Evidence map›Paper›PMID 38454762›Full record

ArticleCurrent pharmaceutical design2024

Challenging Axillary Lymph Nodes on PET/CT in Cancer Patients throughout COVID-19 Vaccination Era.

Alessia Giordano, Rosj Gallicchio, Mariarita Milella, Rebecca Storto, Anna Nardelli, Teresa Pellegrino, Antonio Nappi, Michele Di Cosola, Giovanni Storto

Abstract readEvaluation Study
PubMed Publisher
In one paragraph

Article in Current pharmaceutical design, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Alessia GiordanoDepartment of Nuclear Medicine, IRCCS CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy.
Rosj GallicchioDepartment of Nuclear Medicine, IRCCS CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy.
Mariarita MilellaDepartment of Nuclear Medicine, IRCCS CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy.
Rebecca StortoDepartment of Nuclear Medicine, IRCCS CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy.
Anna NardelliDepartment of Nuclear Medicine, IRCCS CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy.
Teresa PellegrinoDepartment of Nuclear Medicine, IRCCS CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy.
Antonio NappiDepartment of Nuclear Medicine, IRCCS CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy.
Michele Di CosolaDepartment of Head and Neck Pathology, University of Foggia, Foggia, Italy.
Giovanni StortoDepartment of Nuclear Medicine, IRCCS CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy.ORCID 0000-0002-6168-5598

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe unexpected detection of axillary lymphadenopathy (AxL) in cancer patients (pts) represents a real concern during the COVID-19 vaccination era. Benign reactions may take place after vaccine inoculation, which can mislead image interpretation in patients undergoing F-18-FDG, F-18-Choline, and Ga-68-DOTATOC PET/CT. They may also mimic loco-regional metastases or disease. We assessed PET/CT findings after COVID-19 first dose vaccination in cancer patients and the impact on their disease course management.

methodsWe evaluated 333 patients undergoing PET/CT (257 F-18-FDG, 54 F-18-Choline, and 23 Ga-68 DOTATOC) scans after the first vaccination with mRNA vaccine (Pfizer-BioNTech) (study group; SG). The uptake index (SUVmax) of suspected AxL was defined as significant when the ratio was > 1.5 as compared to the contralateral lymph nodes. Besides, co-registered CT (Co-CT) features of target lymph nodes were evaluated. Nodes with aggregate imaging positivity were further investigated.

resultsOverall, the prevalence of apparently positive lymph nodes on PET scans was 17.1% during the vaccination period. 107 pts of the same setting, who had undergone PET/CT before the COVID-19 pandemic, represented the control group (CG). Only 3 patients of CG showed reactive lymph nodes with a prevalence of 2.8% (p < 0.001 as compared to the vaccination period). 84.2% of SG patients exhibited benign characteristics on co-CT images and only 9 pts needed thorough appraisal.

conclusionThe correct interpretation of images is crucial to avoid unnecessary treatments and invasive procedures in vaccinated cancer pts. A detailed anamnestic interview and the analysis of lymph nodes' CT characteristics, after performing PET/CT, may help to clear any misleading diagnosis.

Indexed as

COVID-19COVID-19 VaccinesLymph NodesNeoplasmsPositron Emission Tomography Computed TomographyAdultAgedAged, 80 and overAxillaFemaleFluorodeoxyglucose F18HumansLymphadenopathyMaleMiddle AgedRadiopharmaceuticalsCOVID-19 VaccinesFluorodeoxyglucose F18RadiopharmaceuticalscancerCOVID-19lymph nodes.lympho-adenopathyPET/CTVaccine

Identifiers

PMID38454762

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