Department of Nuclear Medicine Kocaeli University Faculty of Medicine, Kocaeli, Turkey.
Turk J Med Sci. 2022 Dec;52(6):1745-1753. doi: 10.55730/1300-0144.5519. Epub 2022 Dec 21.
It isimportant to evaluate the vaccine-related metabolic changes on FDG PET/CT to avoid confusing results. We here aimed to assess the frequency and intensity of regional and systemic metabolic PET/CT changes of patients who received the mRNAbased COVID-19 vaccine (BNT162b2-Pfizer/BioNTech) and to analyze possible factors affecting these changes.
Among the patients who underwent FDG PET/CT for any indication in our department between July 2021 and December 2021, 129 volunteer patients with a history of COVID-19 vaccination were included in this prospective observational study. Bilateral axillary lymph nodes, ipsilateral deltoid muscle, bone marrow, spleen, thyroid, and liver FDG uptakes were evaluated visually and semiquantitatively for each examination.
The frequencies of positive axillary lymph nodes after vaccination were 40%, 44.4%, 32.6%, and 44.7% in all, 1st dose, 2nd dose, and heterologous vaccination regimens groups, respectively. Maximum standardized uptake values of spleen, liver, and bone marrow were statistically high in patients with positive axillary lymph nodes than with negative ones (p < 0.05). Positive deltoid muscle uptake and diffusely increased thyroid uptake findings were observed in 10 and 8 patients, respectively. The median time interval between vaccination and imaging was 9.5 days for patients with positive axillary lymph nodes and 17 days for patients with negative nodes. In our study group, only 8 patients had a positive documented history of COVID-19 infection.
Regional and systemic metabolic changes were occasionally found on FDG PET/CT imaging in patients who received the mRNA-based COVID-19 vaccine. To avoid these timely decreasing changes, we recommend managing the ideal timing of imaging or vaccination and taking a careful history.
评估 FDG PET/CT 上与疫苗相关的代谢变化对于避免混淆结果非常重要。我们旨在评估接受信使核糖核酸（mRNA）COVID-19 疫苗（BNT162b2-辉瑞/生物科技）的患者的局部和全身代谢性 PET/CT 变化的频率和强度，并分析可能影响这些变化的因素。
在我们科室 2021 年 7 月至 2021 年 12 月期间因任何适应症进行 FDG PET/CT 的患者中，共有 129 名有 COVID-19 疫苗接种史的志愿者患者纳入本前瞻性观察研究。对每一次检查，双侧腋窝淋巴结、同侧三角肌、骨髓、脾脏、甲状腺和肝脏的 FDG 摄取均进行视觉和半定量评估。
接种疫苗后，所有、1 剂、2 剂和异源疫苗接种方案组的腋窝淋巴结阳性率分别为 40%、44.4%、32.6%和 44.7%。与腋窝淋巴结阴性者相比，腋窝淋巴结阳性者的脾脏、肝脏和骨髓最大标准化摄取值明显较高（p<0.05）。10 例患者观察到三角肌摄取阳性，8 例患者观察到甲状腺弥漫性摄取增加。腋窝淋巴结阳性患者的接种和影像学检查的中位时间间隔为 9.5 天，腋窝淋巴结阴性患者为 17 天。在我们的研究组中，只有 8 名患者有明确的 COVID-19 感染病史。
接受基于 mRNA 的 COVID-19 疫苗的患者在 FDG PET/CT 成像上偶尔会发现局部和全身代谢变化。为避免这些及时减少的变化，我们建议管理成像或接种疫苗的理想时间，并仔细询问病史。
