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1.
Int J Mol Sci ; 23(9)2022 Apr 28.
Article in English | MEDLINE | ID: covidwho-1847341

ABSTRACT

Obesity is a leading cause of preventable death and morbidity. To elucidate the mechanisms connecting metabolically active brown adipose tissue (BAT) and metabolic health may provide insights into methods of treatment for obesity-related conditions. 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18FDG-PET/CT) is traditionally used to image human BAT activity. However, the primary energy source of BAT is derived from intracellular fatty acids and not glucose. Beta-methyl-p-iodophenylpentadecanoic acid (BMIPP) is a fatty acid analogue amenable to in vivo imaging by single photon emission computed tomography/CT (SPECT/CT) when radiolabeled with iodine isotopes. In this study, we compare the use of 18FDG-PET/CT and 125I-BMIPP-SPECT/CT for fat imaging to ascertain whether BMIPP is a more robust candidate for the non-invasive evaluation of metabolically active adipose depots. Interscapular BAT, inguinal white adipose tissue (iWAT), and gonadal white adipose tissue (gWAT) uptake of 18FDG and 125I-BMIPP was quantified in mice following treatment with the BAT-stimulating drug CL-316,243 or saline vehicle control. After CL-316,243 treatment, uptake of both radiotracers increased in BAT and iWAT. The standard uptake value (SUVmean) for 18FDG and 125I-BMIPP significantly correlated in these depots, although uptake of 125I-BMIPP in BAT and iWAT more closely mimicked the fold-change in metabolic rate as measured by an extracellular flux analyzer. Herein, we find that imaging BAT with the radioiodinated fatty acid analogue BMIPP yields more physiologically relevant data than 18FDG-PET/CT, and its conventional use may be a pivotal tool for evaluating BAT in both mice and humans.


Subject(s)
Adipose Tissue, Brown , Fluorodeoxyglucose F18 , Adipose Tissue, Brown/diagnostic imaging , Adipose Tissue, Brown/metabolism , Animals , Fatty Acids/metabolism , Fluorodeoxyglucose F18/metabolism , Iodobenzenes , Mice , Obesity/metabolism , Positron Emission Tomography Computed Tomography , Positron-Emission Tomography , Radiopharmaceuticals/metabolism , Tomography, Emission-Computed, Single-Photon/methods
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.
Brain Behav ; 12(4): e2513, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1739128

ABSTRACT

OBJECTIVE: To assess FDG cerebral PET in patients suffering from cognitive impairment linked to Long COVID. The COVID pandemic has affected dozens of millions of people around the world and has resulted in the deaths of more than 3 million people. Following the acute forms, it has been reported sometimes long forms of COVID, with involvements of several organs including the brain. Neurological complications can include cognitive disturbances (brain fog) that are very common and can seriously disturb the life of patients. METHODS: Fluorodeoxyglucose PETs were performed in 3 patients with cognitive decline following COVID infection. RESULTS: We report here 3 cases of brain fog with major hypometabolic areas of the pons revealed by the cerebral FDG PET. CONCLUSION: The dysfunction of the locus coeruleus in these patients could partly explain the cognitive disorders observed. Further studies involving larger cohorts of patients suffering from cognitive dysfunction will be needed to determine if the brainstem is frequently affected in these patients.


Subject(s)
COVID-19 , Cognitive Dysfunction , Brain/diagnostic imaging , Brain Stem/diagnostic imaging , COVID-19/complications , COVID-19/diagnostic imaging , Cognitive Dysfunction/diagnostic imaging , Cognitive Dysfunction/etiology , Fluorodeoxyglucose F18 , Humans , Positron-Emission Tomography , Radiopharmaceuticals
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.
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
8.
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
9.
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
11.
JAMA Cardiol ; 7(3): 298-308, 2022 Mar 01.
Article in English | MEDLINE | ID: covidwho-1620071

