Influenza vaccine and FDG-PET

McCool, D.; Buscombe, J. R.; Hilson, A. J.W.

doi:10.1016/s0140-6736(03)15034-9

Cited by 5 publications

(4 citation statements)

References 1 publication

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“…Delaying scans for two to four weeks post-vaccination has been suggested; however, we feel this may be practically difficult in oncology patients and may cause unnecessary delays. 24,25 Routine follow-up scans of potentially low risk or stable cancers can be delayed.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 vaccine-related lymph node activation – patterns of uptake on PET-CT

et al. 2021

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In a bid to end the current COVID-19 crisis, many countries including UK have begun a mass immunization programme. Immunization can cause transient inflammation thereby causing increased metabolic activity at injection site and hypermetabolic lymph nodes. Various vaccinations and local injections have been known to cause diagnostic dilemma due to false-positive uptake on FDG PET-CT. In this pictorial case review, we present five cases demonstrating various patterns of uptake including an ipsilateral deltoid muscle, axillary, supraclavicular, and subpectoral lymph nodes post COVID-19 vaccination. A careful history of COVID-19 vaccination and normal size and morphology of lymph node on unenhanced low-dose CT will aid the diagnosis. All patients undergoing FDG PET-CT will require detailed documentation of the vaccination history including the time interval since vaccination. Knowledge about these patterns of uptake on PET-CT will ensure accurate interpretation by Nuclear Medicine physicians and radiologists during the current vaccination drive.

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Section: Discussionmentioning

confidence: 99%

COVID-19 vaccine-related lymph node activation – patterns of uptake on PET-CT

et al. 2021

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“…Acquired immune response induced by vaccine therapy can be expected to be stronger and last much longer than CDC, ADCC, and ADCP induced by monoclonal antibodies. Consistent with this expectation, FDG-PET/CT may detect such an adaptive immune response as increased FDG uptake in the case of infectious disease vaccines such as influenza vaccines [49,50] and, recently, COVID-19 vaccines [51]. Since these vaccines do not target antigen-expressing lesions, increased FDG uptake is mainly detected in vaccinated sites and their draining lymph nodes.…”

Section: False Positive Images Resulting From Cancer Vaccine Therapymentioning

confidence: 64%

Imaging Assessment of Tumor Response in the Era of Immunotherapy

et al. 2021

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Assessment of tumor response during treatment is one of the most important purposes of imaging. Before the appearance of immunotherapy, response evaluation criteria in solid tumors (RECIST) and positron emission tomography response criteria in solid tumors (PERCIST) were, respectively, the established morphologic and metabolic response criteria, and cessation of treatment was recommended when progressive disease was detected according to these criteria. However, various types of immunotherapy have been developed over the past 20 years, which show novel false positive findings on images, as well as distinct response patterns from conventional therapies. Antitumor immune response itself causes 18F-fluorodeoxyglucose (FDG) uptake in tumor sites, known as “flare phenomenon”, so that positron emission tomography using FDG can no longer accurately identify remaining tumors. Furthermore, tumors often initially increase, followed by stability or decrease resulting from immunotherapy, which is called “pseudoprogression”, so that progressive disease cannot be confirmed by computed tomography or magnetic resonance imaging at a single time point. As a result, neither RECIST nor PERCIST can accurately predict the response to immunotherapy, and therefore several new response criteria fixed for immunotherapy have been proposed. However, these criteria are still controversial, and also require months for response confirmation. The establishment of optimal response criteria and the development of new imaging technologies other than FDG are therefore urgently needed. In this review, we summarize the false positive images and the revision of response criteria for each immunotherapy, in order to avoid discontinuation of a truly effective immunotherapy.

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“…However, no definite time-course of node activation was confirmed. Waiting at least 4 weeks after vaccination could minimize false-positives from vaccine immunity to tumor involvement of lymph nodes [8]. …”

Section: Discussionmentioning

confidence: 99%

False-Positive Hypermetabolic Lesions on Post-Treatment PET-CT after Influenza Vaccination

Kim

Lee

et al. 2011

Korean J Intern Med

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We report a case of a 59-year-old man with testicular germ cell tumor who showed new hypermetabolic lesions at the left axillary lymph nodes on a post-treatment positron emission tomography-computed tomography (PET-CT) scan. The hypermetabolic lesions were found to be caused by an influenza vaccination 10 days prior to the PET-CT scan and disappeared without additional treatment. To date, he is alive with complete remission.

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Influenza vaccine and FDG-PET

Cited by 5 publications

References 1 publication

COVID-19 vaccine-related lymph node activation – patterns of uptake on PET-CT

COVID-19 vaccine-related lymph node activation – patterns of uptake on PET-CT

Imaging Assessment of Tumor Response in the Era of Immunotherapy

False-Positive Hypermetabolic Lesions on Post-Treatment PET-CT after Influenza Vaccination

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