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2.
J Med Virol ; 94(5): 1833-1845, 2022 05.
Article in English | MEDLINE | ID: covidwho-1777585

ABSTRACT

Coronavirus disease 2019 (COVID-19) has caused a global pandemic that continues to cause numerous deaths to date. Four vaccines have been approved by the Food and Drug Administration as of July 2021 to prevent the transmission of COVID-19: Pfizer, Moderna, AstraZeneca, and Janssen. These vaccines have shown great efficacy and safety profile. One side effect that has been widely reported is post-COVID-19 vaccination lymphadenopathy. Due to the mimicry of the lymphadenopathy for metastases in some oncologic patients, there have been reports of patients who underwent biopsies that showed pathologic confirmation of benign reactive lymphadenopathy secondary to the COVID-19 vaccine. Therefore, understanding the incidence of lymphadenopathy post-COVID-19 vaccinations will help guide radiologists and oncologists in their management of patients, both present oncologic patients, and patients with concerns over their newly presenting lymphadenopathy. A systematic literature search was performed using several databases to identify relevant studies that reported lymphadenopathy post-COVID-19 vaccination. Our results revealed that several cases have been detected in patients undergoing follow-up fluorodeoxyglucose (FDG)-positron emission tomography-computerized tomography scans where lymph nodes ipsilateral to the vaccine injection site show increased uptake of FDG. Thus, knowledge of the incidence of lymphadenopathy may help avoid unnecessary biopsies, interventions, and changes in management for patients, especially oncologic patients who are at risk for malignancies.


Subject(s)
COVID-19 , Lymphadenopathy , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Fluorodeoxyglucose F18 , Humans , Lymphadenopathy/diagnostic imaging , Lymphadenopathy/etiology , Positron Emission Tomography Computed Tomography/adverse effects , Positron Emission Tomography Computed Tomography/methods , SARS-CoV-2 , United States , Vaccination/adverse effects
3.
J Nucl Med ; 63(2): 270-273, 2022 02.
Article in English | MEDLINE | ID: covidwho-1753320

ABSTRACT

The aim of this study was to assess the temporal evolution of pulmonary 18F-FDG uptake in patients with coronavirus disease 2019 (COVID-19) and post-COVID-19 lung disease (PCLD). Methods: Using our hospital's clinical electronic records, we retrospectively identified 23 acute COVID-19, 18 PCLD, and 9 completely recovered 18F-FDG PET/CT patients during the 2 peaks of the U.K. pandemic. Pulmonary 18F-FDG uptake was measured as a lung target-to-background ratio (TBRlung = SUVmax/SUVmin) and compared with temporal stage. Results: In acute COVID-19, less than 3 wk after infection, TBRlung was strongly correlated with time after infection (r s = 0.81, P < 0.001) and was significantly higher in the late stage than in the early stage (P = 0.001). In PCLD, TBRlung was lower in patients treated with high-dose steroids (P = 0.003) and in asymptomatic patients (P < 0.001). Conclusion: Pulmonary 18F-FDG uptake in COVID-19 increases with time after infection. In PCLD, pulmonary 18F-FDG uptake rises despite viral clearance, suggesting ongoing inflammation. There was lower pulmonary 18F-FDG uptake in PCLD patients treated with steroids.


Subject(s)
COVID-19/diagnostic imaging , Fluorodeoxyglucose F18/pharmacokinetics , Lung/diagnostic imaging , Positron Emission Tomography Computed Tomography/methods , Radiopharmaceuticals/pharmacokinetics , SARS-CoV-2 , Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Retrospective Studies , Young Adult
4.
Physiol Rep ; 10(5): e15201, 2022 03.
Article in English | MEDLINE | ID: covidwho-1743019

ABSTRACT

We assessed PET-CT myocardial blood flow (MBF) using N-13 ammonia, brachial flow-mediated dilation, and cardiopulmonary exercise test in five post-discarged MIS-C survivors. None of the patients (median age: 9, range: 7-18 years; 3 females; 2 males) had preexisting pediatric chronic conditions. At the follow-up visit, two patients exhibited severe perfusion defect developed in the left ventricular cavity, suggesting extensive myocardial ischemia (MBF <2.0) and one patient showed persistent mild pericardial effusion. Others two patients demonstrated endothelial dysfunction. Nevertheless, all patients had lower predicted values in the VO2peak , VO2VAT , OUES, and O2 Pulse (range: 35.2%-64.5%; 15.6%-38.2%; 1.0-1.3 L/min; 4-7 ml/beat), respectively. Our d suggested that previously health MIS-C patients had impaired MBF, endothelial dysfunction and lower cardiopulmonary capacity at follow-up analysis. Multidisciplinary further investigations should be conducted to reinforce these findings.


