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Research ArticleCovid-19 Commentaries
Open Access

Incidental Findings Suggestive of COVID-19 in Asymptomatic Patients Undergoing Nuclear Medicine Procedures in a High-Prevalence Region

Domenico Albano, Francesco Bertagna, Mattia Bertoli, Giovanni Bosio, Silvia Lucchini, Federica Motta, Maria Beatrice Panarotto, Alessia Peli, Luca Camoni, Frank M. Bengel and Raffaele Giubbini
Journal of Nuclear Medicine May 2020, 61 (5) 632-636; DOI: https://doi.org/10.2967/jnumed.120.246256
Domenico Albano
1Nuclear Medicine, University of Brescia, Brescia, Italy
2Nuclear Medicine, Spedali Civili Brescia, Brescia, Italy; and
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Francesco Bertagna
1Nuclear Medicine, University of Brescia, Brescia, Italy
2Nuclear Medicine, Spedali Civili Brescia, Brescia, Italy; and
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Mattia Bertoli
2Nuclear Medicine, Spedali Civili Brescia, Brescia, Italy; and
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Giovanni Bosio
2Nuclear Medicine, Spedali Civili Brescia, Brescia, Italy; and
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Silvia Lucchini
2Nuclear Medicine, Spedali Civili Brescia, Brescia, Italy; and
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Federica Motta
2Nuclear Medicine, Spedali Civili Brescia, Brescia, Italy; and
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Maria Beatrice Panarotto
2Nuclear Medicine, Spedali Civili Brescia, Brescia, Italy; and
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Alessia Peli
2Nuclear Medicine, Spedali Civili Brescia, Brescia, Italy; and
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Luca Camoni
2Nuclear Medicine, Spedali Civili Brescia, Brescia, Italy; and
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Frank M. Bengel
3Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany
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Raffaele Giubbini
1Nuclear Medicine, University of Brescia, Brescia, Italy
2Nuclear Medicine, Spedali Civili Brescia, Brescia, Italy; and
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Abstract

Infection with the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may remain asymptomatic, leading to under-recognition of the related disease, coronavirus disease, 2019 (COVID-19), and to incidental findings in nuclear imaging procedures performed for standard clinical indications. Here, we report about our local experience in a region with high COVID-19 prevalence and dynamically increasing infection rates. Methods: Within the 8-d period of March 16–24, 2020, hybrid imaging studies of asymptomatic patients who underwent 18F-FDG PET/CT or 131I SPECT/CT for standard oncologic indications at our institution in Brescia, Italy, were analyzed for findings suggestive of COVID-19. The presence, radiologic features, and metabolic activity of interstitial pneumonia were identified, correlated with the subsequent short-term clinical course, and described in a case series. Results: Six of 65 patients (9%) who underwent PET/CT for various malignancies showed unexpected signs of interstitial pneumonia on CT and elevated regional 18F-FDG avidity. Additionally, 1 of 12 patients who received radioiodine for differentiated thyroid carcinoma also showed interstitial pneumonia on SPECT/CT. Five of 7 patients had subsequent proof of COVID-19 by reverse-transcriptase polymerase chain reaction. The remaining 2 patients were not tested immediately but underwent quarantine and careful monitoring. Conclusion: Incidental findings suggestive of COVID-19 may not be infrequent in hybrid imaging of asymptomatic patients in regions with an expansive spread of SARS-CoV-2. Nuclear medicine services should prepare accordingly.

  • COVID-19
  • PET/CT
  • pneumonia
  • nuclear medicine

Footnotes

  • Published online Apr. 1, 2020.

  • © 2020 by the Society of Nuclear Medicine and Molecular Imaging.

Immediate Open Access: Creative Commons Attribution 4.0 International License (CC BY) allows users to share and adapt with attribution, excluding materials credited to previous publications. License: https://creativecommons.org/licenses/by/4.0/. Details: http://jnm.snmjournals.org/site/misc/permission.xhtml.

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Journal of Nuclear Medicine: 61 (5)
Journal of Nuclear Medicine
Vol. 61, Issue 5
May 1, 2020
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Incidental Findings Suggestive of COVID-19 in Asymptomatic Patients Undergoing Nuclear Medicine Procedures in a High-Prevalence Region
Domenico Albano, Francesco Bertagna, Mattia Bertoli, Giovanni Bosio, Silvia Lucchini, Federica Motta, Maria Beatrice Panarotto, Alessia Peli, Luca Camoni, Frank M. Bengel, Raffaele Giubbini
Journal of Nuclear Medicine May 2020, 61 (5) 632-636; DOI: 10.2967/jnumed.120.246256

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Incidental Findings Suggestive of COVID-19 in Asymptomatic Patients Undergoing Nuclear Medicine Procedures in a High-Prevalence Region
Domenico Albano, Francesco Bertagna, Mattia Bertoli, Giovanni Bosio, Silvia Lucchini, Federica Motta, Maria Beatrice Panarotto, Alessia Peli, Luca Camoni, Frank M. Bengel, Raffaele Giubbini
Journal of Nuclear Medicine May 2020, 61 (5) 632-636; DOI: 10.2967/jnumed.120.246256
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