A case of COVID-19 lung infection first detected by [18F]FDG PET-CT

Amini, Hamidreza; Divband, Ghasemali; Montahaei, Z.; Dehghani, Tohid; Kaviani, Hossein; Adinehpour, Zohreh; Aghdam, Ramin Akbarian; Rezaee, Alireza; Vali, Reza

doi:10.1007/s00259-020-04821-y

Cited by 15 publications

(20 citation statements)

References 3 publications

(3 reference statements)

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“…lower paratracheal node Bilateral, diffuse, and intense FDG uptake (SUVmax: 5.9) in Rt. the lower and Lt. lower lobe (SUVmax: 7.9) P24/M/82 Amini 47 Iran Colon cancer (adenocarcinoma) 18 F-FDG Hypermetabolic mediastinal LN (SUVmax:4.5) Foci of moderate to severely increased FDG activity (SUVmax range:1.5-8.6) in the Lt. lung and 1.2-8.3 in the Rt. lung P25/M/59 Reed-Embleton 48 UK Gastrointestinal stromal tumor 18 F-FDG NR FDG-avid, prominently bilateral and peripheral GGOs in upper and lower lobes P26/F/56 Chuang 49 USA SCC of paratracheal LN 18 F-FDG NR New bilateral multifocal hypermetabolic GGOs P27/M/59 Olivari 50 Italy Prostate cancer (recurrence of prostate cancer) 18 F-choline NR Bilateral subsegmental peripheral areas of GGOs in the lungs, all the pulmonary lesions presented an increased choline-PET uptake (SUV max range: 3–4) P28/F/45 Setti 51 Italy Colon cancer 18 F-FDG Modest mediastinal LN uptake was visible Consolidative opacities P29/M/67 Setti 51 Italy Rectal cancer (adenocarcinoma) 18 F-FDG NR GGOs P30/F/44 Setti 51 Italy Salivary gland carcinoma 18 F-FDG Faint mediastinal LN uptake was detected Consolidative opacities and GGOs P31/F/56 Setti 51 Italy Ovarian carcinoma (clear cells) 18 F-FDG NR GGOs P32/M/70 Setti …”

Section: Resultsmentioning

confidence: 99%

Coronavirus Disease 2019 (COVID-19) in Molecular Imaging: A Systematic Review of Incidental Detection of SARS-CoV-2 Pneumonia on PET Studies

Rafiee

Keshavarz

Katal

et al. 2021

Seminars in Nuclear Medicine

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Purpose There have been several reports of the incidental detection of SARS-CoV-2 pneumonia on Positron Emission Tomography/Computed Tomography (PET/CT) studies, which represent the potential role of molecular imaging in detection and management of coronavirus disease 2019 (COVID-19). Here, we systematically review the value of PET/CT in this setting. Materials and Methods We conducted a systematic search on June 23, 2020, for PET studies with findings suggestive of COVID-19. Web of Science, PubMed, Scopus, EMBASE, and Google Scholar databases were used. Patients with at least one PET/CT imaging evaluation were included in the study. Results Fifty-two patients in 30 publications with a mean age of 60 ± 12.74 (age range; 27-87) were included in this study, of which 28(53.8%) were male, and 19(36.5%) were female. PET/CT was performed with 18 F-FDG for 49(94.2%), 18 F-choline for 2(3.8%), and 68 Ga-PSMA for 1 (1.9%) patients. The mean SUV max of pulmonary lesions with 18 F-FDG uptake was 4.9 ± 2.3. Moreover, 39(75%) cases had an underlying malignancy, including 18 different type of primary cancers and 6(11.5%) patients with metastatic disease. The most common pulmonary findings in PET/CT were bilateral hypermetabolic GGOs 39(75%), consolidation 18(34.6%), and interlobular thickening 4(7.6%). In addition, mediastinal 14(27%) and hilar 10(19.2%) lymph node involvement with increased metabolic activity were frequently identified. Conclusion Early diagnosis of SARS-CoV-2 pneumonia is not only crucial for both appropriate patient management but also helps to ensure appropriate post-exposure precautions are implemented for the department and hospital staff and those who have been in contact with the patient.

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Section: Resultsmentioning

confidence: 99%

Coronavirus Disease 2019 (COVID-19) in Molecular Imaging: A Systematic Review of Incidental Detection of SARS-CoV-2 Pneumonia on PET Studies

Rafiee

Keshavarz

Katal

et al. 2021

Seminars in Nuclear Medicine

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“…[ 18 F]-FDG PET/CT has been already described as a tool to provide a diagnosis of interstitial pneumonia [12,13], which is one of the most common presentation of COVID-19 disease [14]. However, [ 18 F]-FDG PET/CT findings are not specific for COVID-19 pneumonia.…”

Section: Introductionmentioning

confidence: 99%

Increased incidence of interstitial pneumonia detected on [18F]-FDG-PET/CT in asymptomatic cancer patients during COVID-19 pandemic in Lombardy: a casualty or COVID-19 infection?

