1
|
Lauri C, Campagna G, Glaudemans AWJM, Slart RHJA, van Leer B, Pillay J, Colandrea M, Grana CM, Stigliano A, Signore A. SARS-CoV-2 Affects Thyroid and Adrenal Glands: An 18F-FDG PET/CT Study. Biomedicines 2023; 11:2899. [PMID: 38001898 PMCID: PMC10669868 DOI: 10.3390/biomedicines11112899] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 10/12/2023] [Accepted: 10/23/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Since most endocrine glands express ACE-2 receptors and can be infected by SARS-CoV-2 virus, this retrospective multicentre observational study aims to assess the metabolic activity of thyroid and adrenal glands of COVID-19 patients by 18F-FDG PET/CT. METHODS We retrospectively evaluated the 18F-FDG PET/CT scans of COVID-19 patients admitted by three different centres, either in a low-intensity department or in the intensive care unit (ICU). A visual assessment and a semi-quantitative evaluation of areas of interest in thyroid and adrenal glands were performed by recording SUVmax and SUVmean. The 18F-FDG PET/CT uptake in COVID-19 patients was compared with those observed in normal age-matched controls. RESULTS Between March 2020 and March 2022, 33 patients from three different centres (twenty-eight patients in a low-intensity department and five patients in ICU), were studied by 18F-FDG PET/CT during active illness. Seven of them were also studied after clinical remission (3-6 months after disease onset). Thirty-six normal subjects were used as age-matched controls. In the thyroid gland, no statistically significant differences were observed between control subjects and COVID-19 patients at diagnosis. However, at the follow-up PET/CT study, we found a statistically higher SUVmax and SUVmean (p = 0.009 and p = 0.004, respectively) in the thyroid of COVID-19 patients. In adrenal glands, we observed lower SUVmax and SUVmean in COVID-19 patients at baseline compared to control subjects (p < 0.0001) and this finding did not normalize after clinical recovery (p = 0.0018 for SUVmax and p = 0.002 for SUV mean). CONCLUSIONS In our series, we observed persistent low 18F-FDG uptake in adrenal glands of patients at diagnosis of COVID-19 and after recovery, suggesting a chronic hypofunction. By contrast, thyroid uptake was comparable to normal subjects at disease onset, but after recovery, a subgroup of patients showed an increased metabolism, thus possibly suggesting the onset of an inflammatory thyroiditis. Our results should alert clinicians to investigate the pituitary-adrenal axis and thyroid functionality at the time of infection and to monitor them after recovery.
Collapse
Affiliation(s)
- Chiara Lauri
- Nuclear Medicine Unit, Department of Medical-Surgical Sciences and of Translational Medicine, Sant’Andrea University Hospital, “Sapienza” University of Rome, 00161 Rome, Italy; (G.C.); (A.S.)
| | - Giuseppe Campagna
- Nuclear Medicine Unit, Department of Medical-Surgical Sciences and of Translational Medicine, Sant’Andrea University Hospital, “Sapienza” University of Rome, 00161 Rome, Italy; (G.C.); (A.S.)
| | - Andor W. J. M. Glaudemans
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (A.W.J.M.G.); (R.H.J.A.S.); (B.v.L.)
| | - Riemer H. J. A. Slart
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (A.W.J.M.G.); (R.H.J.A.S.); (B.v.L.)
| | - Bram van Leer
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (A.W.J.M.G.); (R.H.J.A.S.); (B.v.L.)
- Department of Critical Care, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands;
| | - Janesh Pillay
- Department of Critical Care, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands;
| | - Marzia Colandrea
- Nuclear Medicine Division, European Institute of Oncology—IRCCS, 20141 Milan, Italy; (M.C.); (C.M.G.)
| | - Chiara Maria Grana
- Nuclear Medicine Division, European Institute of Oncology—IRCCS, 20141 Milan, Italy; (M.C.); (C.M.G.)
| | - Antonio Stigliano
- Endocrinology, Department of Clinical and Molecular Medicine, Sant’Andrea University Hospital, “Sapienza” University of Rome, 00161 Rome, Italy;
| | - Alberto Signore
- Nuclear Medicine Unit, Department of Medical-Surgical Sciences and of Translational Medicine, Sant’Andrea University Hospital, “Sapienza” University of Rome, 00161 Rome, Italy; (G.C.); (A.S.)
