Abstract
We aimed to predict the presence of vaccine-induced hypermetabolic lymph nodes (v-HLNs) on 18F-FDG PET/CT after coronavirus disease 2019 (COVID-19) vaccination and determine their association with lymphocyte counts. Methods: In this retrospective single-center study, we included consecutive patients who underwent 18F-FDG PET/CT imaging after messenger RNA- or viral vector-based COVID-19 vaccination between early March and late April 2021. Demographics, clinical parameters, and absolute lymphocyte count (ALC) were collected, and their association with the presence of v-HLNs in the draining territory was studied by logistic regression. Results: In total, 260 patients were eligible, including 209 (80%) women and 145 (56%) with breast cancer. The median age was 50 y (range, 23-96 y). The messenger RNA vaccine had been given to 233 (90%). Ninety (35%) patients had v-HLNs, with a median SUVmax of 3.7 (range, 2.0-26.3), and 74 (44%) displayed lymphopenia, with a median ALC of 1.4 × 109/L (range, 0.3-18.3 × 109/L). An age of no more than 50 y (odds ratio [OR], 2.2; 95% CI, 1.0-4.5), the absence of lymphopenia (OR, 2.2; 95% CI, 1.1-4.3), and less than a 30-d interval from the last vaccine injection to the 18F-FDG PET/CT (OR, 2.6; 95% CI, 1.3-5.6) were independent factors for v-HLNs on multivariate analysis. In breast cancer patients, the absence of lymphopenia was the only independent factor significantly associated with v-HLNs (OR, 2.9; 95% CI, 1.2-7.4). Conclusion: Patients with a normal ALC after COVID-19 vaccination were more likely to have v-HLNs on 18F-FDG PET/CT, both of which might be associated with a stronger immune response to vaccination.
Highlights
A billion doses have been administered worldwide using currently authorized and recommended Coronavirus disease 2019 (COVID-19) mRNA [1,2] or viral vector vaccines [3]
Rationale: We aimed to predict the presence of vaccine-induced hypermetabolic lymph nodes on 18F-FDG PET/CT after Coronavirus disease 2019 (COVID-19) vaccination and determine their association with lymphocyte counts
The absence of lymphopenia was the only independent factor significantly associated with v-hypermetabolic lymph node(s) (HLN)
Summary
A billion doses have been administered worldwide using currently authorized and recommended Coronavirus disease 2019 (COVID-19) mRNA [1,2] or viral vector vaccines [3]. Such vaccination has been shown to promote immunity against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by inducing strong T and memory B cell responses [4,5]. V-HLN appeared to correlate with an effective humoral response induced by the mRNA vaccination [13] It remains unclear whether similar results would be obtained following the administration of another type of vaccine (e.g. viral vectors)
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