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Burger, I A; Husmann, L; Hany, T F; Schmid, D T; Schaefer, N G (2011). Incidence and intensity of F-18 FDG uptake after vaccination with H1N1 vaccine. Clinical Nuclear Medicine, 36(10):848-853.

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To analyze the effect of H1N1 influenza A virus vaccination in patients referred for staging or follow-up F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for different malignant tumors.

Medical history of all patients scheduled for FDG PET/CT during the national vaccination campaign against H1N1 was evaluated for recent vaccination. Site of injection and time between PET/CT and the date of vaccination (dTime) was determined. A difference in the maximum SUV between ipsi- and contralateral deltoid muscle or axillary lymph node of more than 0.5 was determined as positive reaction. The best cut-off dTime for still visible reaction was calculated. All patients with positive ipsilateral lymph node were clinically followed. Institutional Review Board approval was waived.

Of 269 patients, 58 (21.5%) were vaccinated for the H1N1 within 4 weeks prior to PET/CT (mean, 14.5 ± 8.7 days). Of them, 17 (29.3%) patients had FDG-positive lymph nodes (mean SUV, 1.43 ± 1.06), with a dTime range from 1 to 14 days. Only 2 of them had no increased FDG uptake in the ipsilateral deltoid muscle. The area under the receiver operator characteristic curve revealed a strong relation between time delay (dTime) and axillary activity (AUC, 0.9; 95% confidence interval, 0.816-0.983) with a cutoff at 8 days (Youden Index). At follow-up (mean, 183 days; range, 173-196 days), no patient was found to have required treatment or signs of axillary lymphadenopathy.

H1N1 vaccination can cause false-positive FDG PET/CT findings, when administered less than 14 days before the test, with the highest probability if the vaccination was administered less than 8 days ago. Increased FDG activity in the ipsilateral deltoid muscle is a key finding for accurate interpretation of increased FDG activity in axillary lymph nodes.


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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Nuclear Medicine
Dewey Decimal Classification:610 Medicine & health
Deposited On:10 Feb 2012 20:33
Last Modified:05 Apr 2016 15:36
Publisher:Lippincott Williams and Wilkins
ISSN:0363-9762 (P) 1536-0229 (E)
Publisher DOI:10.1097/RLU.0b013e3182177322
PubMed ID:21892032

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