Association between the extent of intrapulmonary spread on chest CT and false-negative results of T-SPOT.TB in pulmonary tuberculosis: a retrospective study
Abstract Background The T-SPOT.TB assay is widely used for the adjunctive diagnosis of tuberculosis (TB). However, clinicians often encounter false-negative T-SPOT.TB results. The extent of TB spread may influence host immune functions, which can influence the results of the T-SPOT.TB test. However,...
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BMC
2025-03-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | https://doi.org/10.1186/s12879-025-10777-x |
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| author | Ryo Sato Naoki Takasaka Yusuke Hosaka Taiki Fukuda Kyota Shinfuku Makiko Takatsuka Tsukasa Hasegawa Masami Yamada Yumie Yamanaka Kai Ryu Takeo Ishikawa Jun Araya |
| author_facet | Ryo Sato Naoki Takasaka Yusuke Hosaka Taiki Fukuda Kyota Shinfuku Makiko Takatsuka Tsukasa Hasegawa Masami Yamada Yumie Yamanaka Kai Ryu Takeo Ishikawa Jun Araya |
| author_sort | Ryo Sato |
| collection | DOAJ |
| description | Abstract Background The T-SPOT.TB assay is widely used for the adjunctive diagnosis of tuberculosis (TB). However, clinicians often encounter false-negative T-SPOT.TB results. The extent of TB spread may influence host immune functions, which can influence the results of the T-SPOT.TB test. However, few previous reports have investigated the association between radiologic pulmonary tuberculosis (PTB) severity and T-SPOT.TB test results. Methods We retrospectively investigated patients with culture-confirmed pulmonary TB (PTB) at the Jikei University Daisan Hospital between September 2016 and December 2021. We aimed to clarify the association of PTB severity, according to computed tomography (CT), with the false-negative results of the T-SPOT.TB test. Results Among 193 patients with PTB, 43 (22.3%) had false-negative T-SPOT.TB results. High rates of false-negative results were noted for 7/18 (38.9%) patients with PTB spread in two lung segments (mild PTB) and 16/39 (41.0%) patients with PTB spread in 19 lung segments (severe PTB). Multivariate logistic regression analysis showed that mild or severe PTB (odds ratio [OR]: 3.23; 95% confidence interval [CI]: 1.46–7.13; P = 0.004) and lymphopenia (OR: 3.33; 95% CI: 1.20–9.26; P = 0.02) were statistically significant risk factors for false-negative results. Conclusions Mild or severe intrapulmonary lesions on chest CT might be associated with the false-negative results of the T-SPOT.TB assay. Additionally, estimating the intrapulmonary spread of PTB using chest CT could serve as a useful supplementary tool in diagnosing patients with PTB who receive false-negative results on the T-SPOT.TB test. |
| format | Article |
| id | doaj-art-a915fde8372f45bab9ca8b64fe38ce1c |
| institution | DOAJ |
| issn | 1471-2334 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj-art-a915fde8372f45bab9ca8b64fe38ce1c2025-08-20T02:51:23ZengBMCBMC Infectious Diseases1471-23342025-03-0125111010.1186/s12879-025-10777-xAssociation between the extent of intrapulmonary spread on chest CT and false-negative results of T-SPOT.TB in pulmonary tuberculosis: a retrospective studyRyo Sato0Naoki Takasaka1Yusuke Hosaka2Taiki Fukuda3Kyota Shinfuku4Makiko Takatsuka5Tsukasa Hasegawa6Masami Yamada7Yumie Yamanaka8Kai Ryu9Takeo Ishikawa10Jun Araya11Division of Respiratory Diseases, Department of Internal Medicine, The Jikei University Daisan HospitalDivision of Respiratory Diseases, Department of Internal Medicine, The Jikei University Daisan HospitalDivision of Respiratory Diseases, Department of Internal Medicine, The Jikei University Daisan HospitalDepartment of Radiology, The Jikei University Daisan HospitalDivision of Respiratory Diseases, Department of Internal Medicine, The Jikei University Daisan HospitalDivision of Respiratory Diseases, Department of Internal Medicine, The Jikei University Daisan HospitalDivision of Respiratory Diseases, Department of Internal