Nuclear medicine services after COVID-19: gearing up back to normality

Huang, Hian Liang; Gnanasegaran, Gopinath; Páez, Diana; Fanti, Stefano; Hacker, Marcus; Sathekge, Mike; Bom, H S; Cerci, Juliano Júlio; Chiti, Arturo; Lan, Xiaoli; Herrmann, Ken; Scott, Andrew; Vinjamuri, Sobhan; Dorbala, Sharmila; Estrada, Enrique; Pellet, Olivier; Orellana, Pilar; El-Haj, Noura; Giammarile, Francesco; Abdel‐Wahab, May; Bomanji, Jamshed

doi:10.1007/s00259-020-04848-1

Cited by 22 publications

(36 citation statements)

References 16 publications

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“…We are now looking at varying degrees of preparedness for countries to ramp up operations as some regions are currently recovering from the pandemic, other regions have plateaued, and some regions still face increasing numbers of infections. It will take time to assess whether we are prepared to restart operations safely (23).…”

Section: Discussionmentioning

confidence: 99%

Global Impact of COVID-19 on Nuclear Medicine Departments: An International Survey in April 2020

et al. 2020

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Section: Discussionmentioning

confidence: 99%

Global Impact of COVID-19 on Nuclear Medicine Departments: An International Survey in April 2020

et al. 2020

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“…PET/CT or SPECT/CT) scans of the chest (Refs. [ 20,21 ]), it would be interesting to include these kind of diagnostics in future studies investigating asymptomatic patients 5,21 . A study in Italy found an interesting outcome.…”

Section: Discussionmentioning

confidence: 99%

“…This led to a significant reduction in the number of outpatient and inpatient tumor therapies. Moreover to counter and minimize the risk of SARS‐CoV‐2 infection and severe complications, adjuvant chemotherapies, surgeries and other compromising therapies were eventually postponed or changed 5 . It is still unclear whether oncological patients (with or without active disease and with or without current therapy) harbor a higher risk of SARS‐CoV‐2 infection, and potentially of developing more severe forms of COVID‐19.…”

Section: Introductionmentioning

confidence: 99%

SARS‐CoV‐2 infections in cancer outpatients—Most infected patients are asymptomatic carriers without impact on chemotherapy

et al. 2020

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Oncologic patients are regarded as the population most at risk of developing a severe course of COVID‐19 due to the fact that malignant diseases and chemotherapy often weaken the immune system. In the face of the ongoing SARS‐CoV‐2 pandemic, how particular patients deal with this infection remains an important question. In the period between the 15 and 26 April 2020, a total of 1227 patients were tested in one of seven oncologic outpatient clinics for SARS‐CoV‐2, regardless of symptoms, employing RT‐qPCR. Of 1227 patients, 78 (6.4%) were tested positive of SARS‐CoV‐2. Only one of the patients who tested positive developed a severe form of COVID‐19 with pneumonia (CURB‐65 score of 2), and two patients showed mild symptoms. Fourteen of 75 asymptomatic but positively tested patients received chemotherapy or chemo‐immunotherapy according to their regular therapy algorithm (±4 weeks of SARS‐CoV‐2 test), and 48 of 78 (61.5%) positive‐tested patients received glucocorticoids as co‐medication. None of the asymptomatic infected patients showed unexpected complications due to the SARS‐CoV‐2 infection during the cancer treatment. These data clearly contrast the view that patients with an oncologic disease are particularly vulnerable to SARS‐CoV‐2 and suggest that compromising therapies could be continued or started despite the ongoing pandemic. Moreover the relatively low appearance of symptoms due to COVID‐19 among patients on chemotherapy and other immunosuppressive co‐medication like glucocorticoids indicate that suppressing the response capacity of the immune system reduces disease severity.

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“…The observed variation in activity between oncology and non-oncology should perhaps not be a surprise. European guidance published at that time advised on the importance of prioritizing essential nuclear medicine procedures over non-essential procedures if possible [11,17]. In the UK, the British Nuclear Medicine Society recommended prioritizing PET-CT for people with new cancers and sepsis over other PET-CTs if possible [18].…”

Section: Discussionmentioning

confidence: 99%

“…Moving out of the rst wave, the priority within NHS England, has been to return health care services to as near as possible to pre-COVID levels. With this comes the requirement for diagnostic services, including PET-CT, to meet demand while conforming to new COVID-19 safe measures [10,11]. An accurate and detailed understanding of the changes in PET-CT scanning activity during the rst wave, and the extent to which PET-CT services recovered, can contribute to ensuring that management plans for people with cancer are not delayed in the future and that relapse of disease in cancer survivors is detected in a timely fashion.…”

Section: Introductionmentioning

confidence: 99%

The Coronavirus Disease Pandemic 2019 [COVID-19]: Impact on NHS England PET-CT Scanning 

Wl¹,

Ross²,

Peters³

et al. 2020

Preprint

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Purpose To examine the impact of the COVID-19 pandemic on PET-CT scanning activity across England. Methods Monthly PET-CT scanning activity was collected from 41/48 NHS England provider sites. Data from 31/41sites was stratified by non-oncology/oncology and cancer type. Lung cancer and lymphoma activity was split into specific indications. The data was compiled in Excel and analysed using Stata software to assess distribution and statistical significance of variation in activity comparing levels before and during the COVID-19 pandemic. Results In April and May 2020 a 32% and 31% decrease in activity was observed; a larger decrease for non-cancer compared with cancer PET-CT. In June 2020 PET-CT activity started to recover with 6% fewer scans recorded compared with June 2019. Decrease and recovery varied according to cancer types. Of the six most common indications for PET CT, lung and oesophageal cancer had the largest decrease in activity: lung -29%, -45% and oesophagus -43%, -59% in April and May respectively, and slowest recovery, -23%, -26% respectively in June. By contrast, lymphoma and melanoma showed the smallest decrease: lymphoma -14%, -9%; melanoma -16%, +5% in April and May respectively, and fastest recovery +12% lymphoma +14% respectively. Specifically, lung cancer PET-CTs related to initial diagnosis and staging saw the largest fall and slowest recovery compared with PET-CTs for people with known lung cancer. Conclusions There was considerable variation in the rate of decline and recovery in PET-CT scanning across cancer types and specific indications related to the cancer type. The causes for the variation remain to be explained.

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Nuclear medicine services after COVID-19: gearing up back to normality

Cited by 22 publications

References 16 publications

Global Impact of COVID-19 on Nuclear Medicine Departments: An International Survey in April 2020

Global Impact of COVID-19 on Nuclear Medicine Departments: An International Survey in April 2020

SARS‐CoV‐2 infections in cancer outpatients—Most infected patients are asymptomatic carriers without impact on chemotherapy

The Coronavirus Disease Pandemic 2019 [COVID-19]: Impact on NHS England PET-CT Scanning

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Nuclear medicine services after COVID-19: gearing up back to normality

Cited by 22 publications

References 16 publications

Global Impact of COVID-19 on Nuclear Medicine Departments: An International Survey in April 2020

Global Impact of COVID-19 on Nuclear Medicine Departments: An International Survey in April 2020

SARS‐CoV‐2 infections in cancer outpatients—Most infected patients are asymptomatic carriers without impact on chemotherapy

The Coronavirus Disease Pandemic 2019 [COVID-19]: Impact on NHS England PET-CT Scanning&nbsp;

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The Coronavirus Disease Pandemic 2019 [COVID-19]: Impact on NHS England PET-CT Scanning