1. COVID-19 pneumonia: relationship between inflammation assessed by whole-body FDG PET/CT and short-term clinical outcome
- Author
-
Dietz, Matthieu, Chironi, Gilles, Claessens, Yann-Erick, Farhad, Ryan Lukas, Rouquette, Isabelle, Serrano, Benjamin, Nataf, Valérie, Hugonnet, Florent, Paulmier, Benoît, Berthier, Frédéric, Keita-Perse, Olivia, Giammarile, Francesco, Perrin, Christophe, Faraggi, Marc, Fissore-Magdelein, C., Gabriel-Solean, S., Dahmani, B., Riss, I., Sorlin, P., Dupasquier, V., Pathak, A., Dugourd, C., Nicolai, M., Rijo, N., Beau, N., Magdelein, X., Olyve, F., Chaillou-Orpitz, S., Lépine, J., Lorillou, M., Maincent, C., Bertrand, S., Brunner, P., Dittlot, C., Fuerxer, F., Liberatore, M., Armando, G., Bouregba, M., Catineau, J., Garcia, P., and Tran, D.
- Subjects
Male ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Glucose uptake ,Inflammation ,Gastroenterology ,Fluorodeoxyglucose F18 ,Positron Emission Tomography Computed Tomography ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Lung ,Aged ,Aged, 80 and over ,business.industry ,COVID-19 ,Heart ,General Medicine ,Middle Aged ,medicine.disease ,FDG PET/CT ,Pneumonia ,Treatment Outcome ,medicine.anatomical_structure ,Radiology Nuclear Medicine and imaging ,Anaerobic glycolysis ,Original Article ,Female ,Lymph Nodes ,Lymph ,Bone marrow ,Radiopharmaceuticals ,medicine.symptom ,business - Abstract
Purpose [18F]-2-Fluoro-2-deoxy-D-glucose PET/CT (FDG PET/CT) is a sensitive and quantitative technic for detecting inflammatory process. Glucose uptake is correlated with an increased anaerobic glycolysis seen in activated inflammatory cells such as monocytes, lymphocytes, and granulocytes. The aim of the study was to assess the inflammatory status at the presumed peak of the inflammatory phase in non-critically ill patients requiring admission for COVID-19. Methods Patients admitted with COVID-19 were prospectively enrolled. FDG PET/CT was performed from day 6 to day 14 of the onset of symptoms. Depending on FDG PET/CT findings, patients’ profiles were classified as “inflammatory” or “low inflammatory.” FDG PET/CT data were compared with chest CT evolution and short-term clinical outcome. All inflammatory sites were reported to screen potential extra-pulmonary tropism. Results Thirteen patients were included. Maximum standardized uptake values ranged from 4.7 to 16.3 in lungs. All patients demonstrated increased mediastinal lymph nodes glucose uptake. Three patients (23%) presented mild nasopharyngeal, two patients (15%) bone marrow, and five patients (38%) splenic mild increase in glucose uptake. No patient had significant digestive focal or segmental glucose uptake. There was no significant physiological myocardial glucose uptake in all patients except one. There was no correlation between PET lung inflammatory status and chest CT evolution or short-term clinical outcome. Conclusion Inflammatory process at the presumed peak of the inflammatory phase in COVID-19 patients is obvious in FDG PET/CT scans. Glucose uptake is heterogeneous and typically focused on lungs. Trial registration NCT04441489. Registered 22 June 2020 (retrospectively registered). Electronic supplementary material The online version of this article (10.1007/s00259-020-04968-8) contains supplementary material, which is available to authorized users.
- Published
- 2020
- Full Text
- View/download PDF