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Assessment of extra-parenchymal lung involvement in asymptomatic cancer patients with COVID-19 pneumonia detected on 18F-FDG PET-CT studies.
Wakfie-Corieh, Cristina Gamila; Blanes García, Alba María; Ferrando-Castagnetto, Federico; Valhondo-Rama, Raquel; Ortega Candil, Aida; Rodríguez Rey, Cristina; Cabrera Martín, María Nieves; García-Esquinas, Marta García; Couto Caro, Rosa María; Pedrera Canal, María; Carreras Delgado, José Luis.
  • Wakfie-Corieh CG; Department of Nuclear Medicine, Hospital Clínico San Carlos, Av. Profesor Martín Lagos s/n., 28040, Madrid, Spain. cristinagwc@gmail.com.
  • Blanes García AM; Department of Nuclear Medicine, Hospital Clínico San Carlos, Av. Profesor Martín Lagos s/n., 28040, Madrid, Spain.
  • Ferrando-Castagnetto F; Department of Cardiology, Hospital de Clínicas Dr. Manuel Quintela, Montevideo, Uruguay.
  • Valhondo-Rama R; Department of Nuclear Medicine, Hospital Clínico San Carlos, Av. Profesor Martín Lagos s/n., 28040, Madrid, Spain.
  • Ortega Candil A; Department of Nuclear Medicine, Hospital Clínico San Carlos, Av. Profesor Martín Lagos s/n., 28040, Madrid, Spain.
  • Rodríguez Rey C; Department of Nuclear Medicine, Hospital Clínico San Carlos, Av. Profesor Martín Lagos s/n., 28040, Madrid, Spain.
  • Cabrera Martín MN; Department of Nuclear Medicine, Hospital Clínico San Carlos, Av. Profesor Martín Lagos s/n., 28040, Madrid, Spain.
  • García-Esquinas MG; Department of Radiology, Hospital Clínico San Carlos, Madrid, Spain.
  • Couto Caro RM; Department of Nuclear Medicine, Hospital Clínico San Carlos, Av. Profesor Martín Lagos s/n., 28040, Madrid, Spain.
  • Pedrera Canal M; Department of Nuclear Medicine, Hospital Clínico San Carlos, Av. Profesor Martín Lagos s/n., 28040, Madrid, Spain.
  • Carreras Delgado JL; Department of Nuclear Medicine, Hospital Clínico San Carlos, Av. Profesor Martín Lagos s/n., 28040, Madrid, Spain.
Eur J Nucl Med Mol Imaging ; 48(3): 768-776, 2021 03.
Article in English | MEDLINE | ID: covidwho-754640
ABSTRACT

BACKGROUND:

Lung involvement in patients with coronavirus disease 2019 (COVID-19) undergoing PET-CT has been previously reported. However, FDG uptake outside lung parenchyma was poorly characterized in detail. We evaluated the extra-parenchymal lung involvement in asymptomatic cancer patients with COVID-19 pneumonia through 18F-FDG PET-CT.

METHODS:

A total of 1079 oncologic 18F-FDG PET-CT were performed between February 2 and May 18, 2020. Confirmed COVID-19 pneumonia was defined as characteristic ground-glass bilateral CT infiltrates and positive genetic/serologic tests. Nonmetastatic extra-parenchymal lung PET-CT findings were evaluated through qualitative (visual), quantitative (measurements on CT), and semiquantitative (maximum standardized uptake value SUVmax on PET) interpretation. Clinical data, blood tests, and PET-CT results were compared between patients with and without COVID-19 pneumonia.

RESULTS:

A total of 23 18F-FDG PET-CT scans with pulmonary infiltrates suggestive of COVID-19 and available laboratory data were included 14 positive (cases) and 9 negative (controls) for COVID-19 infection, representing a low prevalence of COVID-19 pneumonia (1.3%). Serum lactate dehydrogenase and D-dimers tended to be increased in COVID-19 cases. Extra-parenchymal lung findings were found in 42.9% of patients with COVID-19, most frequently as mediastinal and hilar nodes with 18F-FDG uptake (35.7%), followed by incidental pulmonary embolism in two patients (14.3%). In the control group, extra-pulmonary findings were observed in a single patient (11.1%) with 18F-FDG uptake located to mediastinal, hilar, and cervical nodes. Nasopharyngeal and hepatic SUVmax were similar in both groups.

CONCLUSION:

In cancer patients with asymptomatic COVID-19 pneumonia, 18F-FDG PET-CT findings are more frequently limited to thoracic structures, suggesting that an early and silent distant involvement is very rare. Pulmonary embolism is a frequent and potentially severe finding raising special concern. PET-CT can provide new pathogenic insights about this novel disease.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Radiopharmaceuticals / Fluorodeoxyglucose F18 / Positron Emission Tomography Computed Tomography / COVID-19 / Lung / Neoplasms Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study / Qualitative research / Randomized controlled trials Topics: Long Covid Limits: Female / Humans / Male Language: English Journal: Eur J Nucl Med Mol Imaging Journal subject: Nuclear Medicine Year: 2021 Document Type: Article Affiliation country: S00259-020-05019-y

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Radiopharmaceuticals / Fluorodeoxyglucose F18 / Positron Emission Tomography Computed Tomography / COVID-19 / Lung / Neoplasms Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study / Qualitative research / Randomized controlled trials Topics: Long Covid Limits: Female / Humans / Male Language: English Journal: Eur J Nucl Med Mol Imaging Journal subject: Nuclear Medicine Year: 2021 Document Type: Article Affiliation country: S00259-020-05019-y