Purpose To assess the presence and pattern of incidental interstitial lung alterations suspicious of COVID-19 on fluorine-18-fluorodeoxyglucose positron emission tomography (PET)/computed tomography (CT) ([ 18 F]FDG PET/CT) in asymptomatic oncological patients during the period of active COVID-19 in a country with high prevalence of the virus. Methods This is a multi-center retrospective observational study involving 59 Italian centers. We retrospectively reviewed the prevalence of interstitial pneumonia detected during the COVID period (between March 16 and 27, 2020) and compared to a pre-COVID period (January–February 2020) and a control time (in 2019). The diagnosis of interstitial pneumonia was done considering lung alterations of CT of PET. Results Overall, [ 18 F]FDG PET/CT was performed on 4008 patients in the COVID period, 19,267 in the pre-COVID period, and 5513 in the control period. The rate of interstitial pneumonia suspicious for COVID-19 was significantly higher during the COVID period (7.1%) compared with that found in the pre-COVID (5.35%) and control periods (5.15%) ( p < 0.001). Instead, no significant difference among pre-COVID and control periods was present. The prevalence of interstitial pneumonia detected at PET/CT was directly associated with geographic virus diffusion, with the higher rate in Northern Italy. Among 284 interstitial pneumonia detected during COVID period, 169 (59%) were FDG-avid (average SUVmax of 4.1). Conclusions A significant increase of interstitial pneumonia incidentally detected with [ 18 F]FDG PET/CT has been demonstrated during the COVID-19 pandemic. A majority of interstitial pneumonia were FDG-avid. Our results underlined the importance of paying attention to incidental CT findings of pneumonia detected at PET/CT, and these reports might help to recognize early COVID-19 cases guiding the subsequent management. Supplementary Information The online version contains supplementary material available at 10.1007/s00259-021-05219-0.
【저자키워드】 COVID-19, SARS-CoV-2, Asymptomatic, interstitial pneumonia, 18F-FDG PET/CT, Incidental findings, 【초록키워드】 Pneumonia, COVID-19 pandemic, Diagnosis, lung, tomography, Italy, virus, observational study, COVID, Prevalence, management, Patient, Positron emission tomography, pet, interstitial pneumonia, pattern, retrospective, PET/CT, incidentally detected, positron emission, significant difference, supplementary material, no significant difference, significant increase, COVID-19 case, alteration, average, help, diffusion, fluorine, country, interstitial, Result, subsequent, was performed, majority, recognize, demonstrated, significantly higher, was done, CT finding, Italian centers, 【제목키워드】 pandemic, Prevalence, Retrospective study, interstitial pneumonia, asymptomatic patient, National, country,