Related Experiment Video For COVID-19
Updated: Oct 4, 2025
Lung CT Segmentation to Identify Consolidations and Ground Glass Areas for Quantitative Assesment of SARS-CoV Pneumonia
Published on: December 19, 2020
Incidentally Detected COVID-19 Lung Changes during Oncologic Fluorodeoxyglucose Positron Emission
Nilendu C Purandare1, Anjali Prakash1, Sneha Shah1
1Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India.
Objective:
The objective is to evaluate incidental detection of COVID-19 lung involvement in asymptomatic individuals who undergo fluorodeoxyglucose (FDG) positron emission tomography-computerized tomography (PET/CT) scans for oncologic indications.
Patients And Methods:
The study was conducted in a tertiary care oncology hospital and included patients who were asymptomatic for COVID-19 infection and underwent FDG PET/CT scans for standard oncologic indications between April 15, 2020, and September 30, 2020. Patients who showed CO-RADS category 4/5 changes (high level of suspicion) on the CT chest component of the PET/CT study were considered for analysis. CT severity score, presence of FDG uptake, and maximum standardized uptake value of FDG avid lung involvement were noted and correlated with reverse transcriptase-polymerase chain reaction (RT-PCR) test.
Results:
1982 PET/CT scans were performed, 78 (3.9%) patients showed lung changes with high degree of suspicion of COVID-19 pneumonia (CO-RADS 4/5). Hematolymphoid and head-neck cancer were the most common tumor types (23%), and restaging/response evaluation was the most common PET/CT indication. Of the patients who underwent RT-PCR testing, 70% showed a positive result. The mean CT severity score was 6 (standard deviation 5.9) with no significant difference seen between the RT-PCR positive and negative groups. FDG avidity in lung lesions was noted in 41 out 57 (72%) patients. A significant correlation was seen between the RT-PCR positivity and FDG uptake in lung lesions.
Conclusion:
A small but significant proportion of patients undergoing routine oncologic PET/CT scans showed incidental COVID-19 lung involvement. Lung involvement in these asymptomatic patients showed a low CT severity score in all patients and FDG avidity in majority. Timely detection of such incidental cases can initiate further confirmatory RT-PCR testing and isolation measures that not only influence patient's cancer treatment protocols but also have a larger community impact of limiting the spread of infection.
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