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Journal of Radiation Oncology

Erschienen in:

29.09.2020 | COVID-19 | Review Zur Zeit gratis

Early detection of SARS-CoV-2 from staging PET-CT

verfasst von: Mohamed H. Khattab, Alexander D. Sherry, Aaron C. Jessop, Kristen K. Ciombor, Bapsi Chakravarthy

Erschienen in: Journal of Radiation Oncology | Ausgabe 3-4/2020

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Abstract

Objective

SARS-CoV-2 infection may manifest with minimal or no clinical symptoms. However, signs of infection may appear on routine imaging obtained in the care of patients with cancer. The management of patients planned for chemoradiation with asymptomatic or mildly symptomatic SARS-CoV-2 infection is uncertain.

Methods

Here, we present a case study of a mildly symptomatic patient with anal cancer diagnosed with SARS-CoV-2 from a staging PET-CT scan.

Results

PET-CT scan for anal cancer staging demonstrated pulmonary avidity suspicious for an infectious, rather than malignant, process. In the setting of these imaging findings and new-onset anosmia, viral polymerase chain reaction was ordered and found to be positive for SARS-CoV-2. To avoid myelosuppression in the setting of active infection, planned chemoradiation was delayed until cessation of viral shedding.

Conclusion

In the COVID-19 era, oncologists obtaining routine staging imaging should have high diagnostic suspicion for subclinical SARS-CoV-2 infection. To avoid precipitating severe pneumonia and hospitalization, multidisciplinary discussion with risk-benefit analysis is recommended before initiating immunosuppressive therapies such as chemoradiation.

Giacomelli A, Pezzati L, Conti F, Bernacchia D, Siano M, Oreni L, Rusconi S, Gervasoni C, Ridolfo AL, Rizzardini G, Antinori S, Galli M (2020) Self-reported olfactory and taste disorders in SARS-CoV-2 patients: a cross-sectional study. Clin Infect Dis 71:889–890. https://doi.org/10.1093/cid/ciaa330CrossRefPubMed

Spinato G, Fabbris C, Polesel J, Cazzador D, Borsetto D, Hopkins C, Boscolo-Rizzo P (2020) Alterations in smell or taste in mildly symptomatic outpatients with SARS-CoV-2 infection. JAMA 323:2089–2090. https://doi.org/10.1001/jama.2020.6771CrossRefPubMedPubMedCentral

He X, Lau EHY, Wu P, Deng X, Wang J, Hao X, Lau YC, Wong JY, Guan Y, Tan X, Mo X, Chen Y, Liao B, Chen W, Hu F, Zhang Q, Zhong M, Wu Y, Zhao L, Zhang F, Cowling BJ, Li F, Leung GM (2020) Temporal dynamics in viral shedding and transmissibility of COVID-19. Nat Med 26:672–675. https://doi.org/10.1038/s41591-020-0869-5CrossRefPubMed

McGinnis GJ, Ning MS, Nitsch PL et al (2020) Rapid detection of asymptomatic COVID-19 by CT image-guidance for stereotactic ablative radiotherapy. J Thorac Oncol 15:1085–1087. https://doi.org/10.1016/j.jtho.2020.04.007CrossRefPubMedPubMedCentral

Liang W, Guan W, Chen R, Wang W, Li J, Xu K, Li C, Ai Q, Lu W, Liang H, Li S, He J (2020) Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol 21:335–337. https://doi.org/10.1016/S1470-2045(20)30096-6CrossRefPubMedPubMedCentral

Titel: Early detection of SARS-CoV-2 from staging PET-CT
verfasst von: Mohamed H. Khattab
Alexander D. Sherry
Aaron C. Jessop
Kristen K. Ciombor
Bapsi Chakravarthy
Publikationsdatum: 29.09.2020
Verlag: Springer Berlin Heidelberg
Schlagwort: COVID-19
Erschienen in: Journal of Radiation Oncology / Ausgabe 3-4/2020
Print ISSN: 1948-7894
Elektronische ISSN: 1948-7908
DOI: https://doi.org/10.1007/s13566-020-00436-w

Springer Medizin

Early detection of SARS-CoV-2 from staging PET-CT