EVALUATION OF THE DIAGNOSTIC PERFORMANCE OF HIGH-RESOLUTION COMPUTED TOMOGRAPHY CHEST IN CLINICALLY SUSPECTED SPUTUM-CULTURE-NEGATIVE PULMONARY TUBERCULOSIS IN ADULT PATIENTS

Abstract

Background: Clinically suspected pulmonary tuberculosis (PTB) with negative sputum culture remains diagnostically challenging. High-resolution computed tomography (HRCT) can demonstrate subtle airway and parenchymal abnormalities that may support further diagnostic evaluation. Objective: To assess the utility and imaging patterns of HRCT chest in adults with clinically suspected, sputum-culture-negative PTB. Methodology: A prospective cross-sectional observational study was conducted from January to June 2026 in the Department of Radiology, Gulab Devi Teaching Hospital/Postgraduate Medical Institute, Lahore, in collaboration with Pulmonology. One hundred adults were enrolled by non-probability consecutive sampling. Descriptive statistics, cross-tabulations, chi-square tests, one-way ANOVA and binary logistic regression were used. Results: Sixty percent of participants were male and mean age was 43.52 ± 14.89 years. HRCT was highly suggestive of PTB in 57%, showed another disease pattern in 20%, and was normal in 23%. Consolidation (67%), tree-in-bud appearance (65%), and centrilobular nodules (63%) were the most common findings. Among 57 HRCT-suggestive cases, upper-lobe predominance occurred in 52.6%, bronchiectasis in 56.1%, lymphadenopathy in 70.2%, and pleural effusion in 26.3%. Conclusion: HRCT provides useful structural information in clinically suspected culture-negative PTB, but imaging findings are suggestive rather than confirmatory and require clinical and microbiological or molecular correlation.