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Value of PET/CT and MATLAB in Detection of COVID-19 in an Oncology Patient - Case Report

Received: 24 July 2020     Accepted: 10 August 2020     Published: 25 August 2020
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Abstract

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes the infectious disease COVID-19, was declared a global pandemic in March 2020. The SARS-CoV-2 infection has polymorphic clinical presentations. The real time PCR is the reference diagnostic test; however, it can only detect the presence of virus for a specific window of time and its sensitivity has been reported as low as 60–70%. Case: We report a clinical case for a 28-year-old male patient. His clinical history included known NHL (large B-cell lymphoma) that treated with chemotherapy and autologous bone marrow transplant in 2017. He initially presented with fewer, URTI (upper respiratory infection) and weight loss to have a PET/CT scan for restaging. The follow up PET/CT scan, suggested no worrisome FDG metabolic activity elsewhere to suggest disease recurrence, though, hypermetabolic mediastinal lymph nodes, which were kept with active infectious process and bilateral FDG-avid ground glass attenuation in between the consolidation patches were noted. The follow up RT-PCR post PET/CT scan was proved to be positive. A developed pixelated quantitative map of CT part of the lung using MATLAB showed clearly severity of the lung disease that strongly suggested COVID-19 lung in association with the positive RT-PCR. FDG PET/CT has the potential to add value to the challenges of diagnosing complications caused by viruses such as COVID-19.

Published in American Journal of Internal Medicine (Volume 8, Issue 5)
DOI 10.11648/j.ajim.20200805.15
Page(s) 221-225
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