| |
Collapse
|
2
|
de Souza Nogueira J, Santos-Rebouças CB, Piergiorge RM, Valente AP, Gama-Almeida MC, El-Bacha T, Lopes Moreira ML, Baptista Marques BS, de Siqueira JR, de Carvalho EM, da Costa Ferreira O, Porto LC, Kelly da Silva Fidalgo T, Costa Dos Santos G. Metabolic Adaptations Correlated with Antibody Response after Immunization with Inactivated SARS-CoV-2 in Brazilian Subjects. J Proteome Res 2023. [PMID: 37167433 DOI: 10.1021/acs.jproteome.3c00014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
The adsorbed vaccine SARS-CoV-2 (inactivated) produced by Sinovac (SV) was the first vaccine against COVID-19 to be used in Brazil. To understand the metabolic effects of SV in Brazilian subjects, NMR-based metabolomics was used, and the immune response was studied in Brazilian subjects. Forty adults without (group-, n = 23) and with previous COVID-19 infection (group+, n = 17) were followed-up for 90 days postcompletion of the vaccine regimen. After 90 days, our results showed that subjects had increased levels of lipoproteins, lipids, and N-acetylation of glycoproteins (NAG) as well as decreased levels of amino acids, lactate, citrate, and 3-hydroxypropionate. NAG and threonine were the highest correlated metabolites with N and S proteins, and neutralizing Ab levels. This study sheds light on the immunometabolism associated with the use of SV in Brazilian subjects from Rio de Janeiro and identifies potential metabolic markers associated with the immune status.
Collapse
Affiliation(s)
- Jeane de Souza Nogueira
- Histocompatibility and Cryopreservation Laboratory, IBRAG, Rio de Janeiro State University, CEP 20950-003 Rio de Janeiro, Rio de Janeiro, Brazil
| | - Cíntia Barros Santos-Rebouças
- Department of Genetics, IBRAG, Rio de Janeiro State University, CEP 20550-013 Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rafael Mina Piergiorge
- Department of Genetics, IBRAG, Rio de Janeiro State University, CEP 20550-013 Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ana Paula Valente
- CENABIO I, Institute of Medical Biochemistry, CNRMN, BioNMR, Federal University of Rio de Janeiro, CEP 21941-902 Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcos C Gama-Almeida
- LeBioME-Bioactives, Mitochondria and Placental Metabolism Core, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, CEP 21941-902 Rio de Janeiro, Rio de Janeiro, Brazil
| | - Tatiana El-Bacha
- LeBioME-Bioactives, Mitochondria and Placental Metabolism Core, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, CEP 21941-902 Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | | | | | - Orlando da Costa Ferreira
- Molecular Virology Laboratory, Federal University of Rio de Janeiro, CEP 21941-902 Rio de Janeiro, Rio de Janeiro, Brazil
| | - Luís Cristóvão Porto
- Histocompatibility and Cryopreservation Laboratory, IBRAG, Rio de Janeiro State University, CEP 20950-003 Rio de Janeiro, Rio de Janeiro, Brazil
| | - Tatiana Kelly da Silva Fidalgo
- Department of Preventive and Community Dentistry, Dental School, Rio de Janeiro State University, CEP 20551-030 Rio de Janeiro, Rio de Janeiro, Brazil
| | - Gilson Costa Dos Santos
- Department of Genetics, IBRAG, Rio de Janeiro State University, CEP 20550-013 Rio de Janeiro, Rio de Janeiro, Brazil
| |
Collapse
|
3
|
CALABRIA FERDINANDO, BAGNATO ANTONIO, GUADAGNINO GIULIANA, TOTEDA MARIA, LANZILLOTTA ANTONIO, CARDEI STEFANIA, TAVOLARO ROSANNA, LEPORACE MARIO. COVID-19 vaccine related hypermetabolic lymph nodes on PET/CT: Implications of inflammatory findings in cancer imaging. Oncol Res 2023; 31:117-124. [PMID: 37304242 PMCID: PMC10207995 DOI: 10.32604/or.2023.027705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 02/20/2023] [Indexed: 06/13/2023] Open
Abstract
