A EVOLUÇÃO DA METODOLOGIA DE IMAGEM NA TUBERCULOSE

da radiografia ao PET Scan

Abstract

Pulmonary tuberculosis remains a global health problem and continues to have unacceptable rates of high morbidity and mortality. Diagnosis can be established rapidly by analyzing material from the bronchial tree, obtained spontaneously from sputum, through induced sputum or, in peculiar cases, by bronchoalveolar lavage. Imaging methods play a significant role in the evaluation of thoracic diseases, and chest radiography, along with sputum examination, remain the primary methods for the initial assessment of suspected cases of the disease and for monitoring patients with tuberculosis. Chest radiography can also be used as a screening method in the diagnosis of tuberculosis, particularly in confined populations, such as prisoners, where the incidence of the disease is significantly higher. The use of automatic radiographic report models using artificial intelligence has shown promise, suggesting potential interaction between radiologists and AI in improving the delivery of clinical care; however, validation in clinical context studies is still needed. Computed tomography, being more sensitive and specific than chest radiography, has been used as an excellent diagnostic tool for pulmonary tuberculosis in cases with negative sputum smear microscopy for acid-fast bacilli or chest radiography shows doubtful changes. Positron emission tomography (PET-Scan) has emerged as a complementary tool in the evaluation of pulmonary tuberculosis, by integrating metabolic and anatomical information.