Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland.
University of Zurich, Zurich, Switzerland.
Eur Radiol. 2022 Jan;32(1):508-516. doi: 10.1007/s00330-021-08122-2. Epub 2021 Jun 22.
To assess the frequency, intensity, and clinical impact of [F]FDG-avidity of axillary lymph nodes after vaccination with COVID-19 vaccines BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna) in patients referred for oncological FDG PET/CT.
One hundred forty patients referred for FDG PET/CT during February and March 2021 after first or second vaccination with Pfizer-BioNTech or Moderna were retrospectively included. FDG-avidity of ipsilateral axillary lymph nodes was measured and compared. Assuming no knowledge of prior vaccination, metastatic risk was analyzed by two readers and the clinical impact was evaluated.
FDG PET/CT showed FDG-avid lymph nodes ipsilateral to the vaccine injection in 75/140 (54%) patients with a mean SUV of 5.1 (range 2.0 - 17.3). FDG-avid lymph nodes were more frequent in patients vaccinated with Moderna than Pfizer-BioNTech (36/50 [72%] vs. 39/90 [43%] cases, p < 0.001). Metastatic risk of unilateral FDG-avid axillary lymph nodes was rated unlikely in 52/140 (37%), potential in 15/140 (11%), and likely in 8/140 (6%) cases. Clinical management was affected in 17/140 (12%) cases.
FDG-avid axillary lymph nodes are common after COVID-19 vaccination. The avidity of lymph nodes is more frequent in Moderna compared to that in Pfizer-BioNTech vaccines. To avoid relatively frequent clinical dilemmas, we recommend carefully taking the history for prior vaccination in patients undergoing FDG PET/CT and administering the vaccine contralateral to primary cancer.
• PET/CT showed FDG-avid axillary lymph nodes ipsilateral to the vaccine injection site in 54% of 140 oncological patients after COVID-19 vaccination. • FDG-avid lymphadenopathy was observed significantly more frequently in Moderna compared to patients receiving Pfizer-BioNTech-vaccines. • Patients should be screened for prior COVID-19 vaccination before undergoing PET/CT to enable individually tailored recommendations for clinical management.
评估接种 COVID-19 疫苗 BNT162b2（辉瑞-生物科技）和 mRNA-1273（莫德纳）后，接受肿瘤 FDG PET/CT 的患者腋窝淋巴结的[F]FDG 摄取频率、强度和临床影响。
回顾性纳入 2021 年 2 月至 3 月期间首次或第二次接种辉瑞-生物科技或莫德纳后进行 FDG PET/CT 的 140 名患者。测量并比较同侧腋窝淋巴结的 FDG 摄取情况。假设对先前的疫苗接种一无所知，两名读者分析了转移风险，并评估了临床影响。
140 名患者中有 75 名（54%）在 FDG PET/CT 上显示出疫苗注射同侧的 FDG 摄取性淋巴结，平均 SUV 为 5.1（范围 2.0-17.3）。接种莫德纳的患者中 FDG 摄取性淋巴结比接种辉瑞-生物科技的患者更常见（36/50[72%]与 39/90[43%]病例，p<0.001）。单侧 FDG 摄取性腋窝淋巴结的转移风险被评为不太可能的有 52/140（37%），可能的有 15/140（11%），很可能的有 8/140（6%）。140 例中有 17 例（12%）的临床管理受到影响。
接种 COVID-19 疫苗后，FDG 摄取性腋窝淋巴结很常见。与辉瑞-生物科技疫苗相比，莫德纳疫苗中淋巴结的摄取更为频繁。为了避免相对频繁的临床困境，我们建议在接受 FDG PET/CT 的患者中仔细询问疫苗接种史，并在原发癌对侧接种疫苗。
140 名肿瘤患者接种 COVID-19 疫苗后，140 名肿瘤患者的 FDG PET/CT 显示同侧疫苗注射部位的腋窝淋巴结摄取 FDG。
与接受辉瑞-生物科技疫苗的患者相比，莫德纳患者观察到的 FDG 摄取性淋巴结病明显更频繁。
在进行 PET/CT 之前，患者应接受 COVID-19 疫苗接种情况筛查，以便为临床管理提供个性化建议。