We observed several patients presenting 2-[18F]FDG uptake in the reactive axillary lymph node at PET/CT imaging, ipsilateral to the site of the COVID-19 vaccine injection. Analog finding was documented at [18F]Choline PET/CT. The aim of our study was to describe this source of false positive cases. All patients examined by PET/CT were included in the study. Data concerning patient anamnesis, laterality, and time interval from recent COVID-19 vaccination were recorded. SUVmax was measured in all lymph nodes expressing tracer uptake after vaccination. Among 712 PET/CT scans with 2-[18F]FDG, 104 were submitted to vaccination; 89/104 patients (85%) presented axillary and/or deltoid tracer uptake, related to recent COVID-19 vaccine administration (median from injection: 11 days). The mean SUVmax of these findings was 2.1 (range 1.6-3.3). Among 89 patients with false positive axillary uptake, 36 subjects had received chemotherapy due to lymph node metastases from somatic cancer or lymphomas, prior to the scan: 6/36 patients with lymph node metastases showed no response to therapy or progression disease. The mean SUVmax value of lymph nodal localizations of somatic cancers/lymphomas after chemotherapy was 7.8. Only 1/31 prostate cancer patients examined by [18F]Choline PET/CT showed post-vaccine axillary lymph node uptake. These findings were not recorded at PET/CT scans with [18F]-6-FDOPA, [68Ga]Ga-DOTATOC, and [18F]-fluoride. Following COVID-19 mass vaccination, a significant percentage of patients examined by 2-[18F]FDG PET/CT presents axillary, reactive lymph node uptake. Anamnesis, low-dose CT, and ultrasonography facilitated correct diagnosis. Semi-quantitative assessment supported the visual analysis of PET/CT data; SUVmax values of metastatic lymph nodes were considerably higher than post-vaccine lymph nodes. [18F]Choline uptake in reactive lymph node after vaccination was confirmed. After the COVID-19 pandemic, nuclear physicians need to take these potential false positive cases into account in daily clinical practice.
Collapse
Affiliation(s)
- FERDINANDO CALABRIA
- Department of Nuclear Medicine and Theragnostics, Mariano Santo Hospital, Cosenza, 87100, Italy
| | - ANTONIO BAGNATO
- Department of Nuclear Medicine and Theragnostics, Mariano Santo Hospital, Cosenza, 87100, Italy
| | - GIULIANA GUADAGNINO
- Department of Infectious and Tropical Diseases, St. Annunziata Hospital, Cosenza, 87100, Italy
| | - MARIA TOTEDA
- Department of Nuclear Medicine and Theragnostics, Mariano Santo Hospital, Cosenza, 87100, Italy
| | - ANTONIO LANZILLOTTA
- Department of Nuclear Medicine and Theragnostics, Mariano Santo Hospital, Cosenza, 87100, Italy
| | - STEFANIA CARDEI
- Department of Nuclear Medicine and Theragnostics, Mariano Santo Hospital, Cosenza, 87100, Italy
| | - ROSANNA TAVOLARO
- Department of Nuclear Medicine and Theragnostics, Mariano Santo Hospital, Cosenza, 87100, Italy
| | - MARIO LEPORACE
- Department of Nuclear Medicine and Theragnostics, Mariano Santo Hospital, Cosenza, 87100, Italy
| |
Collapse
|
4
|
Namous NA, Kushner D, Dadparvar S. Bilateral Axillary Nodal Uptake on 99m Tc-White Blood Cell Study Secondary to COVID-19 mRNA Vaccination. Clin Nucl Med 2023; 48:250-252. [PMID: 36127779 PMCID: PMC9907353 DOI: 10.1097/rlu.0000000000004394] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 07/27/2022] [Indexed: 02/04/2023]
Abstract
ABSTRACT A 77-year-old man with a history of chronic lower back pain, and prior spinal fusion surgery X2 was referred for 99m Tc-WBC Study for evaluation of worsening back pain and cervical radiculopathy to rule out any signs of infection. The patients white blood cells were tagged with 99m Tc-HMPAO (hexamethylpropylene amine oxime), and planar and SPECT/CT imaging was performed at 4 and 24 hours. 99m Tc-WBC Study showed no abnormal isotope localization in the spine; however, there was an incidental finding of bilateral increased soft tissue uptake in axillary lymph nodes. Medical history revealed intramuscular injection of second and third dose of Moderna mRNA COVID-19 vaccine in bilateral deltoids approximately 11 and 5 months before scan.
