Quantitative drug distribution in human pulmonary lesions. Closed nodules, cavity wall and cavity caseum samples from each subject were homogenized prior to measuring the concentrations of INH (a), RIF (b), PZA (c), and MXF (d). Each subject contributed an average of 11 to 12 lesions. The major metabolites of INH (acetyl-INH), RIF (desacetyl-RIF) and PZA (POA) are shown as black empty symbols in a,b,c. Note that INH is a prodrug activated by M. tuberculosis’ catalase, the product of which forms transient NAD adducts that may display a distinct distribution pattern but cannot be captured by LCMS or MALDI imaging. The dotted line indicates the lower limit of quantitation. The clear and grey shaded boxes (a,b,d) represent clinical MIC32 and MAC6 ranges, respectively. The orange shaded box in c is the range of PZA activity in acidic conditions13.