PET–CT benchmarked detection and 5-year progression of asymptomatic tuberculosis: a longitudinal, prospective cohort study

作者：Hanif Esmail, Friedrich Thienemann, Bianca Sossen, Sandra Mukasa, Francisco Lakay, Jacob E. Munro, Liana Macpherson, James Warwick, René Goliath, Nashreen Omar-Davies, Emily Douglass, Amanda Jackson, Elizabeth M Streicher, Torben Heinsohn, Dylan Sheerin, Marilou Barrios, Saalikha Aziz, Keboile Serole, Remy Daroowala, Arshad Taliep, Petri Ahlers, Stephanus T. Malherbe, Rory Bowden, Rob M. Warren, Gerhard Walzl, Laura E. Via, Melanie Bahlo, Sandra V. Kik, Morten Rühwald, Karen R Jacobson, C Robert Horsburgh, Padmini Salgame, David Alland, Clifton E. Barry, JoAnne L Flynn, Jerrold J. Ellner, Anna K. Coussens, Robert J Wilkinson · 发表于：The Lancet Respiratory Medicine · 年份：2026 · DOI：10.1016/s2213-2600(26)00056-1 · 被引用次数：3 · 研究领域：Diagnosis and treatment of tuberculosis、Tuberculosis Research and Epidemiology、Hematological disorders and diagnostics

BACKGROUND: F]-fluorodeoxyglucose PET-CT) and compared with chest x-ray computer-aided detection (CAD). METHODS: We enrolled a prospective longitudinal cohort in Khayelitsha, Cape Town, South Africa, of asymptomatic, HIV-uninfected contacts aged 18-65 years of patients with rifampicin-resistant tuberculosis, a tuberculosis high-risk group not eligible for chemoprophylaxis. Participants underwent baseline PET-CT, chest x-ray, phlebotomy, and intensive sputum collection, and were classified into four PET-CT lung categories: consistent with tuberculosis, inactive tuberculosis, other lesions, and normal. Chest x-ray was processed by three types of CAD software (CAD4TB [version 7.0], qXR [version 3.0.0], and Lunit [version 3.1.4.111]). Follow-up included symptom-agnostic tuberculosis screening (23-38 months) and provincial register review (≤74 months), and a subgroup had repeat PET-CT (5-15 months). Tuberculosis was defined as bacteriologically confirmed or clinically diagnosed. The primary outcome measures were hazard ratio (HR) for tuberculosis diagnosis and treatment by baseline PET-CT lung abnormality category with normal as the reference group, and diagnostic performance of chest x-ray CAD software using area under the receiver operator characteristic curve (AUC). FINDINGS: 250 asymptomatic adults were enrolled between March 3, 2015, and Oct 11, 2017, irrespective of tuberculosis history or previous infection, and followed up for 1107 person-years (median 4·7 years [IQR 4·0-5...