Collapse
Affiliation(s)
| | - Daniel Kushner
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Temple University Hospital, Philadelphia, PA
| | - Simin Dadparvar
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Temple University Hospital, Philadelphia, PA
| |
Collapse
|
5
|
Tripathy S, Alvarez N, Jaiswal S, Williams R, Al-Khadimi M, Hackman S, Phillips W, Kaur S, Cervantez S, Kelly W, Taverna J. Hypermetabolic lymphadenopathy following the administration of COVID-19 vaccine and immunotherapy in a lung cancer patient: a case report. J Med Case Rep 2022; 16:445. [PMID: 36434709 PMCID: PMC9700935 DOI: 10.1186/s13256-022-03660-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 10/28/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Given the current climate of the pandemic, lung cancer patients are especially vulnerable to complications from severe acute respiratory syndrome coronavirus 2 infection. As a high-risk population group, these patients are strongly advised to receive coronavirus disease 2019 vaccination in accordance with Center for Disease Control and Prevention guidelines to minimize morbidity and mortality. In recent years, immunotherapy has taken a preeminent role in the treatment of non-small cell lung cancer with dramatic improvement in overall survival. Reactive lymphadenopathy following the administration of a coronavirus disease 2019 vaccination can confound the radiographic interpretation of positron emission tomography-computed tomography or computed tomography scans from lung cancer patients receiving immunotherapy. CASE PRESENTATION Here, we present a case of a 61-year-old Caucasian female and former smoker who developed cervical, hilar, supraclavicular, mediastinal, and left retroauricular lymphadenopathy following her coronavirus disease 2019 booster vaccination. At the time, she had been receiving long-term immunotherapy for the treatment of advanced lung adenocarcinoma. Biopsy was pursued owing to concerns of treatment failure and confirmed recurrent malignancy. CONCLUSION This case report highlights the importance of lymph node biopsies in lung cancer patients who present with contralateral lymphadenopathy following coronavirus disease 2019 vaccination to rule out tumor recurrence in this deserving patient population.
Collapse
Affiliation(s)
- Shreya Tripathy
- grid.267309.90000 0001 0629 5880Department of Medicine, University of Texas Health Science Center, San Antonio, TX USA
| | - Nathaniel Alvarez
- grid.267309.90000 0001 0629 5880Department of Medicine, University of Texas Health Science Center, San Antonio, TX USA
| | - Shubham Jaiswal
- grid.267309.90000 0001 0629 5880Department of Medicine, University of Texas Health Science Center, San Antonio, TX USA
| | - Ryan Williams
- grid.267309.90000 0001 0629 5880Department of Medicine, University of Texas Health Science Center, San Antonio, TX USA ,UT Health San Antonio, MD Anderson Mays Cancer Center, San Antonio, TX USA
| | - Munaf Al-Khadimi
- grid.267309.90000 0001 0629 5880Department of Medicine, University of Texas Health Science Center, San Antonio, TX USA ,UT Health San Antonio, MD Anderson Mays Cancer Center, San Antonio, TX USA
| | - Sarah Hackman
- grid.267309.90000 0001 0629 5880Department of Pathology and Laboratory Medicine, University of Texas Health Science Center, San Antonio, TX USA
| | - William Phillips
- grid.267309.90000 0001 0629 5880Department of Radiology, University of Texas Health Science Center, San Antonio, TX USA
| | - Supreet Kaur
- grid.267309.90000 0001 0629 5880Department of Medicine, University of Texas Health Science Center, San Antonio, TX USA ,UT Health San Antonio, MD Anderson Mays Cancer Center, San Antonio, TX USA
| | - Sherri Cervantez
- grid.267309.90000 0001 0629 5880Department of Medicine, University of Texas Health Science Center, San Antonio, TX USA ,UT Health San Antonio, MD Anderson Mays Cancer Center, San Antonio, TX USA
