• Eur. J. Nucl. Med. Mol. Imaging · Jan 2021

    Clinical Trial

    COVID-19 pneumonia: relationship between inflammation assessed by whole-body FDG PET/CT and short-term clinical outcome.

    • Matthieu Dietz, Gilles Chironi, Yann-Erick Claessens, Ryan Lukas Farhad, Isabelle Rouquette, Benjamin Serrano, Valérie Nataf, Florent Hugonnet, Benoît Paulmier, Frédéric Berthier, Olivia Keita-Perse, Francesco Giammarile, Christophe Perrin, Marc Faraggi, and MONACOVID Group.
    • Nuclear Medicine Department, Centre Hospitalier Princesse Grace, 1 Avenue Pasteur, 98000, Monaco, Monaco.
    • Eur. J. Nucl. Med. Mol. Imaging. 2021 Jan 1; 48 (1): 260-268.

    Purpose[18F]-2-Fluoro-2-deoxy-D-glucose PET/CT (FDG PET/CT) is a sensitive and quantitative technic for detecting inflammatory process. Glucose uptake is correlated with an increased anaerobic glycolysis seen in activated inflammatory cells such as monocytes, lymphocytes, and granulocytes. The aim of the study was to assess the inflammatory status at the presumed peak of the inflammatory phase in non-critically ill patients requiring admission for COVID-19.MethodsPatients admitted with COVID-19 were prospectively enrolled. FDG PET/CT was performed from day 6 to day 14 of the onset of symptoms. Depending on FDG PET/CT findings, patients' profiles were classified as "inflammatory" or "low inflammatory." FDG PET/CT data were compared with chest CT evolution and short-term clinical outcome. All inflammatory sites were reported to screen potential extra-pulmonary tropism.ResultsThirteen patients were included. Maximum standardized uptake values ranged from 4.7 to 16.3 in lungs. All patients demonstrated increased mediastinal lymph nodes glucose uptake. Three patients (23%) presented mild nasopharyngeal, two patients (15%) bone marrow, and five patients (38%) splenic mild increase in glucose uptake. No patient had significant digestive focal or segmental glucose uptake. There was no significant physiological myocardial glucose uptake in all patients except one. There was no correlation between PET lung inflammatory status and chest CT evolution or short-term clinical outcome.ConclusionInflammatory process at the presumed peak of the inflammatory phase in COVID-19 patients is obvious in FDG PET/CT scans. Glucose uptake is heterogeneous and typically focused on lungs.Trial RegistrationNCT04441489. Registered 22 June 2020 (retrospectively registered).

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