Subject(s)
COVID-19 , Cardiovascular System , COVID-19/complications , Child , Female , Humans , Male , Positron Emission Tomography Computed Tomography , SARS-CoV-2 , Systemic Inflammatory Response Syndrome
5.
PET Clin ; 17(2): 213-222, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1719570

ABSTRACT

Head and neck squamous cell carcinoma (HNSCC) imaging is nearly synonymous with positron emission tomography (PET) scans. Many of the nearly 60,000 newly diagnosed patients with HNSCC in the US-and 900,000 worldwide-will undergo a PET scan, if not multiple, throughout the course of their care. In this review, we describe the clinical utility of PET scans in HNSCC, emphasizing whereby their input is most impactful in improving patient outcomes as well as scenarios whereby PET/CT scans should be avoided. We also describe important considerations for capturing and processing PET scans with a special focus on the important role of tumor volume segmentation, scan timing relative to therapy, and concurrent conditions (eg, COVID-19). In addition, we will illustrate the latest innovations in the management of HNSCC. This article also will delve to exhibit novel potential biomarkers in the management of HNSCC. Finally, we describe future directions for PET imaging, including the advent of novel PET radiotracers as an alternative to 18F-fluorodeoxyglucose (18F-FDG).


Subject(s)
COVID-19 , Carcinoma, Squamous Cell , Head and Neck Neoplasms , COVID-19/diagnostic imaging , Carcinoma, Squamous Cell/diagnostic imaging , Fluorodeoxyglucose F18 , Head and Neck Neoplasms/diagnostic imaging , Humans , Positron Emission Tomography Computed Tomography/methods , Positron-Emission Tomography/methods , Radiopharmaceuticals , Squamous Cell Carcinoma of Head and Neck/diagnostic imaging
6.
Eur J Cancer ; 159: 38-51, 2021 12.
Article in English | MEDLINE | ID: covidwho-1719648

ABSTRACT

PURPOSE: Over 1 billion doses of COVID-19 vaccines have been already administered across the United States, the United Kingdom and the European Union at the time of writing. Furthermore, 1.82 million booster doses have been administered in the US since 13th August, and similar booster programmes are currently planned or under consideration in the UK and the EU beginning in the autumn of 2021. Early reports showed an association between vaccine administration and the development of ipsilateral axillary and supraclavicular lymphadenopathy, which could interfere with the diagnosis, treatment and follow-up of breast cancer patients. In this paper, we review the available evidence on vaccine-related lymphadenopathy, and we discuss the clinical implications of the same on breast cancer diagnosis and management. METHODS: A literature search was performed - PubMed, Ovid Medline, Scopus, CINHAL, Springer Nature, ScienceDirect, Academic Search Premier and the Directory of Open Access Journals were searched for articles reporting on regional palpable or image-detected lymphadenopathy following COVID-19 vaccination. Separately, we compiled a series of case studies from the University Hospitals of Derby and Burton, United Kingdom and the Mayo Clinic in Minnesota, United States of America, to illustrate the impact that regional lymphadenopathy post-COVID-19 vaccination can have on the diagnosis and management of patients being seen in diagnostic and therapeutic breast clinics. RESULTS: From the literature search, 15 studies met the inclusion criteria (n = 2057 patients, 737 with lymphadenopathy). The incidence of lymphadenopathy ranged between 14.5% and 53% and persisted for >6 weeks in 29% of patients. CONCLUSIONS: Clinicians managing breast cancer patients should be aware that the COVID-19 vaccination may result in regional lymphadenopathy in a significant number of patients, which can result in unnecessary investigations, treatment and increased patient anxiety. An accurate COVID-19 vaccination history should be collected from all patients where regional lymphadenopathy is a clinical and/or an imaging finding and then combined with clinical judgement when managing individual cases.