Setti

Bonacina

Meroni

et al. 2020

Eur J Nucl Med Mol Imaging

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Purpose The study aimed to compare the incidence of interstitial pneumonia on [ 18 F]-FDG PET/CT scans between two 6-month periods: (a) the COVID-19 pandemic peak and (b) control period. Secondly, we compared the incidence of interstitial pneumonia on [ 18 F]-FDG PET/CT and epidemiological data from the regional registry of COVID-19 cases. Additionally, imaging findings and the intensity of [ 18 F]-FDG PET/CT uptake in terms of maximum standardized uptake value (SUVmax) were compared. Methods We retrospectively analyzed [ 18 F]-FDG PET/CT scans performed in cancer patients referred to nuclear medicine of Humanitas Gavazzeni in Bergamo from December 2019 to May 2020 and from December 2018 to May 2019. The per month incidence of interstitial pneumonia at imaging and the epidemiological data were assessed. To evaluate the differences between the two symmetric groups (period of COVID-19 pandemic and control), the stratified Cochran-Mantel-Haenszel test was used. Chi-square test or Fisher's exact test and t test or Wilcoxon test were performed to compare the distributions of categorical and continuous variables, respectively. Results Overall, 1298 patients were included in the study. The two cohorts-COVID-19 pandemic (n = 575) and control (n = 723)-did not statistically differ in terms of age, disease, or scan indication (p > 0.05). Signs of interstitial pneumonia were observed in 24 (4.2%) and 14 patients (1.9%) in the COVID-19 period and the control period, respectively, with a statistically significant difference (p = 0.013). The level of statistical significance improved further when the period from January to May was considered, with a peak in March (7/83 patients, 8.4% vs 3/134 patients, 2.2%, p = 0.001). The curve of interstitial pneumonia diagnosis overlapped with the COVID-19 incidence in the area of Lombardy (Spearman correlation index was equal to 1). Imaging data did not differ among the two cohorts. Conclusions Significant increase of interstitial lung alterations at [ 18 F]-FDG PET/CT has been demonstrated during the COVID-19 pandemic. Additionally, the incidence curve of imaging abnormalities resulted in resembling the epidemiological data of the general population. These data support the rationale to adopt [ 18 F]-FDG PET/CT as sentinel modality to identify suspicious COVID-19 cases to be referred for additional confirmatory testing. Nuclear medicine physicians and staff should continue active surveillance of interstitial pneumonia findings, especially when new infection peak is expected.

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“…A few reports of patients with COVID-19 have been described by 18 F-FDG PET/CT, mostly symptomatic patients with COVID-19 respiratory disease that include dry cough, shortness of breath and fever [5][6][7][10][11][12][13]. However, a wide range of symptoms have been reported, ranging from asymptomatic or mild symptoms [8,12] to severe illness [5,7,11,13]. These symptoms may appear at 2 to 14 days after exposure to the coronavirus SARS-CoV-2.…”

Section: Discussionmentioning

confidence: 99%

“…These symptoms may appear at 2 to 14 days after exposure to the coronavirus SARS-CoV-2. The spectrum of clinical manifestations includes chills, myalgia, fatigue, headache, sore throat, loss of taste or smell, pressure in the chest, pleuritic pain, and rarely, digestive and neurological symptomatology [1,2,5,13].…”

Section: Discussionmentioning

confidence: 99%

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Incidental 18F-FDG PET/CT finding of COVID-1 pneumonia in asymptomatic patient diagnosed with lung abscess metastasis

Mestre-Fusco

Velasco-Nuño

Negre-Busó

et al. 2020

Preprint

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A 66-year-old male patient, with chronic respiratory disease and right colon resection in March 2017 for colon low-grade adenocarcinoma was assessed for recurrence suggested by elevated levels of tumor marker and no evidence of oncological disease by CT scan. 18F-FDG PET/CT showed bilateral multiple peripheral FDG-avid foci that matched with a peripheral predominant ground-glass opacities (GGOs) observed in lower lobes and multiple FDG-positive enlarged lymph nodes were also identified in the mediastinum. Patient was hospitalized in March 14th 2020, one day after PET/CT scan, with cough, wheezing and fever, and was treated with anti-inflammatory drugs. A first SARS-CoV-2 RT-PCR in March 15th resulted as negative and patient was treated with antibiotic therapy lead to an improvement of respiratory symptoms. PET/CT scan was interpreted as a pneumonia foci. A deteriorating patient condition was observed, with respiratory symptomatology progression, fatigue and D-Dimer elevation and a new RT-PCR resulted positive. A week after PET/CT scan, hospitalization in intensive care unit was necessary for rapidly disease progression and severe respiratory distress syndrome and patient died four days later.

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A case of COVID-19 lung infection first detected by [18F]FDG PET-CT

Cited by 15 publications

References 3 publications

Coronavirus Disease 2019 (COVID-19) in Molecular Imaging: A Systematic Review of Incidental Detection of SARS-CoV-2 Pneumonia on PET Studies

Coronavirus Disease 2019 (COVID-19) in Molecular Imaging: A Systematic Review of Incidental Detection of SARS-CoV-2 Pneumonia on PET Studies

Increased incidence of interstitial pneumonia detected on [18F]-FDG-PET/CT in asymptomatic cancer patients during COVID-19 pandemic in Lombardy: a casualty or COVID-19 infection?

Incidental 18F-FDG PET/CT finding of COVID-1 pneumonia in asymptomatic patient diagnosed with lung abscess metastasis

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