# Diagnostic Imaging of Extrapulmonary Tuberculosis Across Organ Systems

## TL;DR

This review discusses how imaging techniques help diagnose tuberculosis outside the lungs, highlighting challenges and new methods across different body systems.

## Contribution

The paper provides a systematic review of imaging approaches for extrapulmonary tuberculosis, emphasizing organ-specific patterns and emerging diagnostic techniques.

## Key findings

- Imaging techniques like MRI and CT are commonly used but often yield nonspecific results for EPTB.
- Emerging methods like machine learning and contrast-enhanced ultrasound improve lesion characterization.
- A multimodal imaging approach combined with clinical context enhances EPTB diagnosis and management.

## Abstract

Extrapulmonary tuberculosis (EPTB) is an infectious disease characterized by the invasion of Mycobacterium tuberculosis beyond the lungs. Diagnosis is frequently delayed due to nonspecific clinical presentations that vary by organ system, making diagnostic imaging essential for disease detection, characterization, and treatment monitoring. The objective of this review is to examine and summarize imaging-based approaches for the diagnostic evaluation of EPTB across multiple body systems, including the central nervous system, spine, cardiovascular system, lymphatic system, abdominal and hepatic organs, genitourinary tract, cutaneous and soft tissue, and other rare sites. While computed tomography, magnetic resonance imaging, positron emission tomography, and ultrasound are widely used in the evaluation of EPTB, their ability to provide a definitive diagnosis is often limited by nonspecific radiologic findings. Emerging techniques, including perfusion-weighted MRI, contrast-enhanced ultrasound, and machine learning, have been discussed, as they improve lesion characterization and EPTB differentiation. By organizing imaging findings according to affected organ systems, this review highlights both shared diagnostic challenges and site-specific patterns that can inform clinical suspicion. Together, these developments underscore the value of a multimodal, organ-specific imaging approach integrated with the clinical context to improve the recognition and management of EPTB.