Subject(s)
Breast Neoplasms/diagnostic imaging , COVID-19 Vaccines/adverse effects , Lymphadenopathy/diagnostic imaging , Mammography , Positron Emission Tomography Computed Tomography , Vaccination/adverse effects , Breast Neoplasms/epidemiology , Breast Neoplasms/therapy , COVID-19 Vaccines/administration & dosage , Diagnosis, Differential , Diagnostic Errors , Female , Humans , Incidence , Lymphadenopathy/chemically induced , Lymphadenopathy/epidemiology , Predictive Value of Tests , Prognosis , Risk Assessment , Risk Factors , Time Factors
7.
Microcirculation ; 29(3): e12750, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1697657

ABSTRACT

BACKGROUND: Multisystem inflammatory syndrome in children (MIS-c) is associated with severe cardiovascular impairment and eventually death. Pathophysiological mechanisms involved in myocardial injury were scarcely investigated, and cardiovascular outcomes are uncertain. Autopsy studies suggested that microvascular dysfunction may be relevant to LV impairment. OBJECTIVE: We aimed to evaluate segmental LV longitudinal strain by 2DST echocardiography and myocardial flow reserve (MFR) by 13 N-ammonia PET-CT, in six surviving MIS-c patients. METHODS: Each patient generated 34 LV segments for combined 2DST and MRF analysis. MFR was considered abnormal when <2, borderline when between 2 and 2.5 and normal when >2.5. RESULTS: From July 2020 to February 2021, six patients were admitted with MIS-c: three males, aged 9.3 (6.6-15.7) years. Time from admission to the follow-up visit was 6.05 (2-10.3) months. Although all patients were asymptomatic and LV EF was ≥55%, 43/102 (42.1%) LV segments showed MFR <2.5. There was a modest positive correlation between segmental peak systolic longitudinal strain and MFR: r = .36, p = .03 for basal segments; r = .41, p = .022 for mid segments; r = .42, p = .021 for apical segments. Median peak systolic longitudinal strain was different among MRF categories: 18% (12%-24%) for abnormal, 18.5% (11%-35%) for borderline, and 21% (12%-32%) for normal MFR (p = .006). CONCLUSION: We provided preliminary evidence that surviving MIS-c patients may present subclinical impairment of myocardial microcirculation. Segmental cardiac strain assessment 2DST seems useful for MIS-c cardiovascular follow-up, given its good correlation with 13 N-ammonia PET-CT derived MFR.


Subject(s)
Positron Emission Tomography Computed Tomography , Ventricular Dysfunction, Left , Ammonia , Child , Echocardiography/methods , Humans , Male , Microcirculation , Myocardium , Ventricular Dysfunction, Left/diagnostic imaging
8.
Clin Nucl Med ; 47(3): e327-e328, 2022 Mar 01.
Article in English | MEDLINE | ID: covidwho-1691728

ABSTRACT

ABSTRACT: A 46-year-old woman with previous history of breast cancer had follow-up 18F-FDG PET/CT 5 days after COVID-19 vaccination. In addition to avid axillary nodes, a well-documented feature, the scan demonstrated diffuse splenic and marrow uptake. Clinical history, laboratory, and scan findings were in keeping with SIRS (systemic inflammatory response). The patient recovered with supportive management. On follow-up, 18F-FDG PET/CT imaging 3 months later features had resolved. SIRS after vaccination may be observed on 18F-FDG PET/CT.


Subject(s)
COVID-19 , Fluorodeoxyglucose F18 , COVID-19 Vaccines , Female , Follow-Up Studies , Humans , Immunity , Middle Aged , Positron Emission Tomography Computed Tomography , Positron-Emission Tomography , SARS-CoV-2 , Vaccination
9.
Clin Nucl Med ; 47(5): e397-e398, 2022 May 01.
Article in English | MEDLINE | ID: covidwho-1691726

ABSTRACT

ABSTRACT: Of the various adverse reactions to COVID-19 vaccines, fever is a common systemic symptom that often resolves spontaneously without treatment. However, rare vaccine-induced conditions that present with fever and systemic inflammation have been reported. In this case, a 65-year-old man with BNT162b2 mRNA COVID-19 vaccination underwent 18F-FDG PET/CT to evaluate prolonged fever and elevated serum C-reactive protein. PET/CT showed hypermetabolic infiltration in the pericardium and peritoneum suggesting immune-mediated pericarditis and peritonitis. After administration of high-dose corticosteroids, the patient's symptom resolved. This case suggests that multisystem inflammatory syndrome and polyserositis can be induced by the COVID-19 vaccine.


