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      FDG-PET/CT of COVID-19 and Other Lung Infections

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          Abstract

          While not conventionally used as the first-line modality, [ 18F]-2-fluoro-2-deoxy-D-glucose (FDG) - positron emission tomography/computed tomography (PET/CT) can identify infection and inflammation both earlier and with higher sensitivity than anatomic imaging modalities [including chest X-ray (CXR), computed tomography (CT), and magnetic resonance imaging (MRI)]. The extent of inflammation and, conversely, recovery within the lungs, can be roughly quantified on FDG-PET/CT using maximum standardized uptake value (SUVmax) values. The Coronavirus disease 2019 (COVID-19) pandemic has highlighted the value of FDG-PET/CT in diagnosis, elucidation of acute pulmonary and extra-pulmonary manifestations, and long-term follow up. Similarly, many other pulmonary infections such as previously documented coronaviruses, Aspergillosis, Blastomycosis, Candidiasis, Coccidioidomycosis, Cryptococcosis, Histoplasmosis, Mucormycosis, and typical/atypical Mycobacterial infections have all been identified and characterized using FDG-PET/CT imaging. The goal of this review is to summarize the actual and potential benefits of FDG-PET/CT in the imaging of COVID-19 and other lung infections. Further research is necessary to determine the best indications and clinical applications of FDG-PET/CT, improve its specificity, and ultimately ascertain how this modality can best be utilized in the diagnostic work up of infectious pathologies.

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          Portable chest X-ray in coronavirus disease-19 (COVID-19): A pictorial review

          Adam Jacobi, Michael Chung, Adam Bernheim … (2020)
          Abstract/introduction As the global pandemic of coronavirus disease-19 (COVID-19) progresses, many physicians in a wide variety of specialties continue to play pivotal roles in diagnosis and management. In radiology, much of the literature to date has focused on chest CT manifestations of COVID-19 (Zhou et al. [1]; Chung et al. [2]). However, due to infection control issues related to patient transport to CT suites, the inefficiencies introduced in CT room decontamination, and lack of CT availability in parts of the world, portable chest radiography (CXR) will likely be the most commonly utilized modality for identification and follow up of lung abnormalities. In fact, the American College of Radiology (ACR) notes that CT decontamination required after scanning COVID-19 patients may disrupt radiological service availability and suggests that portable chest radiography may be considered to minimize the risk of cross-infection (American College of Radiology [3]). Furthermore, in cases of high clinical suspicion for COVID-19, a positive CXR may obviate the need for CT. Additionally, CXR utilization for early disease detection may also play a vital role in areas around the world with limited access to reliable real-time reverse transcription polymerase chain reaction (RT-PCR) COVID testing. The purpose of this pictorial review article is to describe the most common manifestations and patterns of lung abnormality on CXR in COVID-19 in order to equip the medical community in its efforts to combat this pandemic.
          Article 0 comments Cited 226 times – based on 0 reviews     Review now
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            Coronavirus (COVID-19) Outbreak: What the Department of Radiology Should Know

            Soheil Kooraki, Melina Hosseiny, Lee Myers … (2020)
            In December 2019, a novel coronavirus (COVID-19) pneumonia emerged in Wuhan, China. Since then, this highly contagious COVID-19 has been spreading worldwide, with a rapid rise in the number of deaths. Novel COVID-19–infected pneumonia (NCIP) is characterized by fever, fatigue, dry cough, and dyspnea. A variety of chest imaging features have been reported, similar to those found in other types of coronavirus syndromes. The purpose of the present review is to briefly discuss the known epidemiology and the imaging findings of coronavirus syndromes, with a focus on the reported imaging findings of NCIP. Moreover, the authors review precautions and safety measures for radiology department personnel to manage patients with known or suspected NCIP. Implementation of a robust plan in the radiology department is required to prevent further transmission of the virus to patients and department staff members.
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              18 F-FDG PET/CT findings of COVID-19: a series of four highly suspected cases

              Chunxia Qin, Fang Liu, Tzu-Chen Yen … (2020)
              Purpose The aim of this case series is to illustrate the 18F-FDG PET/CT findings of patients with acute respiratory disease caused by COVID-19 in Wuhan, Hubei province of China. Methods We describe the 18F-FDG PET/CT results from four patients who were admitted to the hospital with respiratory symptoms and fever between January 13 and January 20, 2020, when the COVID-19 outbreak was still unrecognized and the virus infectivity was unknown. A retrospective review of the patients’ medical history, clinical and laboratory data, as well as imaging findings strongly suggested a diagnosis of COVID-19. Results All patients had peripheral ground-glass opacities and/or lung consolidations in more than two pulmonary lobes. Lung lesions were characterized by a high 18F-FDG uptake and there was evidence of lymph node involvement. Conversely, disseminated disease was absent, a finding suggesting that COVID-19 has pulmonary tropism. Conclusions Although 18F-FDG PET/CT cannot be routinely used in an emergency setting and is generally not recommended for infectious diseases, our pilot data shed light on the potential clinical utility of this imaging technique in the differential diagnosis of complex cases.
              Article 0 comments Cited 156 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Semin Nucl Med
                Journal ID (iso-abbrev): Semin Nucl Med
                Title: Seminars in Nuclear Medicine
                Publisher: Elsevier Inc.
                ISSN (Print): 0001-2998
                ISSN (Electronic): 1558-4623
                Publication date PMC-release: 22 June 2021
                Publication date (Electronic): 22 June 2021
                Affiliations
                [1 ]Department of Radiology, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA
                [2 ]Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY
                [3 ]Department of Radiology, University of Pennsylvania, Philadelphia, PA
                [4 ]Department of Radiology, University Hospital Cleveland Medical Center, Cleveland, OH
                [5 ]Department of Nuclear Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
                Author notes
                [* ]Author Correspondence. Ali Gholamrezanezhad, MD. Assistant Professor of Diagnostic Radiology, Department of Radiology Division of Emergency Radiology, Keck School of Medicine, University of Southern California, 1500 San Pablo Street, Los Angeles, CA 90033. Tel.: (443) 839-7134.
                [†]

                These authors contributed equally to the work and should be considered as co-first authors

                Article
                Publisher Item ID: S0001-2998(21)00049-0
                DOI: 10.1053/j.semnuclmed.2021.06.017
                PMC ID: 8216878
                PubMed ID: 34246449
                SO-VID: 98918ed5-3f9f-48f1-a523-c8d5fbbd23d0
                Copyright © © 2021 Elsevier Inc. All rights reserved.
                License:

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

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                Subject: Article

                Keywords: covid-19,sars-cov-2,coronavirus, positron emission tomography, fdg-pet/ct, infection, pneumonia, radiology
                Data availability:
                Keywords: covid-19, sars-cov-2, coronavirus, positron emission tomography, fdg-pet/ct, infection, pneumonia, radiology

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