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Moreno-Ballesteros A, Rebollo-Aguirre ÁC, Bolívar-Roldán I, Busquier T, Sanchez-de Mora E, Jimenez-Heffernan A. Assessment of pulmonary embolism related to active SARS-CoV-2 infection in pregnant women. Rev Esp Med Nucl Imagen Mol 2023; 42:218-222. [PMID: 36758829 PMCID: PMC9904850 DOI: 10.1016/j.remnie.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 11/20/2022] [Indexed: 02/09/2023]
Abstract
AIM To analyze a sample of pregnant patients who underwent pulmonary perfusion scintigraphy to rule out suspicion of pulmonary embolism (PE) during the acute COVID-19 infection hospitalization period in our hospital. MATERIAL AND METHODS SPECT scintigraphy with a reduced dose (111MBq) of 99mTc-macroaggregated albumin was performed in all the patients (n=5). The images obtained were interpreted by comparing the findings with the radiological images according to the PISAPED criteria. RESULTS Only one of the 5 patients was diagnosed with PE. Two patients showed pathological scintigraphy findings attributable to radiological alterations due to COVID-19 pneumonia, and the other two had normal pulmonary perfusion. CONCLUSION Given the non-specific features of the clinical manifestations and d-dimer values in COVID-19, as well as their similarity to those of PE, pulmonary perfusion scintigraphy plays a crucial role in the screening of PE in these patients due to its high sensitivity and lower irradiation compared to CT. Despite the limited number of patients, the results obtained have special relevance due to the absence of scientific publications in this group of patients within the exceptional context of the COVID-19 pandemic.
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Affiliation(s)
- A Moreno-Ballesteros
- Unidad de Medicina Nuclear, Hospital Universitario Juan Ramón Jiménez, Huelva, Spain.
| | - Á C Rebollo-Aguirre
- Unidad de Medicina Nuclear, Hospital Universitario Juan Ramón Jiménez, Huelva, Spain
| | - I Bolívar-Roldán
- Unidad de Medicina Nuclear, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - T Busquier
- Unidad de Radiodiagnóstico, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - E Sanchez-de Mora
- Unidad de Medicina Nuclear, Hospital Universitario Juan Ramón Jiménez, Huelva, Spain
| | - A Jimenez-Heffernan
- Unidad de Medicina Nuclear, Hospital Universitario Juan Ramón Jiménez, Huelva, Spain
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Vaz N, Franquet E, Heidari P, Chow DZ, Jacene HA, Ng TSC. COVID-19: Findings in nuclear medicine from head to toe. Clin Imaging 2023; 99:10-18. [PMID: 37043868 PMCID: PMC10081937 DOI: 10.1016/j.clinimag.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 04/03/2023] [Indexed: 04/14/2023]
Abstract
COVID-19 is a multisystemic disease, and hence its potential manifestations on nuclear medicine imaging can extend beyond the lung. Therefore, it is important for the nuclear medicine physician to recognize these manifestations in the clinic. While FDG-PET/CT is not indicated routinely in COVID-19 evaluation, its unique capability to provide a functional and anatomical assessment of the entire body means that it can be a powerful tool to monitor acute, subacute, and long-term effects of COVID-19. Single-photon scintigraphy is routinely used to assess conditions such as pulmonary embolism, cardiac ischemia, and thyroiditis, and COVID-19 may present in these studies. The most common nuclear imaging finding of COVID-19 vaccination to date is hypermetabolic axillary lymphadenopathy. This may pose important diagnostic and management dilemmas in oncologic patients, particularly those with malignancies where the axilla constitutes a lymphatic drainage area. This article aims to summarize the relevant literature published since the beginning of the pandemic on the intersection between COVID-19 and nuclear medicine.
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Affiliation(s)
- Nuno Vaz
- Department of Radiology, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115, United States.
| | - Elisa Franquet
- Department of Radiology, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115, United States
| | - Pedram Heidari
- Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, United States
| | - David Z Chow
- Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, United States
| | - Heather A Jacene
- Department of Radiology, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115, United States
| | - Thomas S C Ng
- Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, United States
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3
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Moreno-Ballesteros A, Rebollo-Aguirre ÁC, Bolívar-Roldán I, Busquier T, Mora ESD, Jimenez-Heffernan A. [Assessment of pulmonary embolism related to active SARS-CoV-2 infection in pregnant women.]. Rev Esp Med Nucl Imagen Mol 2022; 42:S2253-654X(22)00188-3. [PMID: 36533162 PMCID: PMC9742206 DOI: 10.1016/j.remn.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 11/20/2022] [Indexed: 12/14/2022]
Abstract
AIM To analyze the sample of pregnant patients who underwent pulmonary perfusion scintigraphy to rule out the pulmonary embolism (PE) suspicion during the acute COVID-19 infection hospitalization period in our hospital. MATERIAL AND METHODS SPECT scintigraphy with a reduced dose (111 MBq) of 99mTc-macroaggregated albumin was performed in all of the patients (n=5). The obtained images were interpreted by comparing the findings with the radiological images according to the PISAPED criteria. RESULTS Only one of the 5 patients was diagnosed with PE. Two patients obtained pathological findings of the scintigraphy attributable to radiological alterations due to COVID-19 pneumonia, and the other two had normal pulmonary perfussion. CONCLUSION Given the non-specific features of the clinical manifestations and D-dimer values in COVID-19, as well as their similarity to those of PE, the pulmonary perfusion scintigraphy plays a crucial role in the screening of PE in these patients due to its high sensitivity and lower irradiation compared to CT. Despite the limited number of patients, the results obtained have special relevance related to the absence of scientific publications on this group of patients within the context of COVID-19 pandemic exceptional situation.