Subject(s)
COVID-19 Vaccines , COVID-19 , Aged , COVID-19/complications , COVID-19 Vaccines/adverse effects , Fluorodeoxyglucose F18 , Humans , Inflammation , Male , Positron Emission Tomography Computed Tomography , SARS-CoV-2
10.
Clin Nucl Med ; 47(5): e403-e405, 2022 May 01.
Article in English | MEDLINE | ID: covidwho-1691725

ABSTRACT

ABSTRACT: Causality regarding adverse events following SARS-CoV-2 mRNA vaccine is undetermined for vasculitis. Herein, we report the case of an 80-year-old man who presented with a persistent high fever of 7 days' duration that began shortly after receiving a COVID-19 vaccination. There was also a complaint of persistent lower limb pain and walking difficulty on emergency transportation. FDG PET/CT demonstrated extensive linear hypermetabolic foci along the vessels of both legs, including the hips, and the arms, supraclavicular area, chest wall, and temporal regions, suggesting systemic vasculitis. Subsequent temporal artery biopsy revealed arteritis, which is not typical of giant cell arteritis.


Subject(s)
COVID-19 , Giant Cell Arteritis , Systemic Vasculitis , Aged, 80 and over , COVID-19 Vaccines/adverse effects , Fluorodeoxyglucose F18 , Humans , Male , Positron Emission Tomography Computed Tomography , RNA, Messenger , SARS-CoV-2 , Vaccination , Vaccines, Synthetic
11.
Curr Oncol ; 29(2): 1080-1092, 2022 02 13.
Article in English | MEDLINE | ID: covidwho-1686629

ABSTRACT

The pandemic raised a discussion about the postponement of medical interventions for non-small cell lung cancer (NSCLC). We analyzed the characteristics of pretreatment diagnostic assessment in the pandemic and the influence of diagnostic assessment on outcomes. A total of 96 patients with stereotactic body radiation therapy (SBRT) for NSCLC were included. The number of patients increased from mean 0.9 (2012-2019) to 1.45 per month in the COVID era (p < 0.05). Pandemic-related factors (contact reduction, limited intensive care unit resources) might have influenced clinical decision making towards SBRT. The time from pretreatment assessment (multidisciplinary tumor board decision, bronchoscopy, planning CT) to SBRT was longer during the COVID period (p < 0.05). Reduced services, staff shortage, or appointment management to mitigate infection risks might explain this finding. Overall survival, progression-free survival, locoregional progression-free survival, and distant progression-free survival were superior in patients who received a PET/CT scan prior to SBRT (p < 0.05). This supports that SBRT guidelines advocate the acquisition of a PET/CT scan. A longer time from PET/CT scan/conventional staging to SBRT (<10 vs. ≥10 weeks) was associated with worse locoregional control (p < 0.05). The postponement of diagnostic or therapeutic measures in the pandemic should be discussed cautiously. Patient- and tumor-related features should be evaluated in detail.


Subject(s)
COVID-19 , Carcinoma, Non-Small-Cell Lung , Lung Neoplasms , Radiosurgery , Carcinoma, Non-Small-Cell Lung/pathology , Follow-Up Studies , Humans , Lung Neoplasms/pathology , Neoplasm Staging , Pandemics , Positron Emission Tomography Computed Tomography , Positron-Emission Tomography , Radiosurgery/adverse effects , SARS-CoV-2
12.
Curr Oncol ; 29(2): 989-1000, 2022 02 10.
Article in English | MEDLINE | ID: covidwho-1686627

ABSTRACT

In the following report, we describe 11 patients with various diagnoses and different treatment statuses (newly diagnosed, receiving treatment, or follow-up) of oncological diseases (breast, lymphoma, melanoma, and head and neck cancers). The patients underwent PET-CT for disease staging or follow-up and it was noted that all patients had areas of hypermetabolic uptake in the axillary lymph-nodes of the ipsilateral upper extremity where the Pfizer-BioNTech coronavirus (COVID-19) vaccine was administered. Following further investigations, including an ultrasound (US), biopsies and an examination of medical records, it was concluded that these findings were the result of the vaccination and not a progression of pre-existing disease.


Subject(s)
COVID-19 , Fluorodeoxyglucose F18 , COVID-19 Vaccines , Humans , Positron Emission Tomography Computed Tomography , Positron-Emission Tomography , SARS-CoV-2 , Vaccination
13.
Clin Nucl Med ; 47(2): e187-e189, 2022 Feb 01.
Article in English | MEDLINE | ID: covidwho-1684923

ABSTRACT

ABSTRACT: A 79-year-old man with a history of prostate adenocarcinoma treated with prostatectomy underwent 18F-FCH PET/CT for restaging purpose, which was negative for relapse but showed the presence of choline-positive lymph nodes in the left axilla. The patient underwent a COVID-19 vaccination in the left arm 6 days prior. Thus, PET/CT findings were considered as inflammatory lymph nodes. With the current drive of global COVID-19 immunization, this case underlines the importance of knowing vaccination history to interpret correctly the findings and to avoid false-positive reports.


