Table 1. Summary of published studies evaluating cavitation on chest radiograph or computerized tomography (CT) scan after anti-tuberculous treatment.
Reference | Design | Population | Relevant measure(s) | Frequencies |
---|---|---|---|---|
Sonnenberg (2000)20 | Prognostic cohort for TB outcomes (exclusion of MDR cases and those not cured of TB), stratified by HIV status | Gold miners in South Africa | Chest X-ray at 3 & 6 months after cure | Residual cavitation at cure - 69/326 (21%) |
[HIV strong first factor for TB recurrence among those without cavitation] | ||||
Bombarda (2003)21 | Repeat measures (unclear if losses to follow-up) during active disease and then after treatment conclusion | Referral hospital PTB patients | Repeated conventional CT scans | Thick-walled cavities post treatment 1/20 (5%) and thin-walled cavities post treatment 5/20 (25%); together, 30% |
? selected population | ||||
De Vallière (2004)19 | Post-treatment cross-sectional survey (reporting on 33/42 patients who completed treatment – no comment on selection) | Patients registered in MDR-TB programme in Limpopo province, South Africa | Chest X-ray based on two observers | % with cavities – observer 2, 17/33 (52%) to observer 1, 23/33 (70%) |
Hamilton (2008)17 | Prognostic cohort of post-treatment (6 months), 170 exclusions from 1 004 subjects primarily for missing test results | Multi-centre North American TB trials Consortium RCT | Chest X-ray, consensus criteria, reading kappa 0.54 for cavity (80% raw agreement) | EOT cavity, 23.3% (n = 834) in EOT chest X-ray analysis vs 19.1% among those excluded from main analysis (n = 170) |
Lee (2008)18 | Pre- and post-treatment repeat scans (excluded 31/83, primarily loss to follow-up, 23) | Taiwan, China, general hospital n = 52 | High resolution chest CT scan | Post-treatment, 18/52 (35%) vs pre-treatment, 38/52 (73%) |
EOT, end-of-treatment; HIV, human immunodeficiency virus; MDR, multi-drug resistant; PTB, pulmonary tuberculosis; RCT, randomized controlled trial; TB, tuberculosis.