| | - William Kelly
- grid.267309.90000 0001 0629 5880Department of Medicine, University of Texas Health Science Center, San Antonio, TX USA ,UT Health San Antonio, MD Anderson Mays Cancer Center, San Antonio, TX USA
| | - Josephine Taverna
- grid.267309.90000 0001 0629 5880Department of Medicine, University of Texas Health Science Center, San Antonio, TX USA ,UT Health San Antonio, MD Anderson Mays Cancer Center, San Antonio, TX USA
| |
Collapse
|
6
|
Quak E, Morel A, Faudemer J, Levy C, Ciappuccini R. Subdiaphragmatic Lymph Nodes Uptake on 18F-FDG PET/CT After COVID-19 Vaccination in the Thigh. Clin Nucl Med 2022; 47:275-276. [PMID: 34661560 PMCID: PMC8820748 DOI: 10.1097/rlu.0000000000003941] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 08/15/2021] [Accepted: 08/15/2021] [Indexed: 11/29/2022]
Abstract
ABSTRACT Since worldwide COVID-19 vaccination, 18F-FDG uptake in reactive axillary lymph nodes has been frequently observed in PET/CT studies. We describe a patient with breast cancer who underwent 18F-FDG PET/CT 7 days after receiving COVID-19 vaccination in the right thigh. 18F-FDG uptake was observed in nonenlarged right-sided inguinal, iliac, and para-aortic lymph nodes. As the thigh can be used as an alternate site for COVID-19 vaccine injection in case of lymphedema in both arms or for adequate axillary staging in patients with breast cancer, physicians should be aware of such 18F-FDG uptake pattern.
Collapse
Affiliation(s)
| | - Adeline Morel
- Breast Cancer Unit, Department of Medical Oncology, François Baclesse Comprehensive Cancer Centre
| | | | - Christelle Levy
- Breast Cancer Unit, Department of Medical Oncology, François Baclesse Comprehensive Cancer Centre
| | - Renaud Ciappuccini
- From the Department of Nuclear Medicine
- INSERM 1086 ANTICIPE, Caen University, Caen, France
| |
Collapse
|
7
|
Guglielmo P, Muccioli S, Berti S, Sartorello A, Pesella F, Gregianin M. Detection of Unilateral Axillary Nodal Uptake Both at 68Ga-DOTATOC and 18F-FDG PET/CT After 1 Week From COVID-19 Vaccine. Clin Nucl Med 2022; 47:e123-e124. [PMID: 34524165 PMCID: PMC8745948 DOI: 10.1097/rlu.0000000000003918] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 03/08/2021] [Indexed: 11/27/2022]
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.
Collapse
|
8
|
El-Sayed MS, Wechie GN, Low CS, Adesanya O, Rao N, Leung VJ. The incidence and duration of COVID-19 vaccine-related reactive lymphadenopathy on 18F-FDG PET-CT. Clin Med (Lond) 2021; 21:e633-e638. [PMID: 34862224 DOI: 10.7861/clinmed.2021-0420] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Reactive axillary lymph nodes (ALN) may occur post-COVID-19 vaccination. This may be confused with malignant nodal metastases on oncological imaging. We aimed to determine the reactive ALN incidence and duration on 18F-fluorodeoxyglucose positron emission tomography - computed tomography (18F-FDG PET-CT), and its relationship with gender, age and vaccine type. METHODS A retrospective study was performed. Two-hundred and four eligible patients had 18F-FDG PET-CT between 01 January 2021 and 31 March 2021, post-vaccination with Pfizer-BioNTech or Oxford-AstraZeneca vaccine. Image analysis was performed on dedicated workstations. SPSS was used for statistical analysis. RESULTS Thirty-six per cent of patients had reactive ALN until 10 weeks post-vaccination; reducing in frequency and intensity with time. Women were more likely to have reactive ALN compared with men. The frequency and intensity were higher in patients aged <65 years compared with those aged ≥65 years. However, no difference was found between both vaccine types in our study cohort. CONCLUSIONS Physicians' awareness of COVID-19 vaccine-related reactive ALN on 18F-FDG PET-CT is important to avoid inappropriate upstaging of cancers.