Subject(s)
COVID-19 , Lymphadenopathy , Prostatic Neoplasms , Aged , COVID-19 Vaccines , Choline/analogs & derivatives , Humans , Male , Neoplasm Recurrence, Local , Positron Emission Tomography Computed Tomography , Positron-Emission Tomography , Prostate-Specific Antigen , Prostatectomy , Prostatic Neoplasms/surgery , SARS-CoV-2 , Vaccination
14.
Clin Nucl Med ; 47(2): e123-e124, 2022 Feb 01.
Article in English | MEDLINE | ID: covidwho-1684922

ABSTRACT

ABSTRACT: Recently, vaccination against COVID-19 has gained wide diffusion, especially among vulnerable individuals, such as cancer patients. At the same time, patients have been undergoing PET/CT examinations after vaccination in an increasing number, and cases of false-positive axillary nodal uptake have been described, mostly at 18F-FDG PET. Here, we describe the case of both 68Ga-DOTATOC and 18F-FDG axillary nodal uptake in a young woman affected by a metastatic retroperitoneal paraganglioma.


Subject(s)
COVID-19 , Fluorodeoxyglucose F18 , COVID-19 Vaccines , Female , Humans , Octreotide/analogs & derivatives , Organometallic Compounds , Positron Emission Tomography Computed Tomography , SARS-CoV-2
15.
Clin Nucl Med ; 47(2): 195-196, 2022 Feb 01.
Article in English | MEDLINE | ID: covidwho-1684921

ABSTRACT

ABSTRACT: COVID-19 vaccination has started in most countries, and postvaccination imaging is inevitable in the oncologic population. The immune response to the vaccination in the form of reactive lymphadenopathy has been well documented on 18F-FDG PET/CT. We present the imaging findings of 3 patients who have undergone non-FDG PET/CT imaging including 18F-fluorthanatrace, 68Ga-DOTATATE, and 18F-fluciclovine PET/CT. It is crucial to recognize the timing and laterality of immunization to avoid false-positive findings.


Subject(s)
COVID-19 , Lymphadenopathy , COVID-19 Vaccines , Fluorodeoxyglucose F18 , Humans , Positron Emission Tomography Computed Tomography , Positron-Emission Tomography , Radionuclide Imaging , SARS-CoV-2 , Vaccination
16.
Clin Nucl Med ; 47(2): e177-e179, 2022 Feb 01.
Article in English | MEDLINE | ID: covidwho-1684920

ABSTRACT

ABSTRACT: Occurrence of invasive fungal infections has gained significant attention during recent times in patients with COVID-19. Patients with severe form of COVID-19, such as those treated in the intensive care unit with prolonged steroid use, are particularly vulnerable to secondary bacterial and fungal infections. Disseminated systemic mycosis is a life-threatening condition, especially in immunocompromised patients. Here, we report a case of a recovered severe COVID-19 patient, who presented with persistent fever. 18F-FDG-labeled leukocyte scan revealed focal accumulation of radiotracer in the small intestine and right lung lower lobe. Subsequently, performed biopsy revealed mucormycosis.


Subject(s)
COVID-19 , Invasive Fungal Infections , Fluorodeoxyglucose F18 , Humans , Leukocytes , Positron Emission Tomography Computed Tomography , SARS-CoV-2
17.
J Pak Med Assoc ; 71(12): 2834, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1679127

ABSTRACT

Corona virus disease 2019 (COVID-19), originated from Wuhan province of China, is responsible for causing severe respiratory syndrome (SARS-Cov-2). Initial specific investigation to diagnose the viral infection includes nasopharyngeal nucleic acid testing (RT-PCR). However other modalities can also aid in detection of COVID-19 infection. For instance, COVID pneumonitis related findings on positron emission tomography (PET/CT) scan acquired, during routine evaluation; can help in detection the viral infection in asymptomatic patients thereby preventing further spread of infection to other patients, physicians; and family members. This can alert physicians in taking prophylactic and preventive measures for management of these asymptomatic patient.


