State of the art of 18F-FDG PET/CT application in inflammation and infection: a guide for image acquisition and interpretation.

AIM: The diagnosis, severity and extent of a sterile inflammation or a septic infection could be challenging since there is not one single test able to achieve an accurate diagnosis. The clinical use of 18F-fluorodeoxyglucose ([18F]FDG) positron emission tomography/computed tomography (PET/CT) imaging in the assessment of inflammation and infection is increasing worldwide. The purpose of this paper is to achieve an Italian consensus document on [18F]FDG PET/CT or PET/MRI in inflammatory and infectious diseases, such as osteomyelitis (OM), prosthetic joint infections (PJI), infective endocarditis (IE), prosthetic valve endocarditis (PVE), cardiac implantable electronic device infections (CIEDI), systemic and cardiac sarcoidosis (SS/CS), diabetic foot (DF), fungal infections (FI), tuberculosis (TBC), fever and inflammation of unknown origin (FUO/IUO), pediatric infections (PI), inflammatory bowel diseases (IBD), spine infections (SI), vascular graft infections (VGI), large vessel vasculitis (LVV), retroperitoneal fibrosis (RF) and COVID-19 infections. METHODS: In September 2020, the inflammatory and infectious diseases focus group (IIFG) of the Italian Association of Nuclear Medicine (AIMN) proposed to realize a procedural paper about the clinical applications of [18F]FDG PET/CT or PET/MRI in inflammatory and infectious diseases. The project was carried out thanks to the collaboration of 13 Italian nuclear medicine centers, with a consolidate experience in this field. With the endorsement of AIMN, IIFG contacted each center, and the pediatric diseases focus group (PDFC). IIFG provided for each team involved, a draft with essential information regarding the execution of [18F]FDG PET/CT or PET/MRI scan (i.e., indications, patient preparation, standard or specific acquisition modalities, interpretation criteria, reporting methods, pitfalls and artifacts), by limiting the literature research to the last 20 years. Moreover, some clinical cases were required from each center, to underline the teaching points. Time for the collection of each report was from October to December 2020. RESULTS: Overall, we summarized 291 scientific papers and guidelines published