Lin Runlong, Yu Jing, Tian Aijuan, Wang Xiaomei, Yuan Xin, Xu Wengui, Xie Wenli
Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, People's Republic of China.
Department of Nuclear Medicine, The Second Hospital of Dalian Medical University, Dalian, People's Republic of China.
J Inflamm Res. 2023 Jul 24;16:3109-3117. doi: 10.2147/JIR.S415288. eCollection 2023.
This study aimed to assess COVID-19's effects on vascular inflammatory response, by evaluating 18-Fluorodeoxyglucose (F-FDG) uptake via positron emission tomography/computed tomography (PET/CT) in the artery of diffuse large B cell lymphoma (DLBCL) patients before and after infection with COVID-19.
Thirty-five DLBCL patients administered the chemotherapy regimen R-CHOP and examined by oncological F-FDG PET/CT imaging twice from August 2022 to February 2023 for pre-treatment evaluation or assessment of treatment efficacy were enrolled. Seventeen patients were confirmed with COVID-19 within the study period. Arterial wall FDG uptake was semi-quantitatively analyzed as TBR (target-to-blood pool ratio) in 14 different vascular regions using oncological F-FDG PET/CT. Based on COVID-19 course and the two PET/CT scans, we further analyzed time-related FDG uptake for vascular walls in DLBCL patients with COVID-19.
Arterial TBRs were higher in the last PET/CT examination than previous ones in all patients with or without COVID-19. Besides the ascending aorta, ΔTBR (last PET/CT scanning's TBR minus previous PET/CT scanning's TBR) were not significantly different between the COVID-19 and Control groups. However, cases scanned ≤30 days from infection had remarkably higher ΔTBRs in comparison with those assessed >30 days post-infection in the COVID-19 group (p<0.05). A moderate inverse correlation was observed between ∆Global TBR (last PET/CT scanning's average TBR value minus previous PET/CT scanning's average TBR value) and time distance from COVID-19 onset to F-FDG PET/CT scan (Spearman's rho=-0.591, P=0.012). Interestingly, there were no differences of changes of TBR between different purpose of PET/CT examination group.
This work firstly suggested vascular inflammation is elevated in the early post-COVID-19 phase in DLBCL cases compared with prolonged post-COVID-19 phase or controls. Increasing attention should be paid to these patients and the protection of their vascular function and complications in early COVID-19.
本研究旨在通过评估弥漫性大B细胞淋巴瘤（DLBCL）患者在感染新型冠状病毒肺炎（COVID-19）前后，经正电子发射断层扫描/计算机断层扫描（PET/CT）检测的18-氟脱氧葡萄糖（F-FDG）摄取情况，来评估COVID-19对血管炎症反应的影响。
选取35例接受R-CHOP化疗方案并在2022年8月至2023年2月期间接受两次肿瘤学F-FDG PET/CT成像检查以进行治疗前评估或疗效评估的DLBCL患者。17例患者在研究期间确诊感染COVID-19。使用肿瘤学F-FDG PET/CT在14个不同血管区域将动脉壁FDG摄取半定量分析为靶血池比（TBR）。基于COVID-19病程和两次PET/CT扫描，我们进一步分析了COVID-19患者DLBCL血管壁的时间相关FDG摄取情况。
在所有有或无COVID-19的患者中，最后一次PET/CT检查时的动脉TBR均高于前一次。除升主动脉外，COVID-19组与对照组之间的ΔTBR（最后一次PET/CT扫描的TBR减去前一次PET/CT扫描的TBR）无显著差异。然而，与COVID-19组中感染后>30天评估的患者相比，感染后≤30天扫描的病例的ΔTBR显著更高（p<0.05）。观察到∆总体TBR（最后一次PET/CT扫描的平均TBR值减去前一次PET/CT扫描的平均TBR值）与从COVID-19发病到F-FDG PET/CT扫描的时间距离之间存在中度负相关（Spearman相关系数=-0.591，P=0.012）。有趣的是，PET/CT检查不同目的组之间TBR的变化没有差异。
这项工作首次表明，与COVID-19病程延长阶段或对照组相比，DLBCL病例在COVID-19后早期血管炎症升高。应更加关注这些患者以及在COVID-19早期对其血管功能和并发症的保护。
