PT  - JOURNAL ARTICLE
AU  - Ayubcha, Cyrus
AU  - Werner, Thomas
AU  - Revheim, Mona-Elisabeth
AU  - Alavi, Abass
TI  - FDG-PET/CT as the gold standard in assessing recovery of pulmonary function in COVID-19
DP  - 2021 May 01
TA  - Journal of Nuclear Medicine
PG  - 2013--2013
VI  - 62
IP  - supplement 1
4099  - http://jnm.snmjournals.org/content/62/supplement_1/2013.short
4100  - http://jnm.snmjournals.org/content/62/supplement_1/2013.full
SO  - J Nucl Med2021 May 01; 62
AB  - 2013Objectives: 1. Review the literature related to the radiologic treatment monitoring of the pulmonary system in COVID-19 patients 2. Describe the comparative utility of FDG-PET/CT imaging in the assessment of pulmonary inflammation and other functional changes in the lungs 3. Argue for the integration of FDG-PET/CT into the translational and clinical studies of prospective therapies in the context of treatment-response. Methods: Accessing Google Scholar and PubMed, radiological studies imaging the pulmonary manifestations of the COVID-19 virus will be collated. Studies will be separated by choice of modality, chiefly chest X-Ray, CT, MRI and PET. Within this literature, special attention will be paid to multi-modality imaging studies. The advantages and disadvantages of these modalities will then be ascertained as a result of each study’s rigor and findings. Results: Traditional structural imaging modalities are able to uncover many aspects of the principal respiratory consequences of COVID-19 including, opacities and increased hyperemia along with other pneumonia-related changes. Comparatively, structural imaging is better able to capture the morphological abnormalities, especially fibrotic changes that follow prolonged pulmonary inflammation. However, FDG-PET/CT studies have shown the ability to capture such inflammatory changes earlier and moreover allow for quantification of such processes. Beyond the established role of FDG-PET/CT in pulmonary inflammation, venous thrombi are also readily visualized by FDG-PET as a result of localized leukocytosis and inflammation surrounding the thrombi. Thromboembolism along with microclots are common and serious complications of COVID-19 infections. Thus, total body PET imaging can allow for superior detection of these phenomena, leading to timely treatment and prevention of pulmonary embolism. Conclusions: FDG-PET is not a replacement of structural imaging modalities in the diagnosis and monitoring of the pulmonary involvement in COVID-19. Nevertheless, the functional data provided by the modality is able to improve the rigor of studies assessing the progression of pulmonary changes resulting from the COVID-19 virus. Chief advantages include the ability to assess and quantify subclinical inflammatory changes in the treatment course of prospective therapeutics. Otherwise, there FDG-PET/CT provides a distinct advantage in the ability to detect venous thrombi leading to interventions that could prevent pulmonary emboli. We thus suggest that hybrid FDG-PET/CT should be the gold standard in translational and clinical studies of respiratory disease in COVID-19.