Collapse
Affiliation(s)
| | - Godfrey N Wechie
- University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Chen Sheng Low
- University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | | | - Nikhil Rao
- University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Vincent J Leung
- University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| |
Collapse
|
9
|
Sharma A, Drachtman R, Capozzoli G. Abnormal PET scan result after recent COVID vaccination. Pediatr Blood Cancer 2021; 68:e29262. [PMID: 34302718 PMCID: PMC8441693 DOI: 10.1002/pbc.29262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/13/2021] [Accepted: 07/14/2021] [Indexed: 11/06/2022]
Affiliation(s)
- Archana Sharma
- Rutgers Cancer Institute of New Jersey, Department of PediatricsNew BrunswickNew JerseyUSA
| | - Richard Drachtman
- Rutgers Cancer Institute of New Jersey, Department of PediatricsNew BrunswickNew JerseyUSA
| | - Gabrielle Capozzoli
- Rutgers Cancer Institute of New Jersey, Department of PediatricsRobert Wood Johnson Medical SchoolNew BrunswickNew JerseyUSA
| |
Collapse
|
10
|
Advani P, Chumsri S, Pai T, Li Z, Sharma A, Parent E. Temporal metabolic response to mRNA COVID-19 vaccinations in oncology patients. Ann Nucl Med 2021; 35:1264-1269. [PMID: 34463888 PMCID: PMC8406005 DOI: 10.1007/s12149-021-01675-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 08/22/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND mRNA COVID-19 vaccines are known to provide an immune response seen on FDG PET studies. However, the time course of this metabolic response is unknown. We here present a temporal metabolic response to mRNA COVID-19 vaccination in oncology patients undergoing standard of care FDG PET. METHODS 262 oncology patients undergoing standard of care FDG PET were included in the analysis. 231 patients had at least one dose of mRNA COVID-19 vaccine while 31 patients had not been vaccinated. The SUVmax of the lymph nodes ipsilateral to the vaccination was compared to the contralateral to obtain an absolute change in SUVmax (ΔSUVmax). RESULTS ΔSUVmax was more significant at shorter times between FDG PET imaging and COVID-19 mRNA vaccination, with a median ΔSUVmax of 2.6 (0-7 days), 0.8 (8-14 days), and 0.3 (> 14 days), respectively. CONCLUSION Consideration should be given to performing FDG PET at least 2 weeks after the COVID-19 vaccine.
Collapse
Affiliation(s)
- Pooja Advani
- Department of Oncology, Mayo Clinic Florida, Jacksonville, USA
| | - Saranya Chumsri
- Department of Oncology, Mayo Clinic Florida, Jacksonville, USA
| | - Tanmayi Pai
- Department of Internal Medicine, Mayo Clinic Florida, Jacksonville, USA
| | - Zhuo Li
- Department of Biostatistics, Mayo Clinic Florida, Jacksonville, USA
| | - Akash Sharma
- Department of Radiology, Mayo Clinic Florida, 4500 San Pablo Rd S., Jacksonville, FL, 32224, USA
| | - Ephraim Parent
- Department of Radiology, Mayo Clinic Florida, 4500 San Pablo Rd S., Jacksonville, FL, 32224, USA.
