Pulmonary Tuberculosis: Role of Radiology

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification for enrollments starting after March 18, 2024:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Computed Tomography: 2.00
Procedures: 2.00
Neck and Chest: 2.00

Radiography: 2.00
Procedures: 2.00
Thorax and Abdomen Procedures: 2.00

Registered Radiologist Assistant: 3.00
Patient Care: 0.25
Patient Management: 0.25
Procedures: 2.75
Thoracic Section: 2.75

Outline

1. Introduction
2. Risk Factors
3. Clinical Features
4. Active Tuberculosis
   1. Primary Tubersulosis
      1. Lymphadenopathy
      2. Parenchymal disease
      3. Pleural Effusion
      4. Airway Disease
   2. Miliary Tuberculosis
   3. Postprimary Tuberculosis
      1. Consolidation and Cavitation
      2. Centrilobular Nodules
   4. Tuberculosis in Immunocompromised Patients
   5. Pediatric Tuberculosis
5. Laboratory Evaluation of Active Tuberculosis
   1. Staining
   2. Culture
   3. Nucleic Acid Amplification Test
6. Latent Tuberculosis
7. Tests for Infection
   1. Tuberculin Skin Test
   2. Interferon-g Release Assays
   3. Screening Tests in Patients with Active Tuberculosis
8. Role of Imaging in Diagnosis and Management
9. Nontuberculous Myobacteria
10. Conclusion

Objectives

Upon completion of this course, students will:

1. be familiar with the causes of tuberculosis
2. know which factors affect the probability of transmission of tuberculosis from one individual to another
3. know the three categories of tuberculosis infection and what defines them
4. be familiar with how primary tuberculosis infections develop
5. understand which groups are at increased risk of exposure to tuberculosis
6. understand which groups are at higher risk of progression to active tuberculosis
7. know the typical symptoms of active tuberculosis
8. know the common sites for the spread of extrapulmonary tuberculosis
9. know why any radiologic finding that raises the possibility of active tuberculosis must be promptly communicated to the referring provider
10. be familiar with the appearance of lymphadenopathy on contrast-enhanced CT images
11. know how parenchymal disease most frequently manifests
12. be familiar with the appearance of pleural effusion on a radiograph
13. be familiar with the appearance of airway disease on a radiograph
14. be familiar with the appearance of miliary tuberculosis on a chest radiograph
15. be familiar with the appearance of miliary tuberculosis on CT images
16. be familiar with the appearance of tuberculous empyemas on a radiograph
17. know how patients with postprimary tuberculosis typically present
18. understand the role of imaging in patients with postprimary tuberculosis
19. know what percentage of patients with postprimary tuberculosis show cavitation on chest radiogaphs
20. know what percentage of patients with active tuberculosis show centrilobular nodules on CT images
21. understand how much more likely HIV-positive patients with latent tuberculosis infection are to develop active tuberculosis than HIV-negative patients
22. be familiar with laboratory testing for active tuberculosis
23. know the sensitivity of the smear for AFB in patients with culture-positive tuberculosis
24. know the sensitivity of the smear for AFB in HIV-positive patients
25. understand the features that are characteristic of inactive tuberculosis
26. understand the appropriate initial testing for patients suspected of having latent tuberculosis
27. know what the chest radiography report should indicate in patients suspected of having latent or inactive tuberculosis
28. understand the factors that can cause a false-positive result with the tuberculin skin test
29. understand the factors that can cause a false-negative result with the tuberculin skin test
30. know how the interferon-γ release assay test works
31. know the advantages of using the interferon-γ release assay test
32. be familiar with the initiation phase for patients with active tuberculosis
33. be familiar with the continuation phase for patients with active tuberculosis
34. understand the bactericidal phase for patients with active tuberculosis
35. know the typical treatment regimen for latent tuberculosis
36. be familiar with the clinical features of classic nontuberculous mycobacterial disease
37. be familiar with the clinical features of nonclassic nontuberculous mycobacterial disease
38. know the patient population that classic nontuberculous mycobacterial disease typically affects
39. know the patient population that nonclassic nontuberculous mycobacterial disease typically affects
40. be familiar with the typical treatment for nontuberculous mycobacterial disease