ABSTRACT

IMPORTANCE: Although myocardial injury can occur with acute COVID-19, there is limited understanding of changes with myocardial metabolism in recovered patients. OBJECTIVE: To examine myocardial metabolic changes early after recovery from COVID-19 using fluorodeoxyglucose-positron emission tomography (PET) and associate these changes to abnormalities in cardiac magnetic resonance imaging (MRI)-based function and tissue characterization measures and inflammatory blood markers. DESIGN, SETTING, AND PARTICIPANTS: This prospective cohort study took place at a single-center tertiary referral hospital system. A volunteer sample of adult patients within 3 months of a diagnosis of COVID-19 who responded to a mail invitation were recruited for cardiac PET/MRI and blood biomarker evaluation between November 2020 and June 2021. EXPOSURES: Myocardial inflammation as determined by focal fluorodeoxyglucose (FDG) uptake on PET. MAIN OUTCOMES AND MEASURES: Demographic characteristics, cardiac and inflammatory blood markers, and fasting combined cardiac 18F-FDG PET/MRI imaging were obtained. All patients with focal FDG uptake at baseline returned for repeated PET/MRI and blood marker assessment 2 months later. RESULTS: Of 47 included patients, 24 (51%) were female, and the mean (SD) age was 43 (13) years. The mean (SD) interval between COVID-19 diagnosis and PET/MRI was 67 (16) days. Most patients recovered at home during the acute infection (40 [85%]). Eight patients (17%) had focal FDG uptake on PET consistent with myocardial inflammation. Compared with those without FDG uptake, patients with focal FDG uptake had higher regional T2, T1, and extracellular volume (colocalizing with focal FDG uptake), higher prevalence of late gadolinium enhancement (6 of 8 [75%] vs 9 of 39 [23%], P = .009), lower left ventricular ejection fraction (mean [SD], 55% [4%] vs 62% [5%], P < .001), worse global longitudinal and circumferential strain (mean [SD], -16% [2%] vs -17% [2%], P = .02 and -18% [2%] vs -20% [2%], P = .047, respectively), and higher systemic inflammatory blood markers including interleukin 6, interleukin 8, and high-sensitivity C-reactive protein. Among patients with focal FDG uptake, PET/MRI, and inflammatory blood markers resolved or improved at follow-up performed a mean (SD) of 52 (17) days after baseline PET/MRI. CONCLUSIONS AND RELEVANCE: In this study of patients recently recovered from COVID-19, myocardial inflammation was identified on PET in a small proportion of patients, was associated with cardiac MRI abnormalities and elevated inflammatory blood markers at baseline, and improved at follow-up.


Subject(s)
COVID-19 , Contrast Media , Adult , COVID-19/diagnostic imaging , COVID-19 Testing , Female , Gadolinium , Humans , Magnetic Resonance Imaging/methods , Positron-Emission Tomography , Prospective Studies , Radiopharmaceuticals , SARS-CoV-2 , Stroke Volume , Ventricular Function, Left
12.
Cancer Imaging ; 22(1): 3, 2022 Jan 04.
Article in English | MEDLINE | ID: covidwho-1603334

ABSTRACT

18F-FDG PET/CT plays an increasingly pivotal role in the staging and post-treatment monitoring of high-risk melanoma patients, augmented by the introduction of therapies, including tyrosine kinase inhibitors (TKI) and immune checkpoint inhibitors (ICIs), that have novel modes of action that challenge conventional response assessment. Simultaneously, technological advances have been regularly released, including advanced reconstruction algorithms, digital PET and motion correction, which have allowed the PET community to detect ever-smaller cancer lesions, improving diagnostic performance in the context of indications previously viewed as limitations, such as detection of in-transit disease and confirmation of the nature of small pulmonary metastases apparent on CT.This review will provide advice regarding melanoma-related PET protocols and will focus on variants encountered during the imaging of melanoma patients. Emphasis will be made on pitfalls related to non-malignant diseases and treatment-related findings that may confound accurate interpretation unless recognized. The latter include signs of immune activation and immune-related adverse events (irAEs). Technology-related pitfalls are also discussed, since while new PET technologies improve detection of small lesions, these may also induce false-positive cases and require a learning curve to be observed. In these times of the COVID 19 pandemic, cases illustrating lessons learned from COVID 19 or vaccination-related pitfalls will also be described.


Subject(s)
COVID-19 , Melanoma , Skin Neoplasms , Fluorodeoxyglucose F18 , Humans , Melanoma/diagnostic imaging , Positron Emission Tomography Computed Tomography , Positron-Emission Tomography , Radiopharmaceuticals , SARS-CoV-2 , Skin Neoplasms/diagnostic imaging
13.
Br J Radiol ; 95(1130): 20211079, 2022 Feb 01.
Article in English | MEDLINE | ID: covidwho-1598426

