PhD Scientific Days 2023

Budapest, 22-23 June 2023

Clinical Medicine - Posters I

FDG-PET Brain Imaging in the Evaluation and Follow-up of COVID-19

Lili Száraz1, Sándor Czibor1, Judit Simon2, Márk Di Giovanni2, Veronika Müller3, Pál. Maurovich-Horvat2, Gábor Csukly4, Tamás Györke1
1Department of Nuclear Medicine, Medical Imaging Centre, Semmelweis University, Budapest
2Department of Radiology, Medical Imaging Centre, Semmelweis University, Budapest
3Department of Pulmonology, Medical Imaging Centre, Semmelweis University, Budapest
4Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest

Text of the abstract

Introduction: The novel coronavirus disease (COVID-19) is caused by the respiratory infection of SARS-CoV-2 virus and is characterized by a multisystemic inflammation, presenting with a wide spectrum of symptoms. 18F-fluoro-deoxy-glucose positron emission tomography/computed tomography (FDG-PET/CT) is a promising imaging method in the evaluation of acute-phase and late changes in the central nervous system.
Aims: Our primary aim was to identify brain metabolic changes in COVID-19 patients versus controls at baseline and 3 months follow-up.
Methods: A single-centre, prospective clinical study was initiated where FDG-PET/CT was performed in adult COVID-19 patients during acute, infective state and 3 months later. Brain FDG-PET images were evaluated with a software utilizing a built-in, age-matched normal database and the degree of the differences (Z-scores) were investigated at the two imaging timepoints.
Results: We present the data of 36 patients (14 women, 22 men), with a mean age of 52 years (42-75 years). In the acute, infective state, the majority of the patients presented with diffuse, significant cortical hypometabolism whereas at 3 months follow- up, the involved regions showed a marked and often complete metabolic normalization. The most common regions with residual hypometabolism at 3 months were the medial prefrontal and medial temporal regions and the anterior cingulate. Also, these regions showed the proportionally lowest rates of normalization. Hypometabolism was the least frequent in the cerebellum at the acute, infective state and its FDG-uptake showed a nomalization in all but one case.
Conclusion: Residual hypometabolism is common in the areas encompassing the orbitofrontal cortex and the limbic system while the cerebellar cortex was relatively spared. However, our study is limited by the corticosteroid-effect in the scans performed at the acute, infective state and furthermore, the fact that no metabolic data is available of the patients before SARS-CoV-2 infection.
Funding: SE 250+ Excellence PhD Scholarship, SUPPORTED BY THE ÚNKP-22-3-I-SE-38 NEW NATIONAL EXCELLENCE PROGRAM OF THE MINISTRY FOR CULTURE AND INNOVATION FROM THE SOURCE OF THE NATIONAL RESEARCH, DEVELOPMENT AND INNOVATION FUND.”