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Affiliation(s)
- Ana Moreno-Ballesteros
- Unidad de Medicina Nuclear. Hospital Universitario Juan Ramón Jiménez. Ronda Norte, s/n, 21005, Huelva, España
| | - Ángel C Rebollo-Aguirre
- Unidad de Medicina Nuclear. Hospital Universitario Juan Ramón Jiménez. Ronda Norte, s/n, 21005, Huelva, España
| | - Isabel Bolívar-Roldán
- Unidad de Medicina Nuclear. Hospital Universitario Virgen Macarena. Avenida Dr Fedriani nº3, 41009, Sevilla, España
| | - Teresa Busquier
- Unidad de Radiodiagnóstico. Hospital Universitario Virgen Macarena. Avenida Dr Fedriani nº3, 41009, Sevilla, España
| | - Elena Sanchez-de Mora
- Unidad de Medicina Nuclear. Hospital Universitario Juan Ramón Jiménez. Ronda Norte, s/n, 21005, Huelva, España
| | - Amelia Jimenez-Heffernan
- Unidad de Medicina Nuclear. Hospital Universitario Juan Ramón Jiménez. Ronda Norte, s/n, 21005, Huelva, España
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Tipre DN, Cidon M, Moats RA. Imaging Pulmonary Blood Vessels and Ventilation-Perfusion Mismatch in COVID-19. Mol Imaging Biol 2022; 24:526-536. [PMID: 35041149 PMCID: PMC8764889 DOI: 10.1007/s11307-021-01700-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 12/22/2021] [Accepted: 12/27/2021] [Indexed: 12/16/2022]
Abstract
COVID-19 hypoxemic patients although sharing a same etiology (SARS-CoV-2 infection) present themselves quite differently from one another. Patients also respond differently to prescribed medicine and to prone Vs supine bed positions. A severe pulmonary ventilation-perfusion mismatch usually triggers moderate to severe COVID-19 cases. Imaging can aid the physician in assessing severity of COVID-19. Although useful for their portability X-ray and ultrasound serving on the frontline to evaluate lung parenchymal abnormalities are unable to provide information about pulmonary vasculature and blood flow redistribution which is a consequence of hypoxemia in COVID-19. Advanced imaging modalities such as computed tomography, single-photon emission tomography, and electrical impedance tomography use a sharp algorithm visualizing pulmonary ventilation-perfusion mismatch in the abnormal and in the apparently normal parenchyma. Imaging helps to access the severity of infection, lung performance, ventilation-perfusion mismatch, and informs strategies for medical treatment. This review summarizes the capacity of these imaging modalities to assess ventilation-perfusion mismatch in COVID-19. Despite having limitations, these modalities provide vital information on blood volume distribution, pulmonary embolism, pulmonary vasculature and are useful to assess severity of lung disease and effectiveness of treatment in COVID-19 patients.
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Affiliation(s)
- Dnyanesh N Tipre
- Translational Biomedical Imaging Laboratory, Department of Radiology, Children's Hospital Los Angeles, The Saban Research Institute, 4650 Sunset Blvd Rm 305, Los Angeles, CA, USA.
| | - Michal Cidon
- Department of Rheumatology, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Rex A Moats
- Translational Biomedical Imaging Laboratory, Department of Radiology, Children's Hospital Los Angeles, The Saban Research Institute, 4650 Sunset Blvd Rm 305, Los Angeles, CA, USA
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Woolley I, Steinfort D, Szer J. COVID-19: looking backward. Intern Med J 2021; 51:1203-1204. [PMID: 34423545 PMCID: PMC8652750 DOI: 10.1111/imj.15461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 07/08/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Ian Woolley
- Monash Infectious Diseases, Monash Health, Melbourne, Victoria, Australia.,Centre for Inflammatory Diseases, Monash University, Melbourne, Victoria, Australia
| | - Daniel Steinfort
- Department Respiratory Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia.,Department of Medicine, Faculty of Medicine, Dentistry & Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Jeff Szer
- Clinical Haematology, Peter MacCallum Cancer Centre and The Royal Melbourne Hospital, Melbourne, Victoria, Australia.,University of Melbourne, Melbourne, Victoria, Australia
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