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The Role of Chest CT Scanning in TB Outbreak Investigation

Cited 39 time in Web of Science Cited 40 time in Scopus
Authors
Lee, Sei Won; Jang, Yoon Soo; Park, Chang Min; Kang, Hee Yoon; Yim, Jae-Joon; Jeon, Kyeongman; Koh, Won-Jung
Issue Date
2010-05
Publisher
AMER COLL CHEST PHYSICIANS
Citation
CHEST; Vol.137 5; 1057-1064
Abstract
Background: In TB outbreaks, detecting active cases is the key step in stopping transmission of the disease. The aim of this study was to evaluate the role of high-resolution CT (HRCT) scanning of the chest in the investigation of a TB outbreak that developed in a cohort of 92 soldiers in the South Korean army. Methods: Outbreak investigation, including tuberculin skin test (TST), QuantiFERON TB Gold In-Tube (QFT) test, and simple chest radiograph (CXR), was performed. For participants with any abnormal findings in these tests, HRCT scanning was done. Active pulmonary TB was diagnosed based on sputum studies or HRCT scan findings. In addition, participants with positive results in both TST and QFT were treated as having a latent TB infection (LTBI). TST and QFT were repeated in participants with a positive result in one of these tests. CXR was repeated in all participants at 3 and 6 months of follow-up. Results: Eighty-seven participants completed the study protocol. Among them, 18 active TB cases were diagnosed. Nine of these had normal CXR, but had lesions that were suggestive of active TB on HRCT scan. Twenty-two participants with normal HRCT scans and positive results with TST and QFT at initial investigation were treated as LTBI. Among 13 participants with normal CXR and positive results in either TST or QFT, nine completed a 3-month investigation. All but one of nine participants revealed positive results in both tests. Conclusion: Inclusion of HRCT scanning in the outbreak investigation of TB may be helpful in differentiating active TB from LTBI more reliably. Trial registration: clinicaltrials.gov; Identifier: NCT00889759. CHEST 2010; 137(5):1057-1064
ISSN
0012-3692
Language
English
URI
http://hdl.handle.net/10371/78392
DOI
https://doi.org/10.1378/chest.09-1513
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College of Medicine/School of Medicine (의과대학/대학원)Radiology (영상의학전공)Journal Papers (저널논문_영상의학전공)
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