ABSTRACT

OBJECTIVES: To describe the findings of incidental asymptomatic COVID-19 infection on FDG PET-CT using a case-control design. METHODS: Incidental pulmonary findings suspicious of asymptomatic COVID-19 infection on FDG PET-CT were classified as a confirmed (positive RT-PCR test) or suspected case (no/negative RT-PCR test). Control cases were identified using a 4:1 control:case ratio. Pulmonary findings were re-categorised by two reporters using the BSTI classification. SUV metrics in ground glass opacification (GGO)/consolidation (where present), background lung, intrathoracic nodes, liver, spleen and bone marrow were measured. RESULTS: 7/9 confirmed and 11/15 suspected cases (COVID-19 group) were re-categorised as BSTI 1 (classic/probable COVID-19) or BSTI 2 (indeterminate COVID-19); 0/96 control cases were categorised as BSTI 1. Agreement between two reporters using the BSTI classification was almost perfect (weighted κ = 0.94). SUVmax GGO/consolidation (5.1 vs 2.2; p < 0.0001) and target-to-background ratio, normalised to liver SUVmean (2.4 vs 1.0; p < 0.0001) were higher in the BSTI 1 & 2 group vs BSTI 3 (non-COVID-19) cases. SUVmax GGO/consolidation discriminated between the BSTI 1 & 2 group vs BSTI 3 (non-COVID-19) cases with high accuracy (AUC = 0.93). SUV metrics were higher (p < 0.05) in the COVID-19 group vs control cases in the lungs, intrathoracic nodes and spleen. CONCLUSION: Asymptomatic COVID-19 infection on FDG PET-CT is characterised by bilateral areas of FDG avid (intensity > x2 liver SUVmean) GGO/consolidation and can be identified with high interobserver agreement using the BSTI classification. There is generalised background inflammation within the lungs, intrathoracic nodes and spleen. ADVANCES IN KNOWLEDGE: Incidental asymptomatic COVID-19 infection on FDG PET-CT, characterised by bilateral areas of ground glass opacification and consolidation, can be identified with high reproducibility using the BSTI classification. The intensity of associated FDG uptake (>x2 liver SUVmean) provides high discriminative ability in differentiating such cases from pulmonary findings in a non-COVID-19 pattern. Asymptomatic COVID-19 infection causes a generalised background inflammation within the mid-lower zones of the lungs, hilar and central mediastinal nodal stations, and spleen on FDG PET-CT.


Subject(s)
COVID-19/diagnostic imaging , Fluorodeoxyglucose F18 , Incidental Findings , Lung/diagnostic imaging , Positron Emission Tomography Computed Tomography/methods , Radiopharmaceuticals , Adult , Aged , Aged, 80 and over , Case-Control Studies , Female , Humans , Male , Middle Aged , Reproducibility of Results , SARS-CoV-2
14.
Medicine (Baltimore) ; 100(44): e27545, 2021 Nov 05.
Article in English | MEDLINE | ID: covidwho-1570144

ABSTRACT

RATIONALE: This case report demonstrates the use of flourine-18 fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) to rule out Richter transformation (RT) as the cause of clinical deterioration in a patient with chronic lymphatic leukemia (CLL) and severe COVID-19. 18F-FDG PET/CT can be used to establish the diagnosis of RT in patients with CLL, but the use of 18F-FDG PET/CT to exclude RT as the cause of clinical deterioration in patients with CLL and severe COVID-19 has not previously been described. PATIENT CONCERNS: A 61-year-old male with CLL and COVID-19 developed increased dyspnea, malaise and fever during hospitalization for treatment of severe and prolonged COVID-19. DIAGNOSES: 18F-FDG PET/CT ruled out RT and revealed progression of opacities in both lungs consistent with exacerbation of severe acute respiratory syndrome coronavirus 2 pneumonia. INTERVENTIONS: 18F-FDG PET/CT imaging. OUTCOMES: The patient was discharged at day 52 without the need of supplemental oxygen, with normalized infection marks and continued care for CLL with venetoclax. LESSONS: 18F-FDG PET/CT ruled out RT as the cause of deteriorations in a patient with CLL and severe COVID-19, enabling directed care of exacerbation of severe acute respiratory syndrome coronavirus 2 pneumonia.


