ABSTRACT
PURPOSE: CT signs that are evocative of lung COVID-19 infections have been extensively described, whereas 18F-FDG-PET signs have not. Our current study aimed to identify specific COVID-19 18F-FDG-PET signs in patients that were (i) suspected to have a lung infection based on 18F-FDG-PET/CT recorded during the COVID-19 outbreak and (ii) whose COVID-19 diagnosis was definitely established or excluded by appropriate viral testing. METHODS: Twenty-two consecutive patients referred for routine 18F-FDG-PET/CT examinations during the COVID-19 outbreak (March 25th to May 15th 2020) and for whom CT slices were evocative of a lung infection were included in the study. All patients had undergone a SARS-COV-2 diagnostic test to confirm COVID-19 infection (positivity was based on molecular and/or serological tests) or exclude it (negativity of at least the serological test). RESULTS: Eleven patients were confirmed to be affected by COVID-19 (COVID+), whereas the other eleven patients were not (COVID-) and were predominantly suspected of having bacterial pneumonia. CT abnormalities were not significantly different between COVID+ and COVID- groups, although trends toward larger CT abnormalities (p = 0.16) and lower rates of consolidation patterns (0.09) were observed in the COVID+ group. The maximal standardized uptake values (SUVmax) of lung areas with CT abnormalities were however significantly lower in the COVID+ than the COVID- group (3.7 ± 1.9 vs. 6.9 ± 4.1, p = 0.03), with the highest SUVmax consistently not associated with COVID-19. CONCLUSION: Among CT abnormalities evocative of lung infection, those related to COVID-19 are associated with a more limited 18F-FDG uptake. This observation may help improve our ability to detect COVID-19 patients.
Subject(s)
COVID-19/diagnostic imaging , Fluorodeoxyglucose F18 , Lung/diagnostic imaging , Positron Emission Tomography Computed Tomography/methods , Radiopharmaceuticals , Aged , Aged, 80 and over , COVID-19/diagnosis , COVID-19 Nucleic Acid Testing , COVID-19 Serological Testing , Diagnosis, Differential , Female , Humans , Male , Middle Aged , Positron Emission Tomography Computed Tomography/standardsABSTRACT
BACKGROUND: This study aimed to analyze the rates of tracheobronchitis signs observed on the ventilation scans of COVID-19 patients with shortness of breath, with comparisons to a non-COVID population. METHODS: Lung scintigraphy was collected in 10 such COVID patients, as well as from a non-COVID population investigated outside the epidemic wave period, on a CZT-SPECT/CT system, with ventilation images recorded with 99mTc-labeled Technegas® and perfusion images with 99mTc-labeled albumin macroaggregates. RESULTS: A diffuse tracheobronchial uptake was observed on the ventilation scans from 3 COVID patients (30%), whereas this rate was 3% (3/90) in the non-COVID group (P = 0.013). These 3 patients had no laryngeal extension of Technegas® uptake and limited parenchymal lung abnormalities. Follow-up scintigraphy demonstrated the withdrawal of tracheobronchitis signs in two cases, and the advent of a severe pulmonary embolism in one. CONCLUSION: Signs of tracheobronchitis may constitute the principal finding on lung SPECT/CT images of COVID-19 patients with shortness of breath.