Subject(s)
COVID-19 , Pneumonia , Fluorodeoxyglucose F18 , Humans , Positron Emission Tomography Computed Tomography , Radiopharmaceuticals , SARS-CoV-2
19.
J Nucl Med ; 63(2): 270-273, 2022 02.
Article in English | MEDLINE | ID: covidwho-1674256

ABSTRACT

The aim of this study was to assess the temporal evolution of pulmonary 18F-FDG uptake in patients with coronavirus disease 2019 (COVID-19) and post-COVID-19 lung disease (PCLD). Methods: Using our hospital's clinical electronic records, we retrospectively identified 23 acute COVID-19, 18 PCLD, and 9 completely recovered 18F-FDG PET/CT patients during the 2 peaks of the U.K. pandemic. Pulmonary 18F-FDG uptake was measured as a lung target-to-background ratio (TBRlung = SUVmax/SUVmin) and compared with temporal stage. Results: In acute COVID-19, less than 3 wk after infection, TBRlung was strongly correlated with time after infection (r s = 0.81, P < 0.001) and was significantly higher in the late stage than in the early stage (P = 0.001). In PCLD, TBRlung was lower in patients treated with high-dose steroids (P = 0.003) and in asymptomatic patients (P < 0.001). Conclusion: Pulmonary 18F-FDG uptake in COVID-19 increases with time after infection. In PCLD, pulmonary 18F-FDG uptake rises despite viral clearance, suggesting ongoing inflammation. There was lower pulmonary 18F-FDG uptake in PCLD patients treated with steroids.


Subject(s)
COVID-19/diagnostic imaging , Fluorodeoxyglucose F18/pharmacokinetics , Lung/diagnostic imaging , Positron Emission Tomography Computed Tomography/methods , Radiopharmaceuticals/pharmacokinetics , SARS-CoV-2 , Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Retrospective Studies , Young Adult
20.
J Nucl Med ; 63(2): 274-279, 2022 02.
Article in English | MEDLINE | ID: covidwho-1674255

ABSTRACT

Although the novel coronavirus disease 2019 (COVID-19) can present as nonspecific clinical forms, subclinical cases represent an important route of transmission and a significant source of mortality, mainly in high-risk subpopulations such as cancer patients. A deeper knowledge of the metabolic shift in cells infected with severe acute respiratory syndrome coronavirus 2 could provide new insights about its pathogenic and host response and help to diagnose pulmonary involvement. We explored the potential added diagnostic value of 18F-FDG PET/CT scans in asymptomatic cancer patients with suspected COVID-19 pneumonia by investigating the association between metabolic and structural changes in the lung parenchyma. Methods: 18F-FDG PET/CT studies acquired between February 19 and May 29, 2020, were reviewed to identify those cancer patients with incidental findings suggestive of COVID-19 pneumonia. PET studies were interpreted through qualitative (visual) and semiquantitative (measurement of SUVmax) analysis evaluating lung findings. Several characteristic signs of COVID-19 pneumonia on CT were described as COVID-19 Reporting and Data System (CO-RADS) categories (1-6). After comparing the SUVmax of pulmonary infiltrates among different CO-RADS categories, we explored the best potential cutoffs for pulmonary SUVmax against CO-RADS categories as the gold standard result to eliminate the possibility that the diagnosis of COVID-19 pneumonia exists. Results: On multimodal PET/CT imaging, CT signs classified as CO-RADS category 5 or 6 were found in 16 of 41 (39%) oncologic patients. SUVmax was higher in patients with categories 5 and 6 than in patients with category 4 (6.17 ± 0.82 vs. 3.78 ± 0.50, P = 0.04) or categories 2 and 3 (3.59 ± 0.41, P = 0.01). A specificity of 93.8% (95% CI, 71.7%-99.7%) and an accuracy of 92.9% were obtained when combining a CO-RADS score of 5 or 6 with an SUVmax of 2.45 in pulmonary infiltrates. Conclusion: In asymptomatic cancer patients, the metabolic activity in lung infiltrates is closely associated with several combined tomographic changes characteristic of COVID-19 pneumonia. Multimodal 18F-FDG PET/CT imaging could provide additional information during early diagnosis in selected predisposed patients during the pandemic. The prognostic implications of simultaneous radiologic and molecular findings in cancer patients and other subpopulations at high risk for COVID-19 pneumonia deserve further evaluation in prospective research.


Subject(s)
COVID-19/diagnostic imaging , Fluorodeoxyglucose F18 , Lung/diagnostic imaging , Neoplasms/diagnostic imaging , Positron Emission Tomography Computed Tomography/methods , Radiopharmaceuticals , SARS-CoV-2 , Aged , Aged, 80 and over , Female , Humans , Lung/metabolism , Lung/pathology , Male , Middle Aged , Neoplasms/metabolism , Neoplasms/pathology
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