Clinical nuclear medicine
-
Clinical nuclear medicine · Aug 2020
Case Reports18F-FDG PET/CT in Hodgkin Lymphoma With Unsuspected COVID-19.
We present an asymptomatic 70-year-old man referred for an F-FDG PET/CT for initial staging of a Hodgkin lymphoma. F-FDG PET/CT showed bilateral cervical lymphadenopathy (stage II). Incidentally, the CT demonstrated bilateral ground-glass opacities with low-grade F-FDG activity. ⋯ The COVID-19 reverse transcriptase polymerase chain reaction (RT-PCR) examination result was negative. Given the high clinical suspicion for COVID-19, the patient was isolated and repeat RT-PCR was positive at 72 hours. RT-PCR may be falsely negative in early COVID-19 disease, even with positive CT findings.
-
Clinical nuclear medicine · Aug 2020
Case Reports18F-FDG PET/CT Metabolic Behavior of COVID-19 Pneumonia: A Series of 4 Patients With RT-PCR Confirmation.
Between March 26 and April 6, among 80 patients who underwent F-FDG PET/CT in our department (Brescia, Italy), 4 showed the presence of an interstitial pneumonia suspected for COVID-19 with reverse transcriptase polymerase chain reaction confirmation. All patients except one had bilateral ground-glass opacities and/or lung consolidations in at least 2 pulmonary lobes. Inferior lobes and basal segments were the most frequent site of disease. All lung lesions had an increased FDG uptake corresponding to the interstitial pneumonia, and in one case, mediastinal nodal involvement was registered.
-
A 73-year-old man with chronic obstructive pulmonary disease and no known malignancies was evaluated for back pain. MR examination showed lumbar spine compression fractures, and an F-FDG PET/CT scan was requested to assess for skeletal metastatic disease and potential detection of a primary neoplasm. The PET/CT examination revealed scattered FDG-avid pulmonary opacities with upper lobe preponderance highly suspicious for COVID-19. Real-time polymerase chain reaction testing of nasopharyngeal swabs confirmed the diagnosis.
-
An 85-year-old woman with history of melanoma is referred for a follow-up F-FDG PET/CT. F-FDG PET/CT scan showed bilateral and peripheral ground-glass opacities in upper and lower pulmonary lobes surrounded by consolidations of crescent shape with increased FDG uptake, findings compatible with organizing pneumonia. Following further inquiry, the patient reported low-grade fever, sore throat, and fatigue for the past 6 days. Because of the ongoing COVID-19 pandemic, the patient was tested for SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), which resulted positive.
-
Clinical nuclear medicine · Aug 2020
Case ReportsFDG PET/CT Findings in an Asymptomatic Case of Confirmed COVID-19.
In the current and rapidly worsening pandemic, patients with COVID-19 may undergo imaging with FDG PET/CT. Because a significant proportion of infected patients may be asymptomatic, incidental discovery on a PET/CT scan performed for unrelated reasons can occur. Because of the highly infectious nature of this agent, it is important that interpreting physicians be aware of the typical imaging findings to identify potentially affected patients. We present the case of an asymptomatic patient referred for FDG PET/CT imaging of a lung nodule who demonstrated the typical CT findings of COVID-19 infection and was subsequently found to be positive on testing.