Top

European Journal of Medical Research

Published in:

Open Access 01-12-2023 | Positron Emission Tomography | Research

Comparison of post-COVID-19 vaccination hypermetabolic lymphadenopathy on ¹⁸F-fluorodeoxyglucose PET/CT between virus-vector vaccine and mRNA vaccine

Authors: Meng-Ting Chiang, Jann-Tay Wang, Wan-Yu Lin, Ruoh-Fang Yen, Jei-Yie Huang, Ching-Chu Lu

Published in: European Journal of Medical Research | Issue 1/2023

Abstract

Purpose

We compared hypermetabolic lymphadenopathy (HLN) on ¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) after virus-vector and mRNA vaccines for coronavirus disease 2019 (COVID-19).

Methods

This retrospective study included 573 participants who underwent FDG PET/CT after receiving a virus-vector vaccine (ChAdOx1, AstraZeneca [AZ] group) or an mRNA vaccine (mRNA-1273, Moderna [M] group) from July 2021 to October 2021. The incidence and avidity of HLN were evaluated and correlated with clinical features and vaccine type. The final analysis was conducted with 263 participants in the AZ group and 310 participants in the M group.

Results

The HLN incidence was significantly lower in the AZ group than in the M group (38/263 [14%] vs. 74/310 [24%], p = 0.006). The FDG avidity of HLN was comparable between the two groups. The HLN incidence in both groups was significantly higher within 4 weeks after the vaccination compared with more than 4 weeks. The HLN incidence within 4 weeks of the vaccination was significantly higher in the M group than in the AZ group (p = 0.008), whereas a difference in HLN incidence between the two groups was not observed after the same duration (p = 0.11).

Conclusions

The mRNA mRNA-1273 COVID-19 vaccine was found to be associated with higher glucose hypermetabolism in regional lymph nodes within the first 4 weeks compared with the virus-vector vaccine, as indicated by the presence of HLN on FDG PET/CT. The degree of glucose hypermetabolism was comparable between the two vaccines.

Bernstine H, Priss M, Anati T, Turko O, Gorenberg M, Steinmetz AP, et al. Axillary lymph nodes hypermetabolism after BNT162b2 mRNA COVID-19 vaccination in cancer patients undergoing 18F-FDG PET/CT: a cohort study. Clin Nucl Med. 2021;46(5):396–401. https://doi.org/10.1097/RLU.0000000000003648.CrossRefPubMed

Cohen D, Krauthammer SH, Wolf I, Even-Sapir E. Hypermetabolic lymphadenopathy following administration of BNT162b2 mRNA Covid-19 vaccine: incidence assessed by [(18)F]FDG PET-CT and relevance to study interpretation. Eur J Nucl Med Mol Imaging. 2021;48(6):1854–63. https://doi.org/10.1007/s00259-021-05314-2.CrossRefPubMedPubMedCentral

Eshet Y, Tau N, Alhoubani Y, Kanana N, Domachevsky L, Eifer M. Prevalence of increased FDG PET/CT axillary lymph node uptake beyond 6 weeks after mRNA COVID-19 vaccination. Radiology. 2021;300(3):E345–7. https://doi.org/10.1148/radiol.2021210886.CrossRefPubMed

Cohen D, Hazut Krauthammer S, Cohen YC, Perry C, Avivi I, Herishanu Y, et al. Correlation between BNT162b2 mRNA Covid-19 vaccine-associated hypermetabolic lymphadenopathy and humoral immunity in patients with hematologic malignancy. Eur J Nucl Med Mol Imaging. 2021;48(11):3540–9. https://doi.org/10.1007/s00259-021-05389-x.CrossRefPubMedPubMedCentral

Skawran S, Gennari AG, Dittli M, Treyer V, Muehlematter UJ, Maurer A, et al. [(18)F]FDG uptake of axillary lymph nodes after COVID-19 vaccination in oncological PET/CT: frequency, intensity, and potential clinical impact. Eur Radiol. 2022;32(1):508–16. https://doi.org/10.1007/s00330-021-08122-2.CrossRefPubMed

Shin M, Hyun CY, Choi YH, Choi JY, Lee KH, Cho YS. COVID-19 vaccination-associated lymphadenopathy on FDG PET/CT: distinctive features in adenovirus-vectored vaccine. Clin Nucl Med. 2021;46(10):814–9. https://doi.org/10.1097/RLU.0000000000003800.CrossRefPubMedPubMedCentral

