonary tuberculosis who underwent pneumonectomy at the Shanghai Public Health Clinical Center between December 2017 and January 2022. RESULTS: All 24 patients successfully underwent chest 18F-FDG PET/CT imaging, and complete data pertaining to the maximum standardized uptake value, mean standardized uptake value, minimum standardized uptake value, total lesion glycolysis, and metabolic tumor volume were obtained. Surgical excision plans were finalized using the chest 18F-FDG PET/CT findings along with the conventional chest CT scans. Pneumonectomy was successfully completed in all 24 patients, and these included 13 cases of pulmonary lobectomy, two cases of total pneumonectomy, one case of combined pulmonary lobectomy, one case of segmentectomy, and seven cases of pulmonary wedge resection. The actual surgical procedures had a conformity rate of 100% to the preoperative surgical plans that were made. The intraoperative bronchial stump embedding rate was 69% (11/18 cases), the incidence rate of postoperative air leakage was 3.8% (1/24 cases), and there were no reported cases of postoperative bronchopleural fistula or death. CONCLUSION: Preoperative 18F-FDG PET/CT scans had significant utility in surgical planning, the selection of surgical methods, and the formulation of postoperative antituberculosis treatment courses for patients with pulmonary tuberculosis. The use of 18F-FDG PET/CT shows considerable promise in being promoted clinically for the surgical management of patients with pulmonary tuberculosis.

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