Challenging Axillary Lymph Nodes on PET/CT in Cancer Patients Throughout COVID-19 Vaccination Era
Copyright© Bentham Science Publishers; For any queries, please email at epubbenthamscience.net..
BACKGROUND: The unexpected detection of axillary lymphadenopathy (AxL) in cancer patients (pts) represents a real concern during the COVID-19 vaccination era. Benign reactions may take place after vaccine inoculation, which can mislead image interpretation in patients undergoing F-18-FDG, F-18-Choline, and Ga-68-DOTATOC PET/CT. They may also mimic loco-regional metastases or disease. We assessed PET/CT findings after COVID-19 first dose vaccination in cancer patients and the impact on their disease course management.
METHODS: We evaluated 333 patients undergoing PET/CT (257 F-18-FDG, 54 F-18-Choline, and 23 Ga-68 DOTATOC) scans after the first vaccination with mRNA vaccine (Pfizer-BioNTech) (study group; SG). The uptake index (SUVmax) of suspected AxL was defined as significant when the ratio was >1.5 as compared to the contralateral lymph nodes. Besides, co-registered CT (Co-CT) features of target lymph nodes were evaluated. Nodes with aggregate imaging positivity were further investigated.
RESULTS: Overall, the prevalence of apparently positive lymph nodes on PET scans was 17.1% during the vaccination period. 107 pts of the same setting, who had undergone PET/CT before the COVID-19 pandemic, represented the control group (CG). Only 3 patients of CG showed reactive lymph nodes with a prevalence of 2.8% (p < 0.001 as compared to the vaccination period). 84.2% of SG patients exhibited benign characteristics on co-CT images and only 9 pts needed thorough appraisal.
CONCLUSION: The correct interpretation of images is crucial to avoid unnecessary treatments and invasive procedures in vaccinated cancer pts. A detailed anamnestic interview and the analysis of lymph nodes' CT characteristics, after performing PET/CT, may help to clear any misleading diagnosis.
Medienart: |
E-Artikel |
---|
Erscheinungsjahr: |
2024 |
---|---|
Erschienen: |
2024 |
Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
---|---|
Enthalten in: |
Current pharmaceutical design - (2024) vom: 06. März |
Sprache: |
Englisch |
---|
Beteiligte Personen: |
Giordano, Alessia [VerfasserIn] |
---|
Links: |
---|
Themen: |
---|
Anmerkungen: |
Date Revised 08.03.2024 published: Print-Electronic Citation Status Publisher |
---|
doi: |
10.2174/0113816128246329231016091519 |
---|
funding: |
|
---|---|
Förderinstitution / Projekttitel: |
|
PPN (Katalog-ID): |
NLM369445023 |
---|
LEADER | 01000naa a22002652 4500 | ||
---|---|---|---|
001 | NLM369445023 | ||
003 | DE-627 | ||
005 | 20240308233318.0 | ||
007 | cr uuu---uuuuu | ||
008 | 240308s2024 xx |||||o 00| ||eng c | ||
024 | 7 | |a 10.2174/0113816128246329231016091519 |2 doi | |
028 | 5 | 2 | |a pubmed24n1320.xml |
035 | |a (DE-627)NLM369445023 | ||
035 | |a (NLM)38454762 | ||
040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
041 | |a eng | ||
100 | 1 | |a Giordano, Alessia |e verfasserin |4 aut | |
245 | 1 | 0 | |a Challenging Axillary Lymph Nodes on PET/CT in Cancer Patients Throughout COVID-19 Vaccination Era |
264 | 1 | |c 2024 | |
336 | |a Text |b txt |2 rdacontent | ||
337 | |a ƒaComputermedien |b c |2 rdamedia | ||
338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
500 | |a Date Revised 08.03.2024 | ||
500 | |a published: Print-Electronic | ||
500 | |a Citation Status Publisher | ||
520 | |a Copyright© Bentham Science Publishers; For any queries, please email at epubbenthamscience.net. | ||
520 | |a BACKGROUND: The unexpected detection of axillary lymphadenopathy (AxL) in cancer patients (pts) represents a real concern during the COVID-19 vaccination era. Benign reactions may take place after vaccine inoculation, which can mislead image interpretation in patients undergoing F-18-FDG, F-18-Choline, and Ga-68-DOTATOC PET/CT. They may also mimic loco-regional metastases or disease. We assessed PET/CT findings after COVID-19 first dose vaccination in cancer patients and the impact on their disease course management | ||
520 | |a METHODS: We evaluated 333 patients undergoing PET/CT (257 F-18-FDG, 54 F-18-Choline, and 23 Ga-68 DOTATOC) scans after the first vaccination with mRNA vaccine (Pfizer-BioNTech) (study group; SG). The uptake index (SUVmax) of suspected AxL was defined as significant when the ratio was >1.5 as compared to the contralateral lymph nodes. Besides, co-registered CT (Co-CT) features of target lymph nodes were evaluated. Nodes with aggregate imaging positivity were further investigated | ||
520 | |a RESULTS: Overall, the prevalence of apparently positive lymph nodes on PET scans was 17.1% during the vaccination period. 107 pts of the same setting, who had undergone PET/CT before the COVID-19 pandemic, represented the control group (CG). Only 3 patients of CG showed reactive lymph nodes with a prevalence of 2.8% (p < 0.001 as compared to the vaccination period). 84.2% of SG patients exhibited benign characteristics on co-CT images and only 9 pts needed thorough appraisal | ||
520 | |a CONCLUSION: The correct interpretation of images is crucial to avoid unnecessary treatments and invasive procedures in vaccinated cancer pts. A detailed anamnestic interview and the analysis of lymph nodes' CT characteristics, after performing PET/CT, may help to clear any misleading diagnosis | ||
650 | 4 | |a Clinical Trial | |
650 | 4 | |a COVID-19 | |
650 | 4 | |a PET/CT | |
650 | 4 | |a Vaccine | |
650 | 4 | |a cancer | |
650 | 4 | |a lympho-adenopathy. | |
700 | 1 | |a Gallicchio, Rosj |e verfasserin |4 aut | |
700 | 1 | |a Milella, Mariarita |e verfasserin |4 aut | |
700 | 1 | |a Storto, Rebecca |e verfasserin |4 aut | |
700 | 1 | |a Nardelli, Anna |e verfasserin |4 aut | |
700 | 1 | |a Pellegrino, Teresa |e verfasserin |4 aut | |
700 | 1 | |a Nappi, Antonio |e verfasserin |4 aut | |
700 | 1 | |a Di Cosola, Michele |e verfasserin |4 aut | |
700 | 1 | |a Storto, Giovanni |e verfasserin |4 aut | |
773 | 0 | 8 | |i Enthalten in |t Current pharmaceutical design |d 1998 |g (2024) vom: 06. März |w (DE-627)NLM095430172 |x 1873-4286 |7 nnns |
773 | 1 | 8 | |g year:2024 |g day:06 |g month:03 |
856 | 4 | 0 | |u http://dx.doi.org/10.2174/0113816128246329231016091519 |3 Volltext |
912 | |a GBV_USEFLAG_A | ||
912 | |a GBV_NLM | ||
951 | |a AR | ||
952 | |j 2024 |b 06 |c 03 |