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COVID-19 pneumonia: relationship between inflammation assessed by whole-body FDG PET/CT and short-term clinical outcome.
Dietz, Matthieu; Chironi, Gilles; Claessens, Yann-Erick; Farhad, Ryan Lukas; Rouquette, Isabelle; Serrano, Benjamin; Nataf, Valérie; Hugonnet, Florent; Paulmier, Benoît; Berthier, Frédéric; Keita-Perse, Olivia; Giammarile, Francesco; Perrin, Christophe; Faraggi, Marc.
  • Dietz M; Nuclear Medicine Department, Centre Hospitalier Princesse Grace, 1 Avenue Pasteur, 98000, Monaco, Monaco.
  • Chironi G; Check-up Unit, Centre Hospitalier Princesse Grace, Monaco, Monaco.
  • Claessens YE; Department of Emergency Medicine, Centre Hospitalier Princesse Grace, Monaco, Monaco.
  • Farhad RL; Pulmonary Department, Centre Hospitalier Princesse Grace, Monaco, Monaco.
  • Rouquette I; Department of Intensive Care Medicine, Centre Hospitalier Princesse Grace, Monaco, Monaco.
  • Serrano B; Medical Physics Department, Centre Hospitalier Princesse Grace, Monaco, Monaco.
  • Nataf V; Nuclear Medicine Department, Centre Hospitalier Princesse Grace, 1 Avenue Pasteur, 98000, Monaco, Monaco.
  • Hugonnet F; Nuclear Medicine Department, Centre Hospitalier Princesse Grace, 1 Avenue Pasteur, 98000, Monaco, Monaco.
  • Paulmier B; Nuclear Medicine Department, Centre Hospitalier Princesse Grace, 1 Avenue Pasteur, 98000, Monaco, Monaco.
  • Berthier F; Department of Biostatistics, Centre Hospitalier Princesse Grace, Monaco, Monaco.
  • Keita-Perse O; Infection disease Department, Centre Hospitalier Princesse Grace, Monaco, Monaco.
  • Giammarile F; Division of Human Health, International Atomic Energy Agency, Vienna, Austria.
  • Perrin C; Centre Leon Berard, Lyon, France.
  • Faraggi M; Pulmonary Department, Centre Hospitalier Princesse Grace, Monaco, Monaco.
Eur J Nucl Med Mol Imaging ; 48(1): 260-268, 2021 01.
Article in English | MEDLINE | ID: covidwho-670218
ABSTRACT

PURPOSE:

[18F]-2-Fluoro-2-deoxy-D-glucose PET/CT (FDG PET/CT) is a sensitive and quantitative technic for detecting inflammatory process. Glucose uptake is correlated with an increased anaerobic glycolysis seen in activated inflammatory cells such as monocytes, lymphocytes, and granulocytes. The aim of the study was to assess the inflammatory status at the presumed peak of the inflammatory phase in non-critically ill patients requiring admission for COVID-19.

METHODS:

Patients admitted with COVID-19 were prospectively enrolled. FDG PET/CT was performed from day 6 to day 14 of the onset of symptoms. Depending on FDG PET/CT findings, patients' profiles were classified as "inflammatory" or "low inflammatory." FDG PET/CT data were compared with chest CT evolution and short-term clinical outcome. All inflammatory sites were reported to screen potential extra-pulmonary tropism.

RESULTS:

Thirteen patients were included. Maximum standardized uptake values ranged from 4.7 to 16.3 in lungs. All patients demonstrated increased mediastinal lymph nodes glucose uptake. Three patients (23%) presented mild nasopharyngeal, two patients (15%) bone marrow, and five patients (38%) splenic mild increase in glucose uptake. No patient had significant digestive focal or segmental glucose uptake. There was no significant physiological myocardial glucose uptake in all patients except one. There was no correlation between PET lung inflammatory status and chest CT evolution or short-term clinical outcome.

CONCLUSION:

Inflammatory process at the presumed peak of the inflammatory phase in COVID-19 patients is obvious in FDG PET/CT scans. Glucose uptake is heterogeneous and typically focused on lungs. TRIAL REGISTRATION NCT04441489. Registered 22 June 2020 (retrospectively registered).
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Radiopharmaceuticals / Fluorodeoxyglucose F18 / Positron Emission Tomography Computed Tomography / COVID-19 Type of study: Diagnostic study / Prognostic study / Randomized controlled trials Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Eur J Nucl Med Mol Imaging Journal subject: Nuclear Medicine Year: 2021 Document Type: Article Affiliation country: S00259-020-04968-8

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Radiopharmaceuticals / Fluorodeoxyglucose F18 / Positron Emission Tomography Computed Tomography / COVID-19 Type of study: Diagnostic study / Prognostic study / Randomized controlled trials Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Eur J Nucl Med Mol Imaging Journal subject: Nuclear Medicine Year: 2021 Document Type: Article Affiliation country: S00259-020-04968-8