Adin ME, Isufi E, Kulon M, Pucar D. Association of COVID-19 mRNA vaccine with ipsilateral axillary lymph node reactivity on imaging. JAMA Oncol. 2021;7(8):1241–2. https://doi.org/10.1001/jamaoncol.2021.1794.CrossRefPubMedPubMedCentral

Eifer M, Tau N, Alhoubani Y, Kanana N, Domachevsky L, Shams J, et al. COVID-19 mRNA vaccination: age and immune status and its association with axillary lymph node PET/CT uptake. J Nucl Med. 2022;63(1):134–9. https://doi.org/10.2967/jnumed.121.262194.CrossRefPubMedPubMedCentral

Advani P, Chumsri S, Pai T, Li Z, Sharma A, Parent E. Temporal metabolic response to mRNA COVID-19 vaccinations in oncology patients. Ann Nucl Med. 2021;35(11):1264–9. https://doi.org/10.1007/s12149-021-01675-8.CrossRefPubMedPubMedCentral

10.

Orevi M, Chicheportiche A, Ben HS. Lessons learned from post-COVID-19 vaccination PET/CT studies. J Nucl Med. 2022;63(3):453–60. https://doi.org/10.2967/jnumed.121.262348.CrossRefPubMedPubMedCentral

11.

Ferrari C, Nappi AG, Santo G, Mammucci P, Rubini D, Tucci M, et al. The day after mass COVID-19 vaccination: higher hypermetabolic lymphadenopathy detection on PET/CT and impact on oncologic patients management. Cancers (Basel). 2021. https://doi.org/10.3390/cancers13174340.CrossRefPubMedPubMedCentral

12.

Cohen D, Hazut Krauthammer S, Wolf I, Even-Sapir E. A sigh of relief: vaccine-associated hypermetabolic lymphadenopathy following the third COVID-19 vaccine dose is short in duration and uncommonly interferes with the interpretation of [(18)F]FDG PET-CT studies performed in oncologic patients. Eur J Nucl Med Mol Imaging. 2021. https://doi.org/10.1007/s00259-021-05579-7.CrossRefPubMedPubMedCentral

13.

El-Sayed MS, Wechie GN, Low CS, Adesanya O, Rao N, Leung VJ. The incidence and duration of COVID-19 vaccine-related reactive lymphadenopathy on (18)F-FDG PET-CT. Clin Med (Lond). 2021;21(6):e633–8. https://doi.org/10.7861/clinmed.2021-0420.CrossRefPubMed

14.

Seban RD, Richard C, Nascimento-Leite C, Ghidaglia J, Provost C, Gonin J, et al. Absolute lymphocyte count after COVID-19 vaccination is associated with vaccine-induced hypermetabolic lymph nodes on (18)F-FDG PET/CT: a focus in breast cancer care. J Nucl Med. 2021. https://doi.org/10.2967/jnumed.121.263082.CrossRefPubMed

15.

Su N, Wiefels C, Klein R, Zeng W, Abbaspour F. Intensity of hypermetabolic axillary lymph nodes in oncologic patients in relation to timeline following COVID-19 vaccination. J Med Imaging Radiat Sci. 2022. https://doi.org/10.1016/j.jmir.2022.01.004.CrossRefPubMedPubMedCentral

16.

Kubota K, Saginoya T, Ishiwata K, Nakasato T, Munechika H. [(18)F]FDG uptake in axillary lymph nodes and deltoid muscle after COVID-19 mRNA vaccination: a cohort study to determine incidence and contributing factors using a multivariate analysis. Ann Nucl Med. 2022. https://doi.org/10.1007/s12149-021-01711-7.CrossRefPubMedPubMedCentral

17.

Panagiotidis E, Exarhos D, Housianakou I, Bournazos A, Datseris I. FDG uptake in axillary lymph nodes after vaccination against pandemic (H1N1). Eur Radiol. 2010;20(5):1251–3. https://doi.org/10.1007/s00330-010-1719-5.CrossRefPubMed

18.

