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Examination of iatrogenic FDG accumulation after COVID-19 vaccination

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Abstract

Purpose

This study aimed to investigate the frequency of COVID-19 vaccine-induced reactive change and potential factors including blood type correlated with increased FDG uptake on positron emission tomography (PET)/computed tomography (CT).

Materials and methods

We evaluated 284 patients who underwent PET/CT between June and September 2021 and had a known history of COVID-19 vaccination. Information on the injection site, vaccine type, and adverse reactions was obtained. We visually assessed the presence or absence of accumulation in the axillary and supraclavicular lymph nodes and the deltoid muscles. We measured the maximum standardized uptake value (SUVmax) using semi-quantitative analysis.

Results

Our study included 158 males and 126 females aged 16–94. The median time between vaccination and PET/CT was 9 and 42 days for patients who had received their first and second doses, respectively. We observed axillary lymph node accumulation, supraclavicular lymph node accumulation, and deltoid muscle accumulation in 98 (SUVmax 1.07–25.1), nine (SUVmax 2.28–14.5), and 33 cases (SUVmax 0.93–7.42), respectively. In cases with axillary lymph node (P = 0.0057) or deltoid muscle (P = 0.047) accumulation, the shorter the time since vaccination, the higher the FDG accumulation. Patients with axillary lymph node accumulation were significantly younger (P < 0.0001) and had a significantly higher frequency of adverse reactions such as fever (P < 0.0001) and myalgia (P = 0.002). No significant relationship was observed between blood type and the frequency of FDG accumulation. Logistic regression analysis also showed that age, gender, days since vaccination, and adverse reactions such as fever and myalgia were important factors for axillary lymph node accumulation.

Conclusion

Our study found that FDG accumulation in the axillary lymph nodes and deltoid muscle was higher within a shorter time after vaccination, and axillary lymph node accumulation was higher in young patients, females, and those with adverse reactions of fever and myalgia. No significant relationship was observed between blood type and the frequency of FDG accumulation. Confirming the vaccination status, time since vaccination, and the presence of adverse reactions before PET may reduce false positives.

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Data availability

The datasets used and/or analyzed in the current study are available from the corresponding author upon request.

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Acknowledgements

We would like to thank Editage (www.editage.com) for English language editing.

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Authors and Affiliations

  1. Department of Radiology, Jichi Medical University Saitama Medical Center, 1-847 Amanuma-cho, Omiya-ku, Saitama, 330-8503, Japan

    Keiko Takahashi, Osamu Manabe & Noriko Oyama-Manabe

  2. Saitama Central Clinic, Saitama, Japan

    Kazuya Shizukuishi & Hirohumi Shibata

  3. Central Division of Radiology, Jichi Medical University Saitama Medical Center, Saitama, Japan

    Hiroki Kawakami & Akira Otsuka

  4. Department of Radiology, Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan

    Keiko Takahashi

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Contributions

KT and OM conceived and designed the study. The material preparation, data collection, and analyses were performed by KT and OM. KT and OM wrote the first draft of this manuscript. All authors commented on the previous versions of the manuscript. All the authors have read and approved the final version of the manuscript.

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Correspondence to Osamu Manabe.

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Conflict of interest

Dr. Noriko Oyama-Manabe receives payments for lectures from Bayer Yakuhin, Ltd. and Canon Medical Systems. The other authors declare no financial conflicts of interest.

Ethical approval

Approval from our institutional ethics review board was obtained, and the requirement for informed consent was waived for this retrospective study.

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Takahashi, K., Manabe, O., Shizukuishi, K. et al. Examination of iatrogenic FDG accumulation after COVID-19 vaccination. Ann Nucl Med (2024). https://doi.org/10.1007/s12149-024-01909-5

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