Characterization of Hypermetabolic Lymph Nodes After SARS-CoV-2 Vaccination Using PET-CT Derived Node-RADS, in Patients with Melanoma

Overview

Journal Sci Rep

Specialty Science

Date 2023 Oct 26

PMID 37884535

Authors

Antonio G Gennari

Alexia Rossi

Thomas Sartoretti

Alexander Maurer

Stephan Skawran

Valerie Treyer

Elisabeth Sartoretti

Alessandra Curioni-Fontecedro

Moritz Schwyzer

Stephan Waelti

Martin W Huellner

Michael Messerli

Affiliations

Soon will be listed here.

Abstract

This study aimed to evaluate the diagnostic accuracy of Node Reporting and Data System (Node-RADS) in discriminating between normal, reactive, and metastatic axillary LNs in patients with melanoma who underwent SARS-CoV-2 vaccination. Patients with proven melanoma who underwent a 2-[F]-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (2-[F]-FDG PET/CT) between February and April 2021 were included in this retrospective study. Primary melanoma site, vaccination status, injection site, and 2-[F]-FDG PET/CT were used to classify axillary LNs into normal, inflammatory, and metastatic (combined classification). An adapted Node-RADS classification (A-Node-RADS) was generated based on LN anatomical characteristics on low-dose CT images and compared to the combined classification. 108 patients were included in the study (54 vaccinated). HALNs were detected in 42 patients (32.8%), of whom 97.6% were vaccinated. 172 LNs were classified as normal, 30 as inflammatory, and 14 as metastatic using the combined classification. 152, 22, 29, 12, and 1 LNs were classified A-Node-RADS 1, 2, 3, 4, and 5, respectively. Hence, 174, 29, and 13 LNs were deemed benign, equivocal, and metastatic. The concordance between the classifications was very good (Cohen's k: 0.91, CI 0.86-0.95; p-value < 0.0001). A-Node-RADS can assist the classification of axillary LNs in melanoma patients who underwent 2-[F]-FDG PET/CT and SARS-CoV-2 vaccination.

Citing Articles

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References

Arslan G, Murzoglu Altintoprak K, Kizildag Yirgin I, Atasoy M, Celik L . Diagnostic accuracy of metastatic axillary lymph nodes in breast MRI. Springerplus. 2016; 5(1):735. PMC: 4909659. DOI: 10.1186/s40064-016-2419-7. View

Elsholtz F, Asbach P, Haas M, Becker M, Beets-Tan R, Thoeny H . Introducing the Node Reporting and Data System 1.0 (Node-RADS): a concept for standardized assessment of lymph nodes in cancer. Eur Radiol. 2021; 31(8):6116-6124. PMC: 8270876. DOI: 10.1007/s00330-020-07572-4. View

Yang W, Lam W, Yu M, Cheung T, Metreweli C . Comparison of dynamic helical CT and dynamic MR imaging in the evaluation of pelvic lymph nodes in cervical carcinoma. AJR Am J Roentgenol. 2000; 175(3):759-66. DOI: 10.2214/ajr.175.3.1750759. View

Sadoff J, Gray G, Vandebosch A, Cardenas V, Shukarev G, Grinsztejn B . Safety and Efficacy of Single-Dose Ad26.COV2.S Vaccine against Covid-19. N Engl J Med. 2021; 384(23):2187-2201. PMC: 8220996. DOI: 10.1056/NEJMoa2101544. View

Schwager S, Detmar M . Inflammation and Lymphatic Function. Front Immunol. 2019; 10:308. PMC: 6399417. DOI: 10.3389/fimmu.2019.00308. View

Richman D, Benson C, Doubilet P, Wassner A, Asch E, Cherella C . Assessment of American College of Radiology Thyroid Imaging Reporting and Data System (TI-RADS) for Pediatric Thyroid Nodules. Radiology. 2019; 294(2):415-420. DOI: 10.1148/radiol.2019191326. View

Panigrahi B, Harvey S, Mullen L, Falomo E, Di Carlo P, Lee B . Characteristics and Outcomes of BI-RADS 3 Lesions on Breast MRI. Clin Breast Cancer. 2018; 19(1):e152-e159. DOI: 10.1016/j.clbc.2018.08.011. View

Grimm L, Viradia N, Johnson K . Normal Axillary Lymph Node Variability Between White and Black Women on Breast MRI. Acad Radiol. 2017; 25(3):305-308. DOI: 10.1016/j.acra.2017.10.007. View

Agnello F, Albano D, Sparacia G, Micci G, Matranga D, Toia P . Outcome of LR-3 and LR-4 observations without arterial phase hyperenhancement at Gd-EOB-DTPA-enhanced MRI follow-up. Clin Imaging. 2020; 68:169-174. DOI: 10.1016/j.clinimag.2020.08.003. View

10.