PET/CT, MATLAB, COVID-19, Oncology Patient

References
[1] Naming the coronavirus disease (COVID-19) and the virus that causes it. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technicalguidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it (Accessed 03/22/2020).
[2] Gorbalenya AE, Baker SC, Baric RS, et al. Severe acute respiratory syndrome-related coronavirus: The species and its viruses – a statement of the Coronavirus Study Group. https://doi.org/10.1101/2020.02.07.937862 doi: bioRxiv preprint.
[3] WHO Director-General's opening remarks at the media briefing on COVID-19 - 11 March 2020. https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarksat-the-media-briefing-on-covid-19,11-March-2020 (Accessed on 03/22/2020).
[4] Chung M, Bernheim A, Mei X, Zhang N, Huang M, Zeng X, etal. CT Imaging Features of 2019 Novel Coronavirus (2019-nCoV). Radiology. 2020 Apr; 295 (1): 202-207. Doi: 10.1148/radiol.2020200230. Epub 2020 Feb 4. PubMed PMID: 32017661.
[5] Kong W and Agarwal P. Chest Imaging Appearance of COVID-19 Infection. Radiology Cardiothoracic Imaging 2020 February 13 (published online), doi: 10.1148/ryct.2020200028.
[6] Bernheim A, Mei X, Huang M, Yang Y, Fayad ZA, Zhang N, etal. Chest CT Findings in Coronavirus Disease-19 (COVID-19): Relationship to Duration of Infection. Radiology. 2020 Feb 20: 200463. doi: 10.1148/radiol.2020200463. [Epub ahead of print] PubMed PMID: 32077789.
[7] Pan F, Ye T, Sun P, Gui S, Liang B, Li L, etal. Time Course of Lung Changes On Chest CT During Recovery From 2019 Novel Coronavirus (COVID-19) Pneumonia. Radiology. 2020 Feb 13: 200370. doi: 10.1148/radiol.2020200370. [Epub ahead of print] PubMed PMID: 32053470.
[8] Bai HX, Hsieh B, Xiong Z, Halsey K, Choi JW, Tran TML, Pan I, Shi LB, Wang DC, etal. Performance of radiologists in differentiating COVID-19 from viral pneumonia on chest CT. Radiology. 2020 Mar 10: 200823. doi: 10.1148/radiol.2020200823. [Epub ahead of print] PubMed PMID: 32155105.
[9] Salehi S, Abedi A, Balakrishnan S, Gholamrezanezhad A. Coronavirus Disease 2019 (COVID-19): A Systematic Review of Imaging Findings in 919 Patients. AJR Am J Roentgenol. 2020 Mar 14: 1-7. doi: 10.2214/AJR.20.23034. [Epub ahead of print] PubMed PMID: 32174129.
[10] Kanne JP, Little BP, Chung JH, Elicker BM, Ketai LH. Essentials for radiologists on COVID-19: an update radiology scientific expert panel. Radiology. 2020295 (1); 16–17.
[11] Shi H, Han X, Jiang N, Cao Y, Alwalid O, Gu J, et al. Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. Lancet Infect Dis. 2020. https://doi.org/10.1016/S1473-3099(20)30086-4.
[12] Lee EYP, NgMY, Khong PL. COVID-19 pneumonia: what has CT taught us. Lancet Infect Dis. 2020. https://doi.org/10.1016/S1473-3099(20)30134-1.
[13] Qin C, Liu F, Yen TC, Lan X. 18F-FDG PET/CT findings of COVID-19: a series of four highly suspected cases. Eur J Nucl Med Mol Imaging. 2020. https://doi.org/10.1007/s00259-020-04734-w.
[14] Capitanio S, Nordin AJ, Noraini AR, Rossetti C. PET/CT in non-oncological lung diseases: current applications and future perspectives. Eur Respir Rev. 2016; 25: 247–58.
[15] Jones HA, Marino PS, Shakur BH, Morrell NW. In vivo assessment of lung inflammatory cell activity in patients with COPD and asthma. Eur Respir J. 2003; 21: 567–73.
[16] Albano D, Bertagna F, Bertoli M, Bosio G, Lucchini S, Motta F, et al. Incidental findings suggestive of COVID-19 in asymptomatic patients undergoing nuclear medicine procedures in a high-prevalence region. J Nucl Med 2020; 61: 632–6pp. doi: https://doi.org/10.2967/jnumed.120.246256.
[17] Long C, Xu H, Shen Q, Zhang X, Fan B, Wang C, Zeng B, Li Z, Li X, Li H, Diagnosis of the Coronavirus disease (COVID-19): rRT-PCR or CT? European Journal of Radiology (2020), doi: https://doi.org/10.1016/j.ejrad.2020.108961.
[18] Boom Ting Kung A. An Update on the Role of 18F-FDG-PET/CT in Major Infectious and Inflammatory Diseases. [online] PubMed Central 2020; Accessed 8 May 2020.
[19] Deng Y, Lei L, Chen Y, Zhang W. The potential added value of FDG PET/CT for COVID-19 pneumonia. Eur J Nucl Med Mol Imaging 2020; 47: 1634–5. doi: https://doi.org/10.1007/s00259-020-04767-115.
[20] McDermott S, Kilcoyne A, Wang Y, Scott JA, Halpern EF, Ackman JB. Comparison of the 18F-FDG avidity at PET of benign and malignant pure ground-glass opacities: a paradox? Clin Radiol 2019; 74: 187–95. doi: https://doi.org/10.1016/j.Card. 2018. 12. 009.
[21] Qin C, Liu F, Yen T-C, Lan X. 18F-FDG PET/CT findings of COVID-19: a series of four highly suspected cases. Eur J Nucl Med Mol Imaging 2020; 47: 1281–6pp. doi: https://doi.org/10.1007/s00259- 020- 04734-w.
[22] Setti L, Kirienko M, Dalto SC, Bonacina M, Bombardieri E. Fdg-PET/CT findings highly suspicious for COVID-19 in an Italian case series of asymptomatic patients. Eur J Nucl Med Mol Imaging 2020; 47: 1649–56. doi: https://doi.org/10.1007/s00259-020-04819-6.
Cite This Article
  • APA Style

    Michael Masoomi, Alshaima Al-Shammeri, Esraa Al-Qattan, Haytham Ramzy, Hany A Elrahman, et al. (2020). Value of PET/CT and MATLAB in Detection of COVID-19 in an Oncology Patient - Case Report. American Journal of Internal Medicine, 8(5), 221-225. https://doi.org/10.11648/j.ajim.20200805.15

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    ACS Style

    Michael Masoomi; Alshaima Al-Shammeri; Esraa Al-Qattan; Haytham Ramzy; Hany A Elrahman, et al. Value of PET/CT and MATLAB in Detection of COVID-19 in an Oncology Patient - Case Report. Am. J. Intern. Med. 2020, 8(5), 221-225. doi: 10.11648/j.ajim.20200805.15

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    AMA Style

    Michael Masoomi, Alshaima Al-Shammeri, Esraa Al-Qattan, Haytham Ramzy, Hany A Elrahman, et al. Value of PET/CT and MATLAB in Detection of COVID-19 in an Oncology Patient - Case Report. Am J Intern Med. 2020;8(5):221-225. doi: 10.11648/j.ajim.20200805.15

