TY - JOUR
T1 - COVID-19 mRNA Vaccination
T2 - Age and Immune Status and Its Association with Axillary Lymph Node PET/CT Uptake
AU - Eifer, Michal
AU - Tau, Noam
AU - Alhoubani, Yousef
AU - Kanana, Nayroz
AU - Domachevsky, Liran
AU - Shams, Jala
AU - Keret, Nir
AU - Gorfine, Malka
AU - Eshet, Yael
N1 - Publisher Copyright:
© 2022 by the Society of Nuclear Medicine and Molecular Imaging.
PY - 2022/1/1
Y1 - 2022/1/1
N2 - With hundreds of millions of coronavirus disease 2019 (COVID-19) messenger RNA (mRNA)-based vaccine doses planned to be delivered worldwide in the upcoming months, it is important to recognize PET/CT findings in recently vaccinated immunocompetent or immunocompromised patients. We aimed to assess PET/CT uptake in the deltoid muscle and axillary lymph nodes of patients who received a COVID-19 mRNA-based vaccine and to evaluate its association with patient age and immune status. Methods: All consecutive adults who underwent PET/CT scans with any radiotracer at our center during the first month of a national COVID-19 vaccination rollout (between December 23, 2020, and January 27, 2021) and had received the vaccination were included. Data on clinical status, laterality, and time from vaccination were prospectively collected, retrospectively analyzed, and correlated with deltoid muscle and axillary lymph node uptake. Results: Of 426 eligible subjects (median age, 67±12 y; 49% female), 377 (88%) underwent PET/CT with 18F-FDG, and positive axillary lymph node uptake was seen in 45% of them. Multivariate logistic regression analysis revealed a strong inverse association between positive 18F-FDG uptake in ipsilateral lymph nodes and patient age (odds ratio [OR], 0.57; 95% CI, 0.45-0.72; P <0.001), immunosuppressive treatment (OR, 0.37; 95% CI, 0.20-0.64; P=0.003), and presence of hematologic disease (OR, 0.44; 95% CI, 0.24-0.8; P=0.021). No such association was found for deltoid muscle uptake. The number of days from the last vaccination and the number of vaccine doses were also significantly associated with increased odds of positive lymph node uptake. Conclusion: After mRNA-based COVID-19 vaccination, a high proportion of patients showed ipsilateral lymph node axillary uptake, which was more common in immunocompetent patients. This information will help with the recognition of PET/CT pitfalls and may hint about the patient's immune response to the vaccine.
AB - With hundreds of millions of coronavirus disease 2019 (COVID-19) messenger RNA (mRNA)-based vaccine doses planned to be delivered worldwide in the upcoming months, it is important to recognize PET/CT findings in recently vaccinated immunocompetent or immunocompromised patients. We aimed to assess PET/CT uptake in the deltoid muscle and axillary lymph nodes of patients who received a COVID-19 mRNA-based vaccine and to evaluate its association with patient age and immune status. Methods: All consecutive adults who underwent PET/CT scans with any radiotracer at our center during the first month of a national COVID-19 vaccination rollout (between December 23, 2020, and January 27, 2021) and had received the vaccination were included. Data on clinical status, laterality, and time from vaccination were prospectively collected, retrospectively analyzed, and correlated with deltoid muscle and axillary lymph node uptake. Results: Of 426 eligible subjects (median age, 67±12 y; 49% female), 377 (88%) underwent PET/CT with 18F-FDG, and positive axillary lymph node uptake was seen in 45% of them. Multivariate logistic regression analysis revealed a strong inverse association between positive 18F-FDG uptake in ipsilateral lymph nodes and patient age (odds ratio [OR], 0.57; 95% CI, 0.45-0.72; P <0.001), immunosuppressive treatment (OR, 0.37; 95% CI, 0.20-0.64; P=0.003), and presence of hematologic disease (OR, 0.44; 95% CI, 0.24-0.8; P=0.021). No such association was found for deltoid muscle uptake. The number of days from the last vaccination and the number of vaccine doses were also significantly associated with increased odds of positive lymph node uptake. Conclusion: After mRNA-based COVID-19 vaccination, a high proportion of patients showed ipsilateral lymph node axillary uptake, which was more common in immunocompetent patients. This information will help with the recognition of PET/CT pitfalls and may hint about the patient's immune response to the vaccine.
KW - COVID-19
KW - PET/CT
KW - axillary lymphadenopathy
KW - immunogenicity
KW - mRNA vaccine
UR - http://www.scopus.com/inward/record.url?scp=85123325488&partnerID=8YFLogxK
U2 - 10.2967/jnumed.121.262194
DO - 10.2967/jnumed.121.262194
M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???
C2 - 33893188
AN - SCOPUS:85123325488
SN - 0161-5505
VL - 63
SP - 134
EP - 139
JO - Journal of Nuclear Medicine
JF - Journal of Nuclear Medicine
IS - 1
ER -
