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

On the behalf of Italian Association of Nuclear Medicine (AIMN), D. Albano, F. Bertagna, P. Alongi, S. Baldari, A. Baldoncini, M. Bartolomei, F. Boccaletto, M. Boero, E. Borsatti, A. Bruno, L. Burroni, F. Capoccetti, M. Castellani, A.R. Cervino, F. Chierichetti, A. Ciarmiello, A. Corso, A. Cuocolo, M.L. De RiminiD. Deandreis, M.E. Dottorini, F. Esposito, M. Farsad, M. Gasparini, C.M. Grana, M. Gregianin, L. Guerra, F. Loreti, G. Martino, E. Milan, S. Morbelli, E. Nicolai, P. Romano, P. Rossini, G. Sacchetti, R. Sciuto, E. Seregni, S. Sestini, G. Storto, G. Trifirò, A. Versari, A. Vignati, M.L. Calcagni, L. Evangelista, O. Schillaci, R. Giubbini

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To 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. Methods: This 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. Results: Overall, [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). Conclusions: A 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.

Original languageEnglish
Pages (from-to)2871-2882
Number of pages12
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume48
Issue number9
DOIs
Publication statusPublished - 2021

Keywords

  • 18F-FDG PET/CT
  • Asymptomatic
  • COVID-19
  • Incidental findings
  • Interstitial pneumonia
  • SARS-CoV-2
  • fluorodeoxyglucose f 18
  • clinical trial
  • diagnostic imaging
  • human
  • interstitial lung disease
  • Italy
  • multicenter study
  • pandemic
  • positron emission tomography-computed tomography
  • prevalence
  • retrospective study
  • Fluorodeoxyglucose F18
  • Humans
  • Lung Diseases, Interstitial
  • Pandemics
  • Positron Emission Tomography Computed Tomography
  • Prevalence
  • Retrospective Studies

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