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

    Multicenter Study Observational Study

    Prevalence of interstitial pneumonia suggestive of COVID-19 at 18F-FDG PET/CT in oncological asymptomatic patients in a high prevalence country during pandemic period: a national multi-centric retrospective study.

    • Domenico Albano, Francesco Bertagna, Pierpaolo Alongi, Sergio Baldari, Alfonso Baldoncini, Mirco Bartolomei, Franco Boccaletto, Michele Boero, Eugenio Borsatti, Andrea Bruno, Luca Burroni, Francesca Capoccetti, Massimo Castellani, Anna Rita Cervino, Franca Chierichetti, Andrea Ciarmiello, Angelo Corso, Alberto Cuocolo, Maria Luisa De Rimini, Desiree' Deandreis, Massimo Eugenio Dottorini, Filomena Esposito, Mohsen Farsad, Massimo Gasparini, Chiara Maria Grana, Michele Gregianin, Luca Guerra, Fabio Loreti, Andrea Lupi, Gianluigi Martino, Elisa Milan, Sergio Modoni, Silvia Morbelli, Alfredo Muni, Emanuele Nicolai, Barbara Palumbo, Sergio Papa, Alberto Papaleo, Riccardo Pellerito, Carlo Poti, Pasquale Romano, Claudio Rossetti, Pierluigi Rossini, Giuseppe Rubini, Livia Ruffini, Gianmauro Sacchetti, Giordano Savelli, Saverio Schiavariello, Roberto Sciagrà, Rosa Sciuto, Ettore Seregni, Stelvio Sestini, Michele Sicolo, Angela Spanu, Giovanni Storto, Massimo Tosti Balducci, Giuseppe Trifirò, Annibale Versari, Alberto Vignati, Duccio Volterrani, Maria Lucia Calcagni, Maria Cristina Marzola, Antonio Garufo, Laura Evangelista, Roberto Maroldi, Orazio Schillaci, Raffaele Giubbini, and On the behalf of Italian Association of Nuclear Medicine (AIMN).
    • Nuclear Medicine, University of Brescia and ASST Spedali Civili Brescia, Brescia, Italy. domenico.albano@unibs.it.
    • Eur. J. Nucl. Med. Mol. Imaging. 2021 Aug 1; 48 (9): 2871-2882.

    PurposeTo assess the presence and pattern of incidental interstitial lung alterations suspicious of COVID-19 on fluorine-18-fluorodeoxyglucose positron emission tomography (PET)/computed tomography (CT) ([18F]FDG PET/CT) in asymptomatic oncological patients during the period of active COVID-19 in a country with high prevalence of the virus.MethodsThis is a multi-center retrospective observational study involving 59 Italian centers. We retrospectively reviewed the prevalence of interstitial pneumonia detected during the COVID period (between March 16 and 27, 2020) and compared to a pre-COVID period (January-February 2020) and a control time (in 2019). The diagnosis of interstitial pneumonia was done considering lung alterations of CT of PET.ResultsOverall, [18F]FDG PET/CT was performed on 4008 patients in the COVID period, 19,267 in the pre-COVID period, and 5513 in the control period. The rate of interstitial pneumonia suspicious for COVID-19 was significantly higher during the COVID period (7.1%) compared with that found in the pre-COVID (5.35%) and control periods (5.15%) (p < 0.001). Instead, no significant difference among pre-COVID and control periods was present. The prevalence of interstitial pneumonia detected at PET/CT was directly associated with geographic virus diffusion, with the higher rate in Northern Italy. Among 284 interstitial pneumonia detected during COVID period, 169 (59%) were FDG-avid (average SUVmax of 4.1).ConclusionsA significant increase of interstitial pneumonia incidentally detected with [18F]FDG PET/CT has been demonstrated during the COVID-19 pandemic. A majority of interstitial pneumonia were FDG-avid. Our results underlined the importance of paying attention to incidental CT findings of pneumonia detected at PET/CT, and these reports might help to recognize early COVID-19 cases guiding the subsequent management.

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