Synergy of Bronchoscopy and HRCT in Predicting Disease Activity in Sputum Negative Pulmonary Tuberculosis

Background & Methods: The aim of the study was to evaluate the Synergy of Bronchoscopy and HRCT in Predicting Disease Activity in sputum negative Pulmonary Tuberculosis. HRCT scans were assessed for the presence of centri-lobular nodules, tree in bud pattern, larger nodules, masses, lobular consolidations, cavities, bronchoceles, ground glass opacities and mediastinal lymph node enlargement. Results: The most frequently observed CT findings (in order of decreasing frequency) were consolidation, mediastinal lymphadenopathy, tree-in-bud appearance, and nodules. Tree-in-bud nappearance was the only significant finding associated with active PTB status (P < 0.001, OR =&thinsp;5.10 [2.37–10.99, 95% CI]). Of the 21 PTB-confirmed patients, 16 (71.6%) patients were rapidly diagnosed in less than 1 week by bronchial washing AFB smear, CBNAAT and/or biopsy, and 5 patients were confirmed several weeks later by bronchial washing or sputum culture results. The sensitivity of FOB in the rapid diagnosis of active PTB was 75.9% (95% CI, 69.0–78.6%). Conclusion: HRCT alone was limited for the diagnosis of active PTB, but the combination of FOB and HRCT may improve the sensitivity of FOB in the rapid diagnosis of sputum smear-negative PTB. Based on our results, we suggest that physicians actively consider performing FOB and HRCT in sputum smear-negative patients suspected of TB.