Thomassen A, Lerberg Nielsen A, Gerke O, Johansen A, Petersen H. Duration of 18F-FDG avidity in lymph nodes after pandemic H1N1v and seasonal influenza vaccination. Eur J Nucl Med Mol Imaging. 2011;38(5):894–8. https://doi.org/10.1007/s00259-011-1729-9.CrossRefPubMed

19.

Burger IA, Husmann L, Hany TF, Schmid DT, Schaefer NG. Incidence and intensity of F-18 FDG uptake after vaccination with H1N1 vaccine. Clin Nucl Med. 2011;36(10):848–53. https://doi.org/10.1097/RLU.0b013e3182177322.CrossRefPubMed

20.

Shirone N, Shinkai T, Yamane T, Uto F, Yoshimura H, Tamai H, et al. Axillary lymph node accumulation on FDG-PET/CT after influenza vaccination. Ann Nucl Med. 2012;26(3):248–52. https://doi.org/10.1007/s12149-011-0568-x.CrossRefPubMed

21.

Falsey AR, Sobieszczyk ME, Hirsch I, Sproule S, Robb ML, Corey L, et al. Phase 3 safety and efficacy of AZD1222 (ChAdOx1 nCoV-19) Covid-19 vaccine. N Engl J Med. 2021;385(25):2348–60. https://doi.org/10.1056/NEJMoa2105290.CrossRefPubMed

22.

Voysey M, Clemens SAC, Madhi SA, Weckx LY, Folegatti PM, Aley PK, et al. Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK. Lancet. 2021;397(10269):99–111. https://doi.org/10.1016/S0140-6736(20)32661-1.CrossRefPubMedPubMedCentral

23.

Baden LR, El Sahly HM, Essink B, Kotloff K, Frey S, Novak R, et al. Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine. N Engl J Med. 2021;384(5):403–16. https://doi.org/10.1056/NEJMoa2035389.CrossRefPubMed

24.

Becker AS, Perez-Johnston R, Chikarmane SA, Chen MM, El Homsi M, Feigin KN, et al. Multidisciplinary recommendations regarding post-vaccine adenopathy and radiologic imaging: radiology scientific expert panel. Radiology. 2021;300(2):E323–7. https://doi.org/10.1148/radiol.2021210436.CrossRefPubMed

25.

Pijl JP, Kwee TC, Slart R, Yakar D, Wouthuyzen-Bakker M, Glaudemans A. Clinical implications of increased uptake in bone marrow and spleen on FDG-PET in patients with bacteremia. Eur J Nucl Med Mol Imaging. 2021;48(5):1467–77. https://doi.org/10.1007/s00259-020-05071-8.CrossRefPubMed

26.

Seban RD, Robert C, Dercle L, Yeh R, Dunant A, Reuze S, et al. Increased bone marrow SUVmax on 18F-FDG PET is associated with higher pelvic treatment failure in patients with cervical cancer treated by chemoradiotherapy and brachytherapy. Oncoimmunology. 2019;8(5):e1574197. https://doi.org/10.1080/2162402X.2019.1574197.CrossRefPubMedPubMedCentral

27.

Adams HJ, Kwee TC, Fijnheer R, Dubois SV, Nievelstein RA, de Klerk JM. Bone marrow FDG-PET/CT in Hodgkin lymphoma revisited: do imaging and pathology match? Ann Nucl Med. 2015;29(2):132–7. https://doi.org/10.1007/s12149-014-0920-z.CrossRefPubMed

28.

Hosomi K, Kunisawa J. Diversity of energy metabolism in immune responses regulated by micro-organisms and dietary nutrition. Int Immunol. 2020;32(7):447–54. https://doi.org/10.1093/intimm/dxaa020.CrossRefPubMedPubMedCentral

29.

Choi SC, Morel L. Immune metabolism regulation of the germinal center response. Exp Mol Med. 2020;52(3):348–55. https://doi.org/10.1038/s12276-020-0392-2.CrossRefPubMedPubMedCentral

30.

Jellusova J, Cato MH, Apgar JR, Ramezani-Rad P, Leung CR, Chen C, et al. Gsk3 is a metabolic checkpoint regulator in B cells. Nat Immunol. 2017;18(3):303–12. https://doi.org/10.1038/ni.3664.CrossRefPubMedPubMedCentral

31.

