Purpose CT signs that are evocative of lung COVID-19 infections have been extensively described, whereas 18 F-FDG-PET signs have not. Our current study aimed to identify specific COVID-19 18 F-FDG-PET signs in patients that were (i) suspected to have a lung infection based on 18 F-FDG-PET/CT recorded during the COVID-19 outbreak and (ii) whose COVID-19 diagnosis was definitely established or excluded by appropriate viral testing. Methods Twenty-two consecutive patients referred for routine 18 F-FDG-PET/CT examinations during the COVID-19 outbreak (March 25th to May 15th 2020) and for whom CT slices were evocative of a lung infection were included in the study. All patients had undergone a SARS-COV-2 diagnostic test to confirm COVID-19 infection (positivity was based on molecular and/ or serological tests) or exclude it (negativity of at least the serological test). Results Eleven patients were confirmed to be affected by COVID-19 (COVID+), whereas the other eleven patients were not (COVID−) and were predominantly suspected of having bacterial pneumonia. CT abnormalities were not significantly different between COVID+ and COVID− groups, although trends toward larger CT abnormalities (p = 0.16) and lower rates of consolidation patterns (0.09) were observed in the COVID+ group. The maximal standardized uptake values (SUV max) of lung areas with CT abnormalities were however significantly lower in the COVID+ than the COVID− group (3.7 ± 1.9 vs. 6.9 ± 4.1, p = 0.03), with the highest SUV max consistently not associated with COVID-19. Conclusion Among CT abnormalities evocative of lung infection, those related to COVID-19 are associated with a more limited 18 F-FDG uptake. This observation may help improve our ability to detect COVID-19 patients. Keywords COVID-19. 18 F-FDG-PET. Lung infection. CT. Serological tests This article is part of the Topical Collection on Infection and inflammation Electronic supplementary material The online version of this article (
The whole-body absolute quantification of 177Lu-DOTATATE therapy was achieved using a high-speed 360° CZT SPECT/CT system. Twelve high-resolution swelling detectors may be positioned close to patients, providing a high-count sensitivity that is particularly advantageous for the low-count rate conditions of 177Lu imaging. After initially validating 177Lu quantification on phantom, serial whole-body SPECT/CT acquisitions of only 20 minutes were obtained for a 70-year-old woman treated by 177Lu-DOTATATE injections for a metastatic recurrence of a pancreatic neuroendocrine tumor. The progressive decrease in tumor uptake between the consecutive 177Lu-DOTATATE injections could be quantified, and thereby the corresponding dosimetry changes could be estimated.
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