Medicine, The Jikei University Daisan HospitalDivision of Respiratory Diseases, Department of Internal Medicine, The Jikei University Daisan HospitalDivision of Respiratory Diseases, Department of Internal Medicine, The Jikei University Daisan HospitalDivision of Respiratory Diseases, Department of Internal Medicine, The Jikei University Daisan HospitalDivision of Respiratory Diseases, Department of Internal Medicine, The Jikei University Daisan HospitalDivision of Respiratory Diseases, Department of Internal Medicine, The Jikei University School of MedicineAbstract Background The T-SPOT.TB assay is widely used for the adjunctive diagnosis of tuberculosis (TB). However, clinicians often encounter false-negative T-SPOT.TB results. The extent of TB spread may influence host immune functions, which can influence the results of the T-SPOT.TB test. However, few previous reports have investigated the association between radiologic pulmonary tuberculosis (PTB) severity and T-SPOT.TB test results. Methods We retrospectively investigated patients with culture-confirmed pulmonary TB (PTB) at the Jikei University Daisan Hospital between September 2016 and December 2021. We aimed to clarify the association of PTB severity, according to computed tomography (CT), with the false-negative results of the T-SPOT.TB test. Results Among 193 patients with PTB, 43 (22.3%) had false-negative T-SPOT.TB results. High rates of false-negative results were noted for 7/18 (38.9%) patients with PTB spread in two lung segments (mild PTB) and 16/39 (41.0%) patients with PTB spread in 19 lung segments (severe PTB). Multivariate logistic regression analysis showed that mild or severe PTB (odds ratio [OR]: 3.23; 95% confidence interval [CI]: 1.46–7.13; P = 0.004) and lymphopenia (OR: 3.33; 95% CI: 1.20–9.26; P = 0.02) were statistically significant risk factors for false-negative results. Conclusions Mild or severe intrapulmonary lesions on chest CT might be associated with the false-negative results of the T-SPOT.TB assay. Additionally, estimating the intrapulmonary spread of PTB using chest CT could serve as a useful supplementary tool in diagnosing patients with PTB who receive false-negative results on the T-SPOT.TB test.https://doi.org/10.1186/s12879-025-10777-xPulmonary tuberculosisT-SPOT.TBChest CTInterferon-gamma release assay |
| spellingShingle | Ryo Sato Naoki Takasaka Yusuke Hosaka Taiki Fukuda Kyota Shinfuku Makiko Takatsuka Tsukasa Hasegawa Masami Yamada Yumie Yamanaka Kai Ryu Takeo Ishikawa Jun Araya Association between the extent of intrapulmonary spread on chest CT and false-negative results of T-SPOT.TB in pulmonary tuberculosis: a retrospective study BMC Infectious Diseases Pulmonary tuberculosis T-SPOT.TB Chest CT Interferon-gamma release assay |
| title | Association between the extent of intrapulmonary spread on chest CT and false-negative results of T-SPOT.TB in pulmonary tuberculosis: a retrospective study |
| title_full | Association between the extent of intrapulmonary spread on chest CT and false-negative results of T-SPOT.TB in pulmonary tuberculosis: a retrospective study |
| title_fullStr | Association between the extent of intrapulmonary spread on chest CT and false-negative results of T-SPOT.TB in pulmonary tuberculosis: a retrospective study |
| title_full_unstemmed | Association between the extent of intrapulmonary spread on chest CT and false-negative results of T-SPOT.TB in pulmonary tuberculosis: a retrospective study |
| title_short | Association between the extent of intrapulmonary spread on chest CT and false-negative results of T-SPOT.TB in pulmonary tuberculosis: a retrospective study |
| title_sort | association between the extent of intrapulmonary spread on chest ct and false negative results of t spot tb in pulmonary tuberculosis a retrospective study |
| topic | Pulmonary tuberculosis T-SPOT.TB Chest CT Interferon-gamma release assay |
| url | https://doi.org/10.1186/s12879-025-10777-x |
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