Ersching J, Efeyan A, Mesin L, Jacobsen JT, Pasqual G, Grabiner BC, et al. Germinal center selection and affinity maturation require dynamic regulation of mTORC1 kinase. Immunity. 2017;46(6):1045-58 e6. https://doi.org/10.1016/j.immuni.2017.06.005.CrossRefPubMedPubMedCentral

32.

Jayachandran N, Mejia EM, Sheikholeslami K, Sher AA, Hou S, Hatch GM, et al. TAPP adaptors control B cell metabolism by modulating the phosphatidylinositol 3-kinase signaling pathway: a novel regulatory circuit preventing autoimmunity. J Immunol. 2018;201(2):406–16. https://doi.org/10.4049/jimmunol.1701440.CrossRefPubMed

33.

Polack FP, Thomas SJ, Kitchin N, Absalon J, Gurtman A, Lockhart S, et al. Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine. N Engl J Med. 2020;383(27):2603–15. https://doi.org/10.1056/NEJMoa2034577.CrossRefPubMed

34.

All UK spontaneous reports received between 04/01/21 and 09/03/22 for COVID-19 vaccine Oxford University/AstraZeneca. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1061702/COVID-19_AstraZeneca_Vaccine_Analysis_Print_DLP_09.03.2022.pdf. Accessed.

35.

Bettini E, Locci M. SARS-CoV-2 mRNA vaccines: immunological mechanism and beyond. Vaccines (Basel). 2021. https://doi.org/10.3390/vaccines9020147.CrossRefPubMed

36.

Ukey R, Bruiners N, Mishra H, Mishra PK, McCloskey D, Onyuka A, et al. Dichotomy between the humoral and cellular responses elicited by mRNA and adenoviral vector vaccines against SARS-CoV-2. BMC Med. 2022;20(1):32. https://doi.org/10.1186/s12916-022-02252-0.CrossRefPubMedPubMedCentral

37.

Lederer K, Castano D, Gomez Atria D, Oguin TH 3rd, Wang S, Manzoni TB, et al. SARS-CoV-2 mRNA vaccines foster potent antigen-specific germinal center responses associated with neutralizing antibody generation. Immunity. 2020;53(6):1281-95 e5. https://doi.org/10.1016/j.immuni.2020.11.009.CrossRefPubMedPubMedCentral

38.

Steinberg J, Thomas A, Iravani A. (18)F-fluorodeoxyglucose PET/CT findings in a systemic inflammatory response syndrome after COVID-19 vaccine. Lancet. 2021;397(10279):e9. https://doi.org/10.1016/S0140-6736(21)00464-5.CrossRefPubMedPubMedCentral

Title: Comparison of post-COVID-19 vaccination hypermetabolic lymphadenopathy on 18F-fluorodeoxyglucose PET/CT between virus-vector vaccine and mRNA vaccine
Authors: Meng-Ting Chiang
Jann-Tay Wang
Wan-Yu Lin
Ruoh-Fang Yen
Jei-Yie Huang
Ching-Chu Lu
Publication date: 01-12-2023
Publisher: BioMed Central
Keywords: Positron Emission Tomography
Computed Tomography
Computed Tomography
Lymphadenopathy
Vaccination
COVID-19 Vaccination
COVID-19
Published in: European Journal of Medical Research / Issue 1/2023
Electronic ISSN: 2047-783X
DOI: https://doi.org/10.1186/s40001-023-01456-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Comparison of post-COVID-19 vaccination hypermetabolic lymphadenopathy on ¹⁸F-fluorodeoxyglucose PET/CT between virus-vector vaccine and mRNA vaccine

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2023

Insights into research on myocardial ischemia/reperfusion injury from 2012 to 2021: a bibliometric analysis

Is there a causal nexus between COVID-19 infection, COVID-19 vaccination, and Guillain-Barré syndrome?

A real-world case–control study on the efficacy and safety of pulsed field ablation for atrial fibrillation

From nitrate to NO: potential effects of nitrate-reducing bacteria on systemic health and disease

Association between the Triglyceride–Glucose Index and Non-Alcoholic Fatty Liver Disease in patients with Atrial Fibrillation

The risk and outcome of malignant brain edema in post-mechanical thrombectomy: acute ischemic stroke by anterior circulation occlusion