Increased incidence of interstitial pneumonia detected on [18F]-FDG-PET/CT in asymptomatic cancer patients during COVID-19 pandemic in Lombardy: a casualty or COVID-19 infection?

Autor: Margarita Kirienko, Paola Anna Erba, Manuela Bonacina, Lucia Setti, Francesca Galli, Roberta Meroni, Emilio Bombardieri, Serena Camilla Dalto
Přispěvatelé: Setti, L, Bonacina, M, Meroni, R, Kirienko, M, Galli, F, Dalto, S, Erba, P, Bombardieri, E
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
medicine.medical_specialty
Short Communication
Population
COVID-19
Ground-glass opacities
Interstitial pneumonia
Lung consolidations
SARS-CoV-2
[
18
F]-FDG-PET/CT
Standardized uptake value
Asymptomatic
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
Fluorodeoxyglucose F18
Statistical significance
Neoplasms
Positron Emission Tomography Computed Tomography
Epidemiology
medicine
Humans
Radiology
Nuclear Medicine and imaging
education
Retrospective Studies
education.field_of_study
business.industry
Incidence (epidemiology)
Incidence
Retrospective cohort study
General Medicine
[18F]-FDG-PET/CT
Lung consolidation
Ground-glass opacitie
Exact test
Italy
Radiology Nuclear Medicine and imaging
030220 oncology & carcinogenesis
Female
Radiology
medicine.symptom
Radiopharmaceuticals
business
Lung Diseases
Interstitial
Zdroj: European Journal of Nuclear Medicine and Molecular Imaging
Europe PubMed Central
ISSN: 1619-7089
1619-7070
Popis: Purpose: The study aimed to compare the incidence of interstitial pneumonia on [18F]-FDG PET/CT scans between two 6-month periods: (a) the COVID-19 pandemic peak and (b) control period. Secondly, we compared the incidence of interstitial pneumonia on [18F]-FDG PET/CT and epidemiological data from the regional registry of COVID-19 cases. Additionally, imaging findings and the intensity of [18F]-FDG PET/CT uptake in terms of maximum standardized uptake value (SUVmax) were compared. Methods: We retrospectively analyzed [18F]-FDG PET/CT scans performed in cancer patients referred to nuclear medicine of Humanitas Gavazzeni in Bergamo from December 2019 to May 2020 and from December 2018 to May 2019. The per month incidence of interstitial pneumonia at imaging and the epidemiological data were assessed. To evaluate the differences between the two symmetric groups (period of COVID-19 pandemic and control), the stratified Cochran–Mantel–Haenszel test was used. Chi-square test or Fisher’s exact test and t test or Wilcoxon test were performed to compare the distributions of categorical and continuous variables, respectively. Results: Overall, 1298 patients were included in the study. The two cohorts—COVID-19 pandemic (n= 575) and control (n= 723)—did not statistically differ in terms of age, disease, or scan indication (p> 0.05). Signs of interstitial pneumonia were observed in 24 (4.2%) and 14 patients (1.9%) in the COVID-19 period and the control period, respectively, with a statistically significant difference (p= 0.013). The level of statistical significance improved further when the period from January to May was considered, with a peak in March (7/83 patients, 8.4% vs 3/134 patients, 2.2%, p= 0.001). The curve of interstitial pneumonia diagnosis overlapped with the COVID-19 incidence in the area of Lombardy (Spearman correlation index was equal to 1). Imaging data did not differ among the two cohorts. Conclusions: Significant increase of interstitial lung alterations at [18F]-FDG PET/CT has been demonstrated during the COVID-19 pandemic. Additionally, the incidence curve of imaging abnormalities resulted in resembling the epidemiological data of the general population. These data support the rationale to adopt [18F]-FDG PET/CT as sentinel modality to identify suspicious COVID-19 cases to be referred for additional confirmatory testing. Nuclear medicine physicians and staff should continue active surveillance of interstitial pneumonia findings, especially when new infection peak is expected.
Databáze: OpenAIRE
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