From the *Vaccine Research Center, National Institute of Allergy and Infectious Disease, †Biostatistics Research Branch, Division of Clinical Research, National Institute of Allergy and Infectious Disease, and ‡Positron Emission Tomography Department, Clinical Center, National Institutes of Health, Bethesda, MD.
Clin Nucl Med. 2017 May;42(5):329-334. doi: 10.1097/RLU.0000000000001603.
While PET using F-FDG is most commonly used for imaging malignant tumors, vaccination is known to cause transient inflammation of lymph nodes inducing positive findings on F-FDG PET scans. The pattern, magnitude, and duration of lymph node activation following vaccination have not been clearly defined. Furthermore, the addition of adjuvants to vaccines can further enhance the immune response. The presented study was designed to define lymph node activation following administration of the Food and Drug Administration-licensed human papillomavirus vaccines, Cervarix and Gardasil, which contain similar antigens with different adjuvants.
Twenty-seven women aged 18 to 25 years were randomized to receive either Cervarix or Gardasil in the clinical trial VRC 900. Fifteen subjects participated in the PET/CT portion of the trial and received scans of lymph node activation at prevaccination and "1 week" (8-14 days) and "1 month" (23-36 days) after the first or third vaccination.
PET/CT scans revealed that all vaccine recipients had ipsilateral axillary lymph node activity. Three of 4 Cervarix recipients also showed contralateral lymph node activity 1 month after the first vaccination. For both Cervarix and Gardasil, the SUV activity resolved over time, with activity extended up to day 37 after the first and third vaccinations.
Following intramuscular vaccination, there were no major differences between duration of uptake and intensity of SUV between Cervarix and Gardasil recipients in ipsilateral axillary lymph nodes. Contralateral node activation was detected up to 1 month after the first vaccination in Cervarix recipients only, possibly reflecting differences in vaccine adjuvant formulation.
正电子发射断层扫描（PET）使用 F-FDG 对恶性肿瘤进行成像，而众所周知，疫苗接种会导致淋巴结短暂炎症，从而使 F-FDG PET 扫描显示阳性结果。然而，疫苗接种后淋巴结激活的模式、程度和持续时间尚未明确界定。此外，疫苗中添加佐剂可以进一步增强免疫反应。本研究旨在明确已获美国食品药品监督管理局（FDA）批准的人乳头瘤病毒（HPV）疫苗 Cervarix 和 Gardasil 接种后淋巴结的激活情况，这两种疫苗包含相似的抗原，但佐剂不同。
27 名年龄在 18 至 25 岁的女性随机接受 Cervarix 或 Gardasil 疫苗的临床试验 VRC 900。其中 15 名受试者参加了试验的 PET/CT 部分，在接种第一针或第三针疫苗前和接种后“1 周”（8-14 天）和“1 个月”（23-36 天）时接受了淋巴结激活的扫描。
PET/CT 扫描显示，所有疫苗接种者的同侧腋窝淋巴结均有活性。在接种第一针 Cervarix 疫苗后 1 个月，有 3 名接种者的对侧淋巴结也有活性。对于 Cervarix 和 Gardasil，SUV 活性随时间推移而消退，接种第一针和第三针后的第 37 天活性仍有延长。
接种肌内疫苗后，在同侧腋窝淋巴结中，Cervarix 和 Gardasil 接种者的摄取持续时间和 SUV 强度之间没有明显差异。在 Cervarix 接种者中，仅在接种第一针疫苗后 1 个月检测到对侧淋巴结激活，这可能反映了疫苗佐剂配方的差异。
