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18F-Fluciclovine–Avid Axillary Lymph Nodes After COVID-19 Vaccination on PET/CT for Suspected Recurrence of Prostate Cancer

Authors
  • Peacock, Justin G.
  • Banks, Elisabeth A.
  • McWhorter, Nathan
Type
Published Article
Journal
Journal of Nuclear Medicine Technology
Publisher
Society of Nuclear Medicine
Publication Date
Mar 01, 2022
Volume
50
Issue
1
Pages
73–74
Identifiers
DOI: 10.2967/jnmt.121.263001
PMID: 34872921
PMCID: PMC9178550
Source
PubMed Central
Keywords
Disciplines
  • Teaching Case Studies
License
Unknown

Abstract

Abnormally increased 18F-FDG avidity of axillary lymph nodes has become a frequent diagnostic dilemma on PET/CT in the current climate of global vaccinations directed against severe acute respiratory syndrome coronavirus 2. This avidity is due to the inflammatory response evoked by vaccines and the nonspecific nature of 18F-FDG uptake, which is increased in both malignant and inflammatory processes. Similarly, 18F-fluciclovine, an amino acid analog indicated for the assessment of biochemical recurrence of prostate cancer, may also demonstrate nonspecific inflammatory uptake. We report a case of 18F-fluciclovine PET/CT obtained for concern about prostate cancer. In this case, isolated avid lymph nodes were seen in the left axilla. A screening questionnaire revealed that the patient had recently received the second dose of the Pfizer-BioNTech coronavirus disease 2019 vaccine in his left shoulder, and hence, the uptake was determined to be reactive.

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