Abstract Rationale Pulmonary tuberculosis (PTB) remains a global health challenge, particularly in high-burden regions such as the Philippines. Despite advances in molecular diagnostics, radiologic imaging continues to provide critical insights into disease activity and extent. This study evaluated the diagnostic association between high-resolution computed tomography (HRCT) findings and sputum Gene Xpert MTB/RIF assay results in patients with pulmonary tuberculosis. Methods A five-year retrospective cohort study was conducted involving 122 patients with PTB admitted between January 2020 and January 2024. Clinical, demographic, and HRCT variables were reviewed and correlated with sputum Gene Xpert MTB/RIF results. Univariate logistic regression analysis was performed to identify HRCT features predictive of microbiologic confirmation. Results Of the 122 patients, 37 (30%) were Gene Xpert-positive. Significant clinical correlates included male sex, smoking, and alcohol history (p = 0.001). The HRCT features most predictive of PTB positivity were cavities (OR = 5.0, p 0.001), tree-in-bud opacities (OR = 3.25, p = 0.043), and consolidation (OR = 2.76, p = 0.018). Non-calcified nodules and pleural thickening were inversely correlated with positivity. Lesions predominantly involved mixed and upper-zone distributions. Conclusion Distinct HRCT patterns, especially cavities, tree-in-bud, and consolidation, exhibit strong correlation with Gene Xpert-confirmed PTB. These findings underscore the diagnostic utility of HRCT in supporting early tuberculosis detection and guiding clinical management, particularly in smear-negative and resource-limited settings. This abstract is funded by: None
Villarubia-Abella et al. (Fri,) studied this question.