Coordination and optimization of FDG PET/CT and COVID-19 vaccination; Lessons learned in the early stages of mass vaccination. (July 2021)

• Record Type: Journal Article
• Authors: McIntosh, Lacey J.; Rosen, Max P.; Mittal, Kriti; Whalen, Giles F.; Bathini, Venu G.; Ali, Tasneem; Edmiston, Kathryn L.; Walsh, William V.; Gerber, Jonathan M.
• Is Part Of: Cancer treatment reviews. Volume 98(2021)
• Publication Date: 2021-07
• Subjects: Oncologic imaging -- COVID-19 vaccine -- FDG PET/CT; Cancer -- Periodicals; Cancer -- Treatment -- Periodicals; Neoplasms -- therapy -- Periodicals; Cancer -- Périodiques; Cancer -- Traitement -- Périodiques; Cancer -- Treatment; Electronic journals; Periodicals; 616.99406
• DOI: 10.1016/j.ctrv.2021.102220
• Languages: English
• ISSNs: 0305-7372

Abstract

Highlights: Vaccine-related findings on FDG PET/CT can mimic cancer and lead to confounding imaging results. Confounding cases may pose a significant dilemma for diagnostic purposes, follow-up, and management. Dilemmas can result in treatment delays, unnecessary imaging/sampling, and patient anxiety. Coordination with imaging and preemptive vaccine site/side selection can largely avoid these dilemmas. Coordination hinges on patient, oncologist, and radiologists' awareness and collaboration. Abstract: As the world embarks on mass vaccination for COVID-19, we are beginning to encounter unintended dilemmas in imaging oncology patients; particularly with regards to FDG PET/CT. In some cases, vaccine-related lymphadenopathy and FDG uptake on PET/CT can mimic cancer and lead to confounding imaging results. These cases where findings overlap with cancer pose a significant dilemma for diagnostic purposes, follow-up, and management leading to possible treatment delays, unnecessary repeat imaging and sampling, and patient anxiety. These cases can largely be avoided by optimal coordination between vaccination and planned imaging as well as preemptive selection of vaccine administration site. This coordination hinges on patient, oncologist, and radiologists' awareness of this issue and collaboration. Through close communication and patient education, we believe this will eliminate significant challenges for our oncology patients as we strive to end this pandemic.