Coordination and optimization of FDG PET/CT and COVID-19 vaccination; Lessons learned in the early stages of mass vaccination

Cancer Treat Rev. 2021 Jul:98:102220. doi: 10.1016/j.ctrv.2021.102220. Epub 2021 May 11.


As the world embarks on mass vaccination for COVID-19, we are beginning to encounter unintended dilemmas in imaging oncology patients; particularly with regards to FDG PET/CT. In some cases, vaccine-related lymphadenopathy and FDG uptake on PET/CT can mimic cancer and lead to confounding imaging results. These cases where findings overlap with cancer pose a significant dilemma for diagnostic purposes, follow-up, and management leading to possible treatment delays, unnecessary repeat imaging and sampling, and patient anxiety. These cases can largely be avoided by optimal coordination between vaccination and planned imaging as well as preemptive selection of vaccine administration site. This coordination hinges on patient, oncologist, and radiologists' awareness of this issue and collaboration. Through close communication and patient education, we believe this will eliminate significant challenges for our oncology patients as we strive to end this pandemic.

Keywords: COVID-19 vaccine; FDG PET/CT; Oncologic imaging.

Publication types

  • Review

MeSH terms

  • COVID-19 / prevention & control*
  • COVID-19 / virology
  • COVID-19 Vaccines / adverse effects*
  • Diagnosis, Differential
  • Disease Progression
  • Fluorodeoxyglucose F18 / metabolism
  • Humans
  • Lymphadenopathy / chemically induced
  • Lymphadenopathy / diagnosis*
  • Lymphadenopathy / diagnostic imaging
  • Neoplasms / chemically induced
  • Neoplasms / diagnosis*
  • Neoplasms / diagnostic imaging
  • Positron Emission Tomography Computed Tomography / standards*
  • Radiopharmaceuticals / metabolism
  • SARS-CoV-2 / isolation & purification
  • Vaccination / adverse effects*


  • COVID-19 Vaccines
  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18