PT - JOURNAL ARTICLE AU - Albano, Domenico AU - Bertagna, Francesco AU - Bertoli, Mattia AU - Bosio, Giovanni AU - Lucchini, Silvia AU - Motta, Federica AU - Panarotto, Maria Beatrice AU - Peli, Alessia AU - Camoni, Luca AU - Bengel, Frank M. AU - Giubbini, Raffaele TI - Incidental Findings Suggestive of COVID-19 in Asymptomatic Patients Undergoing Nuclear Medicine Procedures in a High-Prevalence Region AID - 10.2967/jnumed.120.246256 DP - 2020 May 01 TA - Journal of Nuclear Medicine PG - 632--636 VI - 61 IP - 5 4099 - http://jnm.snmjournals.org/content/61/5/632.short 4100 - http://jnm.snmjournals.org/content/61/5/632.full SO - J Nucl Med2020 May 01; 61 AB - 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.