Subject(s)
COVID-19 , Clinical Deterioration , Leukemia, Lymphocytic, Chronic, B-Cell , Lymphoma, Large B-Cell, Diffuse , COVID-19/complications , Fluorodeoxyglucose F18 , Humans , Leukemia, Lymphocytic, Chronic, B-Cell/complications , Leukemia, Lymphocytic, Chronic, B-Cell/diagnostic imaging , Male , Middle Aged , Positron Emission Tomography Computed Tomography , Positron-Emission Tomography , Radiopharmaceuticals
15.
Eur J Nucl Med Mol Imaging ; 49(5): 1623-1629, 2022 04.
Article in English | MEDLINE | ID: covidwho-1562023

ABSTRACT

PURPOSE: To investigate whether the COVID-19 pandemic and national lockdown had an impact on the extent of cancer disease at FDG PET/CT staging as surrogate marker. METHODS: Retrospective observational study including cancer patients submitted to FDG PET/CT staging from June 1 to October 31, 2020, and June 1 to October 31, 2019, respectively. Data regarding primary tumour, nodal (N) status and number of involved nodal stations, and presence and number of distant metastases (M) were collected. Each scan was classified in limited vs advanced status. Data were aggregated across the study population and tumour type. Bi-weekly frequencies of the observed events were analysed. RESULTS: Six hundred eleven patients were included (240 in 2019 vs 371 in 2020, respectively). A significant increase of advanced disease patients (rate 1.56, P < 0.001), N + or M + patients (rate 1.84 and 2.09, respectively, P < 0.001), and patients with a greater number of involved N stations or M (rate 2.01 and 2.06, respectively, P < 0.001) were found in 2020 compared with data of 2019. Analysis by tumour type showed a significant increase of advanced disease in lymphoma and lung cancer in 2020 compared with 2019 (P < 0.001). In addition, a significant increase of nodal involvement was found in lung, gastro-intestinal, and breast cancers, as well as in lymphoma patients (P < 0.02). A significant increase of distant metastases was found in lung cancers (P = 0.002). CONCLUSION: Cancer patients with advanced disease at FDG PET/CT staging increased in 2020 compared with 2019, following the national lockdown due to the COVID-19 pandemic, 1.5-fold with a significant increase of patients with N or M involvement. Targeted health interventions are needed to mitigate the effects of the pandemic on patient outcome.


Subject(s)
COVID-19 , Lung Neoplasms , Communicable Disease Control , Fluorodeoxyglucose F18 , Humans , Lung Neoplasms/pathology , Neoplasm Staging , Pandemics , Positron Emission Tomography Computed Tomography , Positron-Emission Tomography , Radiopharmaceuticals
16.
AJR Am J Roentgenol ; 217(5): 1206-1216, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1559710

ABSTRACT

BACKGROUND. COVID-19 vaccination may trigger reactive lymphadenopathy, confounding imaging interpretation. There has been limited systematic analysis of PET findings after COVID-19 vaccination. OBJECTIVE. The purpose of this study was to evaluate the frequency and characteristics of abnormal FDG and 11C-choline uptake on PET performed after COVID-19 vaccination. METHODS. This retrospective study included 67 patients (43 men and 24 women; mean [± SD] age, 75.6 ± 9.2 years) who underwent PET examination between December 14, 2020, and March 10, 2021, after COVID-19 vaccination and who had undergone prevaccination PET examination without visible axillary node uptake. A total of 52 patients received the BNT162b2 mRNA COVID-19 vaccine (Pfizer-BioNTech; hereafter referred to as the Pfizer-BioNTech vaccine), and 15 received the SARS-CoV-2 mRNA-1273 vaccine (Moderna; hereafter referred to as the Moderna vaccine). Sixty-six of the patients underwent PET/CT, and one underwent PET/MRI. Fifty-four PET examinations used FDG, and 13 used 11C-choline. PET was performed a median of 13 and 10 days after vaccination for patients who had received one (n = 44) and two (n = 23) vaccine doses, respectively. Two nuclear medicine physicians independently reviewed images and were blinded to injection laterality and the number of days since vaccination. Lymph node or deltoid SUVmax greater than the blood pool SUVmax was considered positive. Interreader agreement was assessed, and the measurements made by the more experienced physician were used for subsequent analysis. RESULTS. Positive axillary lymph node uptake was observed in 10.4% (7/67) of patients (7.4% [4/54] of FDG examinations and 23.1% [3/13] of 11C-choline examinations); of the patients with positive axillary lymph nodes, four had received the Pfizer vaccine, and three had received the Moderna vaccine. Injection laterality was documented for five of seven patients with positive axillary lymph nodes and was ipsilateral to the positive node in all five patients. PET was performed within 24 days of vaccination for all patients with a positive node. One patient showed extraaxillary lymph node uptake (ipsilateral supraclavicular uptake on FDG PET). Ipsilateral deltoid uptake was present in 14.5% (8/55) of patients with documented injection laterality, including 42.9% (3/7) of patients with positive axillary lymph nodes. Interreader agreement for SUV measurements (expressed as intraclass correlation coefficients) ranged from 0.600 to 0.988. CONCLUSION. Increased axillary lymph node or ipsilateral deltoid uptake is occasionally observed on FDG or 11C-choline PET performed after COVID-19 vaccination with the Pfizer-BioNTech or Moderna vaccine. CLINICAL IMPACT. Interpreting physicians should recognize characteristics of abnormal uptake on PET after COVID-19 vaccination to guide optimal follow-up management and reduce unnecessary biopsies.


