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Lung CT Segmentation to Identify Consolidations and Ground Glass Areas for Quantitative Assesment of SARS-CoV Pneumonia
Published on: December 19, 2020
Unknown SARS-CoV-2 pneumonia detected by PET/CT in patients with cancer
Maura Scarlattei1, Giorgio Baldari1, Mario Silva2
1Nuclear Medicine Unit, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy.
Introduction:
In January 2020, the coronavirus disease 2019 (COVID-19) outbreak in Italy necessitated rigorous application of more restrictive safety procedures in the management and treatment of patients with cancer to ensure patient and staff protection. Identification of respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was a challenge during the pandemic owing to a large number of asymptomatic or mildly symptomatic patients.
Methods:
We report 5 patients with unknown SARS-CoV-2 infection undergoing positron emission tomography (PET)/computed tomography (CT) with radiopharmaceuticals targeting different tumor processes: 18F-FDG, 18F-choline (FCH), and 68Ga-PSMA.
Results:
In all patients, PET/CT showed increased tracer uptake in the lungs corresponding to CT findings of SARS-CoV-2 pneumonia. Quantitative assessment of tracer uptake showed more elevated values for the glucose analogue 18F-FDG (mean SUVmax 5.4) than for the other tracers (mean SUVmax 3.5).
Conclusions:
Our findings suggest that PET/CT is a sensitive modality to hypothesize SARS-CoV-2 pneumonia in patients with cancer, even when asymptomatic. More data are needed to verify the correlation among immune response to SARS-CoV-2 infection, clinical evolution, and PET results. Under the strict safety measures implemented at the PET center, the number of potentially SARS-CoV-2-positive patients undergoing PET/CT was very low (1.6%), and no staff member has been diagnosed with infection as of April 30, 2020.
Insights
Positron emission tomography/computed tomography (PET/CT) can help identify severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia in cancer patients, even if they have no symptoms. This imaging technique aids in early detection and management during the COVID-19 pandemic.
Area of Science:
- Nuclear medicine and oncology
- Radiopharmaceuticals and molecular imaging
- Infectious disease imaging
Background:
- The COVID-19 pandemic in Italy required stringent safety protocols for cancer patient care.
- Detecting SARS-CoV-2 infection was difficult due to asymptomatic or mild cases.
Purpose of the Study:
- To evaluate the utility of PET/CT in identifying SARS-CoV-2 pneumonia in cancer patients.
- To assess tracer uptake patterns in patients with concurrent cancer and COVID-19.
Main Methods:
- Five cancer patients with unknown SARS-CoV-2 infection underwent PET/CT scans.
- Radiopharmaceuticals used included 18F-FDG, 18F-choline (FCH), and 68Ga-PSMA.
- Scans were performed under strict safety measures in a PET center.
Main Results:
- All patients showed increased lung tracer uptake on PET/CT, consistent with CT findings of SARS-CoV-2 pneumonia.
- 18F-FDG demonstrated higher mean SUVmax (5.4) compared to other tracers (mean SUVmax 3.5).
Conclusions:
- PET/CT is a sensitive tool for hypothesizing SARS-CoV-2 pneumonia in asymptomatic cancer patients.
- Further research is needed to correlate immune response, clinical outcomes, and PET findings.
- The PET center maintained a low infection rate (1.6%) among patients, with no staff infections reported.
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