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  • @article{10.11648/j.ajim.20200805.15,
      author = {Michael Masoomi and Alshaima Al-Shammeri and Esraa Al-Qattan and Haytham Ramzy and Hany A Elrahman and Aisha Al-Qattan and Latifah Al-Kandari and Iman Al-Shammeri},
      title = {Value of PET/CT and MATLAB in Detection of COVID-19 in an Oncology Patient - Case Report},
      journal = {American Journal of Internal Medicine},
      volume = {8},
      number = {5},
      pages = {221-225},
      doi = {10.11648/j.ajim.20200805.15},
      url = {https://doi.org/10.11648/j.ajim.20200805.15},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajim.20200805.15},
      abstract = {The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes the infectious disease COVID-19, was declared a global pandemic in March 2020. The SARS-CoV-2 infection has polymorphic clinical presentations. The real time PCR is the reference diagnostic test; however, it can only detect the presence of virus for a specific window of time and its sensitivity has been reported as low as 60–70%. Case: We report a clinical case for a 28-year-old male patient. His clinical history included known NHL (large B-cell lymphoma) that treated with chemotherapy and autologous bone marrow transplant in 2017. He initially presented with fewer, URTI (upper respiratory infection) and weight loss to have a PET/CT scan for restaging. The follow up PET/CT scan, suggested no worrisome FDG metabolic activity elsewhere to suggest disease recurrence, though, hypermetabolic mediastinal lymph nodes, which were kept with active infectious process and bilateral FDG-avid ground glass attenuation in between the consolidation patches were noted. The follow up RT-PCR post PET/CT scan was proved to be positive. A developed pixelated quantitative map of CT part of the lung using MATLAB showed clearly severity of the lung disease that strongly suggested COVID-19 lung in association with the positive RT-PCR. FDG PET/CT has the potential to add value to the challenges of diagnosing complications caused by viruses such as COVID-19.},
     year = {2020}
    }
    

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  • TY  - JOUR
    T1  - Value of PET/CT and MATLAB in Detection of COVID-19 in an Oncology Patient - Case Report
    AU  - Michael Masoomi
    AU  - Alshaima Al-Shammeri
    AU  - Esraa Al-Qattan
    AU  - Haytham Ramzy
    AU  - Hany A Elrahman
    AU  - Aisha Al-Qattan
    AU  - Latifah Al-Kandari
    AU  - Iman Al-Shammeri
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    T2  - American Journal of Internal Medicine
    JF  - American Journal of Internal Medicine
    JO  - American Journal of Internal Medicine
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    EP  - 225
    PB  - Science Publishing Group
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    AB  - The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes the infectious disease COVID-19, was declared a global pandemic in March 2020. The SARS-CoV-2 infection has polymorphic clinical presentations. The real time PCR is the reference diagnostic test; however, it can only detect the presence of virus for a specific window of time and its sensitivity has been reported as low as 60–70%. Case: We report a clinical case for a 28-year-old male patient. His clinical history included known NHL (large B-cell lymphoma) that treated with chemotherapy and autologous bone marrow transplant in 2017. He initially presented with fewer, URTI (upper respiratory infection) and weight loss to have a PET/CT scan for restaging. The follow up PET/CT scan, suggested no worrisome FDG metabolic activity elsewhere to suggest disease recurrence, though, hypermetabolic mediastinal lymph nodes, which were kept with active infectious process and bilateral FDG-avid ground glass attenuation in between the consolidation patches were noted. The follow up RT-PCR post PET/CT scan was proved to be positive. A developed pixelated quantitative map of CT part of the lung using MATLAB showed clearly severity of the lung disease that strongly suggested COVID-19 lung in association with the positive RT-PCR. FDG PET/CT has the potential to add value to the challenges of diagnosing complications caused by viruses such as COVID-19.
    VL  - 8
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Author Information
  • Nuclear Medicine and Molecular Imaging Section, Department of Medical Imaging, ADAN Hospital, Ministry of Health, Hadiya, Kuwait

  • Nuclear Medicine and Molecular Imaging Section, Department of Medical Imaging, ADAN Hospital, Ministry of Health, Hadiya, Kuwait

  • Nuclear Medicine and Molecular Imaging Section, Department of Medical Imaging, ADAN Hospital, Ministry of Health, Hadiya, Kuwait

  • Radiology Section, Department of Medical Imaging, ADAN Hospital, Ministry of Health, Hadiya, Kuwait

  • Nuclear Medicine and Molecular Imaging Section, Department of Medical Imaging, ADAN Hospital, Ministry of Health, Hadiya, Kuwait

  • Nuclear Medicine and Molecular Imaging Section, Department of Medical Imaging, ADAN Hospital, Ministry of Health, Hadiya, Kuwait

  • Radiology Section, Department of Medical Imaging, ADAN Hospital, Ministry of Health, Hadiya, Kuwait

  • Nuclear Medicine and Molecular Imaging Section, Department of Medical Imaging, ADAN Hospital, Ministry of Health, Hadiya, Kuwait

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