F-18 FDG PET/CT and post-treatment lung function in adolescent tuberculosis
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Accepted version (early view)
Author(s)
Type
Journal Article
Abstract
Background: Data on post tuberculosis outcomes in adolescents are scarce. Although fluorine-18 fluorodeoxyglucose (FDG) positron emission
tomography/computed tomography (PET/CT) has been used in adult tuberculosis research, little is known about the association between PET/CT findings and functional outcomes in general.
Methods: Early FDG PET/CT images of fifty (n=50) adolescents (31 female, median age 17.2 years) with confirmed pulmonary tuberculosis were read visually and quantitative data of disease burden (total lung volume, cavity volume, total hard volume, and total glycolytic activity [TGA were extracted and tested for associations with clinical risk factors and spirometry measures after treatment completion.
Findings: Involvement of ≥3 lobes was present in 66% of adolescents, with consolidation in 84%, nodules in 92%, and cavities in 84%. Comparatively, smokers had lower TGA values (p= 0.034). Higher cavity volume was the strongest predictor of reduced forced expiratory volume in 1 second and forced vital capacity post-treatment (β= -1.78– -0.87; p=0.0024–0.047). Corrected total hard volume and corrected TGA were
associated with FEV1 and FVC z-scores, though no individual predictor coefficients survived correction for multiple comparisons.
Interpretation: PET/CT features in this adolescent cohort matched patterns described in adults and were frequently severe. Radiological severity measures were associated with poorer spirometry after treatment. More data, including longitudinal imaging and functional
outcomes, are required to better understand pathophysiology in this age group.
Funding: EDCTP, NIH, UKMRC, SA MRC, DFID, BMBF.
tomography/computed tomography (PET/CT) has been used in adult tuberculosis research, little is known about the association between PET/CT findings and functional outcomes in general.
Methods: Early FDG PET/CT images of fifty (n=50) adolescents (31 female, median age 17.2 years) with confirmed pulmonary tuberculosis were read visually and quantitative data of disease burden (total lung volume, cavity volume, total hard volume, and total glycolytic activity [TGA were extracted and tested for associations with clinical risk factors and spirometry measures after treatment completion.
Findings: Involvement of ≥3 lobes was present in 66% of adolescents, with consolidation in 84%, nodules in 92%, and cavities in 84%. Comparatively, smokers had lower TGA values (p= 0.034). Higher cavity volume was the strongest predictor of reduced forced expiratory volume in 1 second and forced vital capacity post-treatment (β= -1.78– -0.87; p=0.0024–0.047). Corrected total hard volume and corrected TGA were
associated with FEV1 and FVC z-scores, though no individual predictor coefficients survived correction for multiple comparisons.
Interpretation: PET/CT features in this adolescent cohort matched patterns described in adults and were frequently severe. Radiological severity measures were associated with poorer spirometry after treatment. More data, including longitudinal imaging and functional
outcomes, are required to better understand pathophysiology in this age group.
Funding: EDCTP, NIH, UKMRC, SA MRC, DFID, BMBF.
Date Issued
2026-07-14
Date Acceptance
2026-06-16
Citation
ERJ Open Research, 2026
ISSN
2312-0541
Publisher
European Respiratory Society
Journal / Book Title
ERJ Open Research
Copyright Statement
Copyright ©The authors 2026 This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0. For commercial reproduction rights and permissions contact permissions@ersnet.org
License URL
Identifier
10.1183/23120541.00484-2026)
Subjects
Tuberculosis
adolescent
FDG PET/CT
quantitative imaging analysis
post-tuberculosis
Publication Status
Published online
Date Publish Online
2026-07-14