Temporal metabolic response to mRNA COVID-19 vaccinations in oncology patients

Abstract

Background mRNA COVID-19 vaccines are known to provide an immune response seen on FDG PET studies. However, the time course of this metabolic response is unknown. We here present a temporal metabolic response to mRNA COVID-19 vaccination in oncology patients undergoing standard of care FDG PET. Methods 262 oncology patients undergoing standard of care FDG PET were included in the analysis. 231 patients had at least one dose of mRNA COVID-19 vaccine while 31 patients had not been vaccinated. The SUVmax of the lymph nodes ipsilateral to the vaccination was compared to the contralateral to obtain an absolute change in SUVmax (ΔSUVmax). Results ΔSUVmax was more significant at shorter times between FDG PET imaging and COVID-19 mRNA vaccination, with a median ΔSUVmax of 2.6 (0–7 days), 0.8 (8–14 days), and 0.3 (> 14 days), respectively. Conclusion Consideration should be given to performing FDG PET at least 2 weeks after the COVID-19 vaccine.

Temporary reactive response of axillary lymph nodes to COVID-19 vaccination on 18F-rhPSMA-7.3 PET/CT in patients with prostate cancer

“…Eight weeks following the vaccination, axillary lymph node uptake was no longer significantly different from unvaccinated patients. The frequency of positive axillary lymph nodes on PSMA-ligand PET/CT examinations in our series is comparable to recently published data for 18 F-FDG PET/CT examinations following COVID-19 vaccinations (1)(2)(3)(4)(5)13,17). It is well established that activated lymphatic cells show increased metabolic activity and consequently accumulate more 18 F-FDG.…”

Misdiagnosis of Reactive Lymphadenopathy Remotely After COVID-19 Vaccination: A Case Report and Literature Review

“…However, the maximal standardized uptake value (SUVmax) should not be solely used to differentiate between benign and malignant lymph nodes ( 14 ). There were attempts to improve the diagnostic rate by comparing the SUVmax of the ipsilateral lymph nodes to the contralateral lymph nodes ( 27 ) as well as the increased uptake in the deltoid muscle ( 28 , 29 ) or using different tracers ( 30 ). PET is the most sensitive imaging modality for differentiating lymphadenopathy, whereas the radioactive nature and high cost are limitations.…”

Optimization of FDG PET study after mRNA COVID-19 vaccination to reduce the interference of vaccine-associated hypermetabolic lymphadenopathy

“…The interpretation of PET study in oncologic patients might be impacted especially in head and neck cancer, breast cancer or lymphoma in which supraclavicular and axillary lymph node metastases are suspected. Hence, Advani et al [ 1 ] suggest that FDG PET study should be performed at least 2 weeks after vaccination to reduce the interference of lymphadenopathy causing by vaccination in PET interpretation.…”

“…For patients receiving the third booster dose of mRNA vaccine, the incidence of VAHL at the axillary and supraclavicular regions during 11–15 days and at least 16 days from the booster dose were 17.7% and 2.8%, respectively [ 4 ]. Thus, performing an FDG PET study more than 2 weeks after vaccine administration as suggested by Advani et al [ 1 ] might be applicable to oncologic patients who receive the third booster shot since the incidence of VAHL was low during the recommended period.…”