| |
Collapse
|
11
|
Shin M, Hyun CY, Choi YH, Choi JY, Lee KH, Cho YS. COVID-19 Vaccination-Associated Lymphadenopathy on FDG PET/CT: Distinctive Features in Adenovirus-Vectored Vaccine. Clin Nucl Med 2021; 46:814-819. [PMID: 34115709 PMCID: PMC8411598 DOI: 10.1097/rlu.0000000000003800] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/13/2021] [Accepted: 05/13/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE This study investigated 18F-FDG PET/CT features of adenovirus-vectored vaccination against COVID-19 in healthy subjects. PATIENTS AND METHODS Thirty-one health care workers had been vaccinated Vaxzevria and underwent FDG PET/CT as an optional test for a cancer screening program. Size and FDG uptake of the hypermetabolic lymph nodes were measured. Uptake value of spleen was also measured with liver for comparison. RESULTS All examinees who underwent FDG PET/CT within 14 days' interval showed hypermetabolic lymphadenopathies ipsilateral to vaccine injection. All examinees with hypermetabolic lymphadenopathy had simultaneous muscular uptakes until 23 days' interval. Among 12 examinees who underwent FDG PET/CT more than 15 days after vaccination, only 3 male examinees did not show hypermetabolism in the axillary lymph nodes. There was no female examinee with negative hypermetabolic lymphadenopathy until 29 days after vaccination. CONCLUSIONS Hypermetabolic reactive lymphadenopathy in the ipsilateral axillary area with or without supraclavicular area is most likely to occur in a healthy person with recent adenovirus-vectored COVID-19 vaccination on FDG PET/CT.
Collapse
Affiliation(s)
| | | | - Yoon Ho Choi
- Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | | | | | | |
Collapse
|
12
|
Indini A, Costa S, Ierardi AM, Rijavec E, Passoni E, Grossi F. COVID-19 vaccination mimicking lymph-node progression in a patient with melanoma: a case report. Melanoma Res 2021; 31:490-493. [PMID: 34433198 PMCID: PMC8423031 DOI: 10.1097/cmr.0000000000000768] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 07/03/2021] [Indexed: 11/26/2022]
Abstract
COVID-19 vaccination has been rapidly implemented among patients with cancer. We present the case of a patient with high-risk resected cutaneous melanoma, who was a candidate for adjuvant treatment, with postsurgery 18-fluorodeoxyglucose (FDG) PET/computed tomography (CT) scan showing positive axillary lymph nodes after COVID-19 vaccination. This report presents a 50-year-old man with a history of stage IIA cutaneous melanoma. During follow-up, the patient experienced subcutaneous and lymph-node disease progression, documented with 18FDG PET/CT scan. The patient underwent laparoscopic left para-aortic lymphadenectomy and excision of subcutaneous lesion. Histologic examination showed presence of melanoma metastases in 2 lymph nodes out of total 17 excised and neoplastic emboli to the subcutaneous tissue. In view of starting adjuvant nivolumab, the patient underwent CT scan restaging, with evidence of suspect centimetric periaortic and paracaval lymph nodes, which were deemed worthy of 18FDG PET investigation. The 18FDG PET/CT was negative for abdominal hypercaptation, but showed left axillary pathologic lymph nodes. The medical history of the patient revealed that he had received intramuscular Moderna COVID-19 mRNA vaccine in the left deltoid, one week before 18FDG PET examination. Since the patient's clinical examination was negative and suspecting postvaccination false-positive adenopathy, bilateral axillary ultrasound was performed, excluding the presence of pathologic lymph nodes. The patient has started adjuvant treatment with nivolumab, which is currently ongoing. This case demonstrates unexpected findings in response to COVID-19 vaccination in a patient with melanoma. In this specific case, the detection of 18FDG PET hypercaptation could significantly change the patient's management. With growing evidence about the pattern and occurrence of adenopathies after mRNA COVID-19 vaccination, recommendations for scheduling and interpretation of 18FDG PET/CT scans among cancer patients will be implemented, in order to reduce equivocal findings and improve outcomes.