Meyer H, Schnarkowski B, Pappisch J, Kerkhoff T, Wirtz H, Hohn A . CT texture analysis and node-RADS CT score of mediastinal lymph nodes - diagnostic performance in lung cancer patients. Cancer Imaging. 2022; 22(1):75. PMC: 9791752. DOI: 10.1186/s40644-022-00506-x. View

11.

Shin M, Hyun C, Choi Y, Choi J, Lee K, Cho Y . COVID-19 Vaccination-Associated Lymphadenopathy on FDG PET/CT: Distinctive Features in Adenovirus-Vectored Vaccine. Clin Nucl Med. 2021; 46(10):814-819. PMC: 8411598. DOI: 10.1097/RLU.0000000000003800. View

12.

Leonardo C, Flammia R, Lucciola S, Proietti F, Pecoraro M, Bucca B . Performance of Node-RADS Scoring System for a Standardized Assessment of Regional Lymph Nodes in Bladder Cancer Patients. Cancers (Basel). 2023; 15(3). PMC: 9913205. DOI: 10.3390/cancers15030580. View

13.

Sollini M, Gelardi F, Biroli M, Chiti A . Patients' findings after COVID-19 infection and vaccinations: what to expect from [18F]FDG PET/CT. Eur J Nucl Med Mol Imaging. 2021; 49(3):791-795. PMC: 8685163. DOI: 10.1007/s00259-021-05652-1. View

14.

Walker S, Mehralivand S, Harmon S, Sanford T, Merino M, Wood B . Prospective Evaluation of PI-RADS Version 2.1 for Prostate Cancer Detection. AJR Am J Roentgenol. 2020; 215(5):1098-1103. PMC: 8974984. DOI: 10.2214/AJR.19.22679. View

15.

Skawran S, Gennari A, Dittli M, Treyer V, Muehlematter U, Maurer A . [F]FDG uptake of axillary lymph nodes after COVID-19 vaccination in oncological PET/CT: frequency, intensity, and potential clinical impact. Eur Radiol. 2021; 32(1):508-516. PMC: 8217971. DOI: 10.1007/s00330-021-08122-2. View

16.

Cagigi A, Lore K . Immune Responses Induced by mRNA Vaccination in Mice, Monkeys and Humans. Vaccines (Basel). 2021; 9(1). PMC: 7831080. DOI: 10.3390/vaccines9010061. View

17.

Maurer A, Schiesser H, Skawran S, Gennari A, Dittli M, Burger I . Frequency and intensity of [F]-PSMA-1007 uptake after COVID-19 vaccination in clinical PET. BJR Open. 2022; 4(1):20210084. PMC: 9364367. DOI: 10.1259/bjro.20210084. View

18.

Steinkohl F, Gruber L, Bektic J, Nagele U, Aigner F, Herrmann T . Retrospective analysis of the development of PIRADS 3 lesions over time: when is a follow-up MRI reasonable?. World J Urol. 2017; 36(3):367-373. DOI: 10.1007/s00345-017-2135-0. View

19.

Smith R, WOOD Jr W . Cellular mechanisms of antibacterial defense in lymph nodes; the origin and filtration effect of granulocytes in the nodal sinuses during acute bacterial lymphadenitis. J Exp Med. 1949; 90(6):567-76, pl. PMC: 2135927. DOI: 10.1084/jem.90.6.567. View

20.

Zoumalan R, Kleinberger A, Morris L, Ranade A, Yee H, Delacure M . Lymph node central necrosis on computed tomography as predictor of extracapsular spread in metastatic head and neck squamous cell carcinoma: pilot study. J Laryngol Otol. 2010; 124(12):1284-8. PMC: 3005594. DOI: 10.1017/S0022215110001453. View