Skip to main content

Assessing immune response upon systemic RNA vaccination on [18F]-FDG PET/CT for COVID-19 vaccine and then for immuno-oncology?

Dear Sir,

The publication “18 Fluorodeoxyglucose PET/CT findings in a systemic inflammatory response syndrome after COVID-19 vaccine” reports the case of a 65-year-old woman with increased glucose metabolism in lymphoid tissues diagnosed on [18F]-FDG PET/CT performed 4 days after the first dose of mRNA COVID-19 vaccine [1]. This finding highlights the phenomenon of reactive adenopathy on imaging examinations following vaccination and the need for increasing public awareness and guidelines for clinical practice [2].

The Lancet report also raises the potential of [18F]-FDG PET/CT as a potent tool to assess immune response after mRNA vaccinations. There is now an abundance of evidence demonstrating that immune response increases glucose metabolism in lymphoid organs, which are critical modulators of T-cell immunity [3].

The technology of mRNA vaccination offers promising prophylactic and therapeutic potentials in several medical fields including immuno-oncology [4]. Therefore, current oncological clinical trials should consider the potential theranostic value of [18F]-FDG PET and correlate temporal changes in glucose metabolism of lymphoid tissues with treatment outcome. For instance, a rapid and transient increase in spleen glucose metabolism after RNA cancer vaccine connotes robust immune activation and T-cell proliferation [5]. The same argument can be made for hypermetabolic draining lymph nodes, which could reflect a prominent B cell germinal center activation and an effective humoral response elicited by mRNA vaccine [6].

In conclusion, while the contemporary role of [18F]-FDG PET/CT is predominantly cancer imaging, there is a paradigm shift toward assessing healthy lymphoid tissues for in vivo quantification of the immune response. In the setting of RNA vaccination, this could be used as a theranostic tool for a wide range of indications in multiple therapeutic areas.

References

  1. Steinberg J, Thomas A, Iravani A. 18F-fluorodeoxyglucose PET/CT findings in a systemic inflammatory response syndrome after COVID-19 vaccine. Lancet. 2021;397:e9.

    CAS  Article  Google Scholar 

  2. Becker AS, Perez-Johnston R, Chikarmane SA, Chen MM, El Homsi M, Feigin KN, et al. Multidisciplinary recommendations regarding post-vaccine adenopathy and radiologic imaging: radiology scientific expert panel. Radiology. 2021;210436. https://doi.org/10.1148/radiol.2021210436.

  3. Cafri G, Gartner JJ, Zaks T, Hopson K, Levin N, Paria BC, et al. mRNA vaccine-induced neoantigen-specific T cell immunity in patients with gastrointestinal cancer. J Clin Invest. 2020;130:5976–88.

    CAS  Article  Google Scholar 

  4. Miao L, Zhang Y, Huang L. mRNA vaccine for cancer immunotherapy. Mol Cancer. 2021;20:41.

    CAS  Article  Google Scholar 

  5. Pektor S, Hilscher L, Walzer KC, Miederer I, Bausbacher N, Loquai C, et al. In vivo imaging of the immune response upon systemic RNA cancer vaccination by FDG-PET. EJNMMI Res. 2018;8:80.

    Article  Google Scholar 

  6. Cohen D, Hazut Krauthammer S, Cohen YC, Perry C, Avivi I, Herishanu Y, et al. Correlation between BNT162b2 mRNA Covid-19 vaccine-associated hypermetabolic lymphadenopathy and humoral immunity in patients with hematologic malignancy. Eur J Nucl Med Mol Imaging [Internet]. 2021 [cited 2021 Jun 3]; Available from: https://link.springer.com/10.1007/s00259-021-05389-x.

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Romain-David Seban.

Ethics declarations

Ethics approval

This article does not contain any studies with human participants performed by any of the authors.

Consent to participate

Not applicable.

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Oncology - General

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Seban, RD., Champion, L., Yeh, R. et al. Assessing immune response upon systemic RNA vaccination on [18F]-FDG PET/CT for COVID-19 vaccine and then for immuno-oncology?. Eur J Nucl Med Mol Imaging 48, 3351–3352 (2021). https://doi.org/10.1007/s00259-021-05468-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00259-021-05468-z

Keywords

  • RNA vaccination
  • [18F]-FDG PET/CT
  • COVID-19
  • Immuno-oncology