Imaging Modalities in Tuberculosis

Comprehensive Summary

This research presented by Bomanji et al. conducted a systematic review of imaging studies to determine diagnostic accuracy for tuberculosis disease in predominantly pediatric patients. Imaging and clinical data were pulled from PubMed and Embase dating from 1972 to 2022 in patients with suspected or confirmed tuberculosis. The diagnostic yield and sensitivity of these imaging modalities were compared resulting in CT (CAT scan) being the most sensitive identifying TB more often than chest X-rays in all patients (n = 1244). MRI was comparatively able to detect lymph node disease, cavitation, and pleural effusion more accurately than chest X-rays thereby delineating its higher sensitivity and specificity. The findings ranked CT as highest in diagnostic accuracy for TB patients, MRI, ultrasound, and then chest X-ray. Bomanji et al. acknowledged the limitation of observational evidence and a majority pediatric population.

Outcomes and Implications

Pediatric tuberculosis often necessitates advanced diagnostic imaging which is why identifying a mode of analysis is so critical for a population where labs studies can be inconclusive. MRI scans can also be considered for radiation avoidance especially in pediatric cohorts. However, cost and global accessibility are two clinical implications that should be taken into account when considering the practicality of imaging software.