Collapse
Affiliation(s)
| | | | | | | | - Emanuela Passoni
- Dermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milano
| | - Francesco Grossi
- Unit of Medical Oncology, Department of Medicine and Surgery, University of Insubria, ASST dei Sette Laghi, Varese, Italy
| |
Collapse
|
13
|
Mingels C, Alberts I, Fischlin C, Wartenberg J, Afshar-Oromieh A, Rominger A. FDG uptake in axillary lymph nodes after COVID-19 vaccination - a pitfall in a case of highly suspicious lymph node metastases of malignant melanoma. Nuklearmedizin 2021; 60:456-457. [PMID: 34412144 DOI: 10.1055/a-1561-2046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Clemens Mingels
- Inselspital, Bern University Hospital, Department of Nuclear Medicine, University of Bern, Bern, Switzerland
| | - Ian Alberts
- Inselspital, Bern University Hospital, Department of Nuclear Medicine, University of Bern, Bern, Switzerland
| | - Claudia Fischlin
- Department of Hand, Plastic and Reconstructive Surgery, Inselspital University Hospital Bern, Bern, Switzerland
| | - Jan Wartenberg
- Inselspital, Bern University Hospital, Department of Nuclear Medicine, University of Bern, Bern, Switzerland
| | - Ali Afshar-Oromieh
- Inselspital, Bern University Hospital, Department of Nuclear Medicine, University of Bern, Bern, Switzerland
| | - Axel Rominger
- Inselspital, Bern University Hospital, Department of Nuclear Medicine, University of Bern, Bern, Switzerland
| |
Collapse
|
14
|
PET findings after COVID-19 vaccination: "Keep Calm and Carry On". Clin Transl Imaging 2021; 9:209-214. [PMID: 34007835 PMCID: PMC8117802 DOI: 10.1007/s40336-021-00430-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 05/06/2021] [Indexed: 12/18/2022]
|
15
|
Shah S, Wagner T, Nathan M, Szyszko T. COVID-19 vaccine-related lymph node activation - patterns of uptake on PET-CT. BJR Case Rep 2021; 7:20210040. [PMID: 34131510 PMCID: PMC8171126 DOI: 10.1259/bjrcr.20210040] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 03/31/2021] [Accepted: 04/06/2021] [Indexed: 11/05/2022] Open
Abstract
In a bid to end the current COVID-19 crisis, many countries including UK have begun a mass immunization programme. Immunization can cause transient inflammation thereby causing increased metabolic activity at injection site and hypermetabolic lymph nodes. Various vaccinations and local injections have been known to cause diagnostic dilemma due to false-positive uptake on FDG PET-CT. In this pictorial case review, we present five cases demonstrating various patterns of uptake including an ipsilateral deltoid muscle, axillary, supraclavicular, and subpectoral lymph nodes post COVID-19 vaccination. A careful history of COVID-19 vaccination and normal size and morphology of lymph node on unenhanced low-dose CT will aid the diagnosis. All patients undergoing FDG PET-CT will require detailed documentation of the vaccination history including the time interval since vaccination. Knowledge about these patterns of uptake on PET-CT will ensure accurate interpretation by Nuclear Medicine physicians and radiologists during the current vaccination drive.
Collapse
Affiliation(s)
- Sweni Shah
- Department of Nuclear Medicine, Royal Free London NHS Foundation Trust, London, United Kingdom
| | - Thomas Wagner
- Department of Nuclear Medicine, Royal Free London NHS Foundation Trust, London, United Kingdom
| | - Malavika Nathan
- Department of Nuclear Medicine, Royal Free London NHS Foundation Trust, London, United Kingdom
| | - Teresa Szyszko
- Department of Nuclear Medicine, Royal Free London NHS Foundation Trust, London, United Kingdom
| |
Collapse
|
16
|
Bauckneht M, Aloè T, Tagliabue E, Cittadini G, Guadagno A, Morbelli S, Barisione E. Beyond Covid-19 vaccination-associated pitfalls on [ 18F]Fluorodeoxyglucose (FDG) PET: a case of a concomitant sarcoidosis. Eur J Nucl Med Mol Imaging 2021; 48:2661-2662. [PMID: 33876261 PMCID: PMC8055475 DOI: 10.1007/s00259-021-05360-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 04/05/2021] [Indexed: 12/17/2022]
Affiliation(s)
- Matteo Bauckneht
- Nuclear Medicine Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Teresita Aloè
- Interventional Pulmonology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Elena Tagliabue
- Clinic of Respiratory Disease and Allergology, Department of Internal Medicine and Medical Specialties, University of Genoa, Genoa, Italy
| | | | - Antonio Guadagno
- Anatomic Pathology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Silvia Morbelli
- Nuclear Medicine Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy. .,Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.
| | - Emanuela Barisione
- Interventional Pulmonology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| |
Collapse
|