Incidental findings suggestive of COVID-19 in asymptomatic cancer patients undergoing 18F-FDG PET/CT in a low prevalence
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SHORT COMMUNICATION
Incidental findings suggestive of COVID-19 in asymptomatic cancer patients undergoing 18F-FDG PET/CT in a low prevalence region Amandine Pallardy 1 & Caroline Rousseau 2,3 & Catherine Labbe 4 & Renan Liberge 5 & Caroline Bodet-Milin 1,3 & Françoise Kraeber-Bodere 1,2,3 & Vincent Fleury 2 Received: 26 May 2020 / Accepted: 24 August 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose To assess the rate and pattern of incidental interstitial lung abnormalities suggestive of COVID-19 on 18F-FDG PET/ CT in asymptomatic cancer patients during the period of active COVID-19 circulation between March and April 2020 in a geographic area of low prevalence of the virus. Methods 1396 18F-FDG PET/CT performed between January 1, 2020, and February 21, 2020, and between March 16, 2020, and April 17, 2020 for routine oncological indication were retrospectively analyzed. No patients had symptoms suggestive of COVID-19 at the time of the 18F-FDG PET/CT. Incidental interstitial pneumonias suggestive of COVID-19 were identified, and the 18F-FDG PET/CT patterns were described. We compared the incidence of these lesions in the pre-COVID and pandemic phases. Results We observed a 1.6% increase in interstitial lung abnormalities during the period of COVID-19 circulation. All had < 50% lung involvement. We describe a case series with typical and atypical interstitial pneumonias suggestive of COVID-19 as unilateral or bilateral with ground-glass opacity, consolidation, or crazy-paving patterns. Conclusion The relatively low increase in incidental findings suggestive of COVID-19 infection on 18F-FDG PET/CT in asymptomatic cancer patients was in accordance with the low COVID-19 transmission in our geographic region. Nevertheless, nuclear medicine physicians should familiarize themselves with typical and atypical 18F-FDG PET/CT patterns suggestive of COVID-19 pneumonia and initiate appropriate intervention where necessary. Keywords PET/CT . 18F-FDG . Lung . Infection . Covid-19
Introduction
This article is part of the Topical Collection on Infection and inflammation * Amandine Pallardy [email protected] 1
Nuclear Medicine Department, University Hospital of Nantes, Nantes, France
2
Nuclear Medicine Department, Institut de Cancérologie de l’Ouest René Gauducheau, Saint-Herblain, France
3
CRCINA, INSERM, CNRS, Université d’Angers, Université de Nantes, Nantes, France
4
Radiology, Institut de Cancérologie de l’Ouest René Gauducheau, Saint-Herblain, France
5
Radiology, University Hospital of Nantes, Nantes, France
In December 2019, the novel coronavirus disease 19 (COVID-19) emerged in Wuhan, China. The virus (SARSCoV-2) spread rapidly around the globe and was declared a pandemic in March 2020 by the World Health Organization. The COVID-19 clinical symptoms are well-known, and the radiological lung imaging were features widely described [1]. Chest CT imaging of confirmed COVID-19 infection mainly shows typical peripheral or subpleural ground-glass opacities (GGO) and grou
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