COVID-19 vaccination, implications for PET/CT image interpretation and future perspectives

Margarita Kirienko; Matteo Biroli; Cristiano Pini; Fabrizia Gelardi; Martina Sollini; Arturo Chiti

doi:10.1007/s40336-022-00521-9

COVID-19 vaccination, implications for PET/CT image interpretation and future perspectives

Clin Transl Imaging. 2022;10(6):631-642. doi: 10.1007/s40336-022-00521-9. Epub 2022 Aug 16.

Authors

Margarita Kirienko^#¹, Matteo Biroli^#², Cristiano Pini^{2

3}, Fabrizia Gelardi^{2

3}, Martina Sollini^{2

3}, Arturo Chiti^{2

3}

Affiliations

¹ Fondazione IRCCS Istituto Nazionale Tumori, Via G. Venezian 1, 20133 Milan, Italy.
² Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy.
³ IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy.

^# Contributed equally.

Abstract

Introduction: The present paper aims to systematically review the literature on COVID-19 vaccine-related findings in patients undergoing PET/CT.

Methods: The search algorithms included the following combination of terms: "PET" OR "positron emission tomography" AND "COVID"; "PET" OR "positron emission tomography" AND "COVID" AND "vaccination"; "PET" OR "positron emission tomography" AND "COVID", AND "autoimmune".

Results: We selected 17 articles which were assessed for quality and included in the systematic analysis. The most frequent vaccine-related signs on PET/CT were the deltoid [¹⁸F]FDG uptake and axillary hypermetabolic lymph nodes, which were described in 8-71% and 7-90% of the patients, respectively. Similarly, frequency of these findings using other tracers than [¹⁸F]FDG was greatly variable. This large variability was related to the variability in time elapsed between vaccination and PET/CT, and the criteria used to define positivity. In addition, vaccine-related findings were detected more frequently in young and immunocompetent patients than in elderly and immunocompromised ones.

Discussion: Therefore, awareness on vaccination status (timing, patient characteristics, and concurrent therapies) and knowledge on patterns of radiopharmaceutical uptake are necessary to properly interpret PET/CT findings.

Keywords: COVID-19; Infection; Inflammation; PET/CT; SARS-CoV-2; Vaccination.

© The Author(s), under exclusive licence to Italian Association of Nuclear Medicine and Molecular Imaging 2022, Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Publication types

Review