Subject(s)
COVID-19 Vaccines/adverse effects , COVID-19/prevention & control , Deltoid Muscle/diagnostic imaging , Lymphadenopathy/diagnostic imaging , Lymphadenopathy/etiology , Magnetic Resonance Imaging , Positron Emission Tomography Computed Tomography , Aged , Axilla/diagnostic imaging , Carbon Radioisotopes/pharmacokinetics , Choline/pharmacokinetics , Female , Fluorodeoxyglucose F18/pharmacokinetics , Humans , Male , Radiopharmaceuticals/pharmacokinetics , Retrospective Studies , SARS-CoV-2
17.
J Thorac Imaging ; 36(5): W70-W88, 2021 Sep 01.
Article in English | MEDLINE | ID: covidwho-1526237

ABSTRACT

Infections of the cardiovascular system may present with nonspecific symptoms, and it is common for patients to undergo multiple investigations to arrive at the diagnosis. Echocardiography is central to the diagnosis of endocarditis and pericarditis. However, cardiac computed tomography (CT) and magnetic resonance imaging also play an additive role in these diagnoses; in fact, magnetic resonance imaging is central to the diagnosis of myocarditis. Functional imaging (fluorine-18 fluorodeoxyglucose-positron emission tomography/CT and radiolabeled white blood cell single-photon emission computed tomography/CT) is useful in the diagnosis in prosthesis-related and disseminated infection. This pictorial review will detail the most commonly encountered cardiovascular bacterial and viral infections, including coronavirus disease-2019, in clinical practice and provide an evidence basis for the selection of each imaging modality in the investigation of native tissues and common prostheses.


Subject(s)
Cardiovascular Infections/diagnostic imaging , Bacterial Infections/diagnostic imaging , COVID-19/diagnostic imaging , Fluorodeoxyglucose F18 , Humans , Positron Emission Tomography Computed Tomography , Radiopharmaceuticals , Software Design , Virus Diseases/diagnostic imaging
20.
Hum Brain Mapp ; 43(2): 593-597, 2022 02 01.
Article in English | MEDLINE | ID: covidwho-1460200

ABSTRACT

This study aims to evaluate the impact of French national lockdown of 55 days on brain metabolism of patients with neurological disorders. Whole-brain voxel-based PET analysis was used to correlate 18 F-FDG metabolism to the number of days after March 17, 2020 (in 95 patients; mean age: 54.3 years ± 15.7; 59 men), in comparison to the same period in 2019 before the SARS-CoV-2 outbreak (in 212 patients; mean age: 59.5 years ± 15.8; 114 men), and to the first 55 days of deconfinement (in 188 patients; mean age: 57.5 years ± 16.5; 93 men). Lockdown duration was negatively correlated to the metabolism of the sensory-motor cortex with a prevailing effect on the left dominant pyramidal tract and on younger patients, also including the left amygdala, with only partial reversibility after 55 days of deconfinement. Weak overlap was found with the reported pattern of hypometabolism in long COVID (<9%). Restriction of physical activities, and possible related deconditioning, and social isolation may lead to functional disturbances of sensorimotor and emotional brain networks. Of note, this metabolic pattern seems distinct to those reported in long COVID. Further longitudinal studies with longer follow-up are needed to evaluate clinical consequences and relationships on cognitive and mental health against functional deactivation hypothesis, and to extend these findings to healthy subjects in the context of lockdown.


Subject(s)
Brain/metabolism , COVID-19 , Pandemics , Quarantine , Aged , Aged, 80 and over , Brain/diagnostic imaging , COVID-19/complications , COVID-19/metabolism , Emotions , Exercise , Female , Fluorodeoxyglucose F18 , Humans , Longitudinal Studies , Male , Middle Aged , Motor Cortex/diagnostic imaging , Motor Cortex/metabolism , Nerve Net/metabolism , Positron-Emission Tomography , Radiopharmaceuticals , Retrospective Studies , Social Isolation , Somatosensory Cortex/diagnostic imaging , Somatosensory Cortex/metabolism
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