Nucl Med Mol Imaging.  2022 Feb;56(1):29-41. 10.1007/s13139-021-00730-6.

Abnormality Pattern of F‑18 FDG PET Whole Body with Functional MRI Brain in Post‑Acute COVID‑19

• Kiatkittikul P
• Promteangtrong C
• Kunawudhi A
• Siripongsatian D
• Siripongboonsitti T
• Ruckpanich P
• Thongdonpua S
• Jantarato A
• Piboonvorawong C
• Fonghoi N
• Chotipanich C

• KMID: 2526703
• DOI: http://doi.org/10.1007/s13139-021-00730-6

Abstract

Purpose
The study aimed to investigate imaging abnormalities associated with post-acute COVID-19 using F-18 FDG PET/ CT and PET/ rsfMRI brain.
Methods
We retrospectively recruited 13 patients with post-acute COVID-19. The post-acute COVID-19 symptoms and neuropsychiatric tests were performed before F-18 FDG PET/CT whole body with PET/rsfMRI brain. Qualitative and semiquantitative analyses were also conducted in both whole body and brain images.
Results
Among the 13 patients, 8 (61.5%) had myositis, followed by 8 (61.5%) with vasculitis (mainly in the thoracic aorta), and 7 (53.8%) with lung abnormalities.. Interestingly, one patient with a very high serum RBD IgG antibody demonstrated diffuse myositis throughout the body which potentially associated with immune-mediated myositis. One patient experienced psoriasis exacerbation with autoimmune-mediated after COVID-19. Most patients had multiple areas of abnormal brain connectivity involving the frontal and parieto-temporo-occipital lobes, as well as the thalamus.
Conclusion
The whole body F-18 FDG PET can be a potential tool to assess inflammatory process and support the hyperinflammatory etiology, mainly for lesions in skeletal muscle, vascular wall, and lung, as well as, multiple brain abnormalities in post-acute COVID-19. Nonetheless, further studies are recommended to confirm the results.

Keyword

Post-acute COVID-19; Long COVID-19; Inflammation; F-18 FDG PET; Fluorodeoxyglucose; Resting-state functional MRI