Imperial College London
Professor Robert Wilkinson

ProfessorRobertWilkinson

Faculty of Medicine, Department of Infectious Disease

Professor in Infectious Diseases
 
 
 
//

Contact

 

r.j.wilkinson Website

 
 
//

Location

 

Commonwealth BuildingHammersmith Campus

//

Summary

 

Publications

Citation

BibTex format

@article{Chen:2021:10.1016/S2666-5247(21)00058-6,
author = {Chen, RY and Yu, X and Smith, B and Liu, X and Gao, J and Diacon, AH and Dawson, R and Tameris, M and Zhu, H and Qu, Y and Zhang, R and Pan, S and Jin, X and Goldfeder, LC and Cai, Y and Arora, K and Wang, J and Vincent, J and Malherbe, S and Thienemann, F and Wilkinson, RJ and Walzl, G and Barry, CE},
doi = {10.1016/S2666-5247(21)00058-6},
journal = {The Lancet Microbe},
pages = {E518--E526},
title = {Radiological and functional evidence of the bronchial spread of tuberculosis: an observational analysis},
url = {http://dx.doi.org/10.1016/S2666-5247(21)00058-6},
volume = {2},
year = {2021}
}
Download

RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundDirect bronchial spread of tuberculosis was extensively described in pre-antibiotic human pathology literature but this description has been overlooked in the post-antibiotic era, in which most pathology data come from animal models that emphasise the granuloma. Modern techniques, such as [18F]2-fluoro-2-deoxy-D-glucose (FDG) PET-CT scans, might provide further insight. Our aim was to understand normal early tuberculosis resolution patterns on pulmonary PET-CT scans in treated patients with tuberculosis who were subsequently cured.MethodsIn this observational analysis, we analysed data from PredictTB, an ongoing, prospective, randomised clinical trial that examined sequential baseline and week 4 FDG-PET-CT scans from participants successfully treated (sputum culture negative 18 months after enrolment) for drug-susceptible pulmonary tuberculosis in South Africa and China. Participants who were aged 18–75 years, GeneXpert MTB/RIF positive for tuberculosis and negative for rifampicin resistance, had not yet started tuberculosis treatment, had not been treated for active tuberculosis within the previous 3 years, and met basic safety laboratory criteria were included and participants with diabetes, HIV infection, or with extrapulmonary tuberculosis including pleural tuberculosis were excluded. Scans were assessed by two readers for the location of tuberculosis lesions (eg, cavities and consolidations), bronchial thickening patterns, and changes from baseline to week 4 of treatment.FindingsAmong the first 124 participants (enrolled from June 22, 2017, to Sept 27, 2018) who were successfully treated, 161 primarily apical cavitary lesions were identified at baseline. Bronchial thickening and inflammation linking non-cavitary consolidative lesions to cavities were observed in 121 (98%) of 124 participants' baseline PET-CT scans. After 4 weeks of treatment, 21 (17%) of 124 participants had new or expanding lesions linked to cavities via bronchial inflammation
AU  - Chen,RY
AU  - Yu,X
AU  - Smith,B
AU  - Liu,X
AU  - Gao,J
AU  - Diacon,AH
AU  - Dawson,R
AU  - Tameris,M
AU  - Zhu,H
AU  - Qu,Y
AU  - Zhang,R
AU  - Pan,S
AU  - Jin,X
AU  - Goldfeder,LC
AU  - Cai,Y
AU  - Arora,K
AU  - Wang,J
AU  - Vincent,J
AU  - Malherbe,S
AU  - Thienemann,F
AU  - Wilkinson,RJ
AU  - Walzl,G
AU  - Barry,CE
DO  - 10.1016/S2666-5247(21)00058-6
EP  - 526
PY  - 2021///
SN  - 2666-5247
SP  - 518
TI  - Radiological and functional evidence of the bronchial spread of tuberculosis: an observational analysis
T2  - The Lancet Microbe
UR  - http://dx.doi.org/10.1016/S2666-5247(21)00058-6
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000704457300011&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - https://www.sciencedirect.com/science/article/pii/S2666524721000586?via%3Dihub
UR  - http://hdl.handle.net/10044/1/92276
VL  - 2
ER  -
Download