COVID-19 Vaccination-Related Uptake on FDG PET/CT: An Emerging Dilemma and Suggestions for Management
UMass Chan Affiliations
Department of RadiologyDocument Type
Journal ArticlePublication Date
2021-03-01Keywords
COVID-19vaccination
lymph nodes
oncology patients
PET
CT
Hemic and Lymphatic Diseases
Infectious Disease
Neoplasms
Oncology
Radiology
Virus Diseases
Metadata
Show full item recordAbstract
As mass COVID-19 vaccination is underway, radiologists are encountering transient FDG uptake in normal or enlarged axillary, supraclavicular, and cervical lymph nodes after ipsilateral deltoid vaccination. This phenomenon may confound interpretation in oncology patients undergoing FDG PET/CT. In this article, we present our institutional approach for management of COVID-19 vaccine-related lymphadenopathy on FDG PET/CT based on our early experience. We suggest performing PET/CT at least two weeks after vaccination in patients with a cancer for which interpretation is anticipated to be potentially impacted by the vaccination, though optimally 4-6 weeks after vaccination given increased immunogenicity of mRNA vaccines and potentially longer time for resolution than lymphadenopathy after other vaccines. PET/CT should not be delayed when clinically indicated to be performed sooner. Details regarding vaccination should be collected at the time of PET/CT to facilitate interpretation. Follow-up recommendations for post-vaccination lymphadenopathy are provided, considering the lymph node's morphology and likely clinical relevance. Consideration should also be given to administering the vaccine in the arm contralateral to a unilateral cancer to avoid potentially confounding FDG uptake on the side of cancer. Our preliminary experience and suggested institutional experience should guide radiologists in the management of oncology patients undergoing PET/CT after COVID-19 vaccination.Source
McIntosh LJ, Bankier AA, Vijayaraghavan GR, Licho R, Rosen MP. COVID-19 Vaccination-Related Uptake on FDG PET/CT: An Emerging Dilemma and Suggestions for Management. AJR Am J Roentgenol. 2021 Mar 1. doi: 10.2214/AJR.21.25728. Epub ahead of print. PMID: 33646823. Link to article on publisher's website
DOI
10.2214/AJR.21.25728Permanent Link to this Item
http://hdl.handle.net/20.500.14038/27387PubMed ID
33646823Related Resources
ae974a485f413a2113503eed53cd6c53
10.2214/AJR.21.25728