Incidence and Intensity of F-18 FDG Uptake After Vaccination With H1N1 Vaccine
Incidence and Intensity of F-18 FDG Uptake After Vaccination With H1N1 Vaccine
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DOI：
10.1097/rlu.0b013e3182177322
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发表时间：
2011-10-01
影响因子：
10.6
通讯作者：
Schaefer, Niklaus G.
中科院分区：
文献类型：
--
作者：
Burger, Irene A.;Husmann, Lars;Schaefer, Niklaus G.
目的：分析H1N1甲型流感病毒疫苗接种的影响，在病人提到分期或后续F-18氟脱氧葡萄糖（FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）为不同的恶性tumors.Method和材料：所有患者的病史安排FDG PET/CT在全国疫苗接种运动对H1N1进行了评估，最近的疫苗接种。确定注射部位和PET/CT与接种日期之间的时间（dTime）。同侧和对侧三角肌或腋窝淋巴结之间的最大SUV差异大于0.5被确定为阳性反应。计算仍然可见反应的最佳截止dTime。对所有同侧淋巴结阳性的患者进行临床随访。结果：在269名患者中，58名（21.5%）在PET/CT前4周内接种了H1N1疫苗（平均14.5 +/- 8.7天）。其中，17例（29.3%）患者有FDG阳性淋巴结（平均SUV，1.43 ± 1.06），dTime范围为1 - 14天。仅2例患侧三角肌FDG摄取无增加。受试者工作特征曲线下面积显示，时间延迟（dTime）和腋窝活动（AUC，0.9; 95%置信区间，0.816-0.983）之间存在强相关性，截止时间为8天（Youden指数）。在后续行动（平均值，183天，范围，173-196天），没有病人被发现需要治疗或腋窝lymphadenopathy.Conclusions的迹象：H1N1疫苗接种可能会导致假阳性FDG PET/CT结果，当管理不到14天前的测试，最高的概率，如果接种疫苗是在不到8天前。同侧三角肌FDG活性增加是准确解释腋窝淋巴结FDG活性增加的关键。
Objective: To analyze the effect of H1N1 influenza A virus vaccination in patients referred for staging or follow-up F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for different malignant tumors.Method and Materials: Medical history of all patients scheduled for FDG PET/CT during the national vaccination campaign against H1N1 was evaluated for recent vaccination. Site of injection and time between PET/CT and the date of vaccination (dTime) was determined. A difference in the maximum SUV between ipsi- and contralateral deltoid muscle or axillary lymph node of more than 0.5 was determined as positive reaction. The best cut-off dTime for still visible reaction was calculated. All patients with positive ipsilateral lymph node were clinically followed. Institutional Review Board approval was waived.Results: Of 269 patients, 58 (21.5%) were vaccinated for the H1N1 within 4 weeks prior to PET/CT (mean, 14.5 +/- 8.7 days). Of them, 17 (29.3%) patients had FDG-positive lymph nodes (mean SUV, 1.43 +/- 1.06), with a dTime range from 1 to 14 days. Only 2 of them had no increased FDG uptake in the ipsilateral deltoid muscle. The area under the receiver operator characteristic curve revealed a strong relation between time delay (dTime) and axillary activity (AUC, 0.9; 95% confidence interval, 0.816-0.983) with a cutoff at 8 days (Youden Index). At follow-up (mean, 183 days; range, 173-196 days), no patient was found to have required treatment or signs of axillary lymphadenopathy.Conclusions: H1N1 vaccination can cause false-positive FDG PET/CT findings, when administered less than 14 days before the test, with the highest probability if the vaccination was administered less than 8 days ago. Increased FDG activity in the ipsilateral deltoid muscle is a key finding for accurate interpretation of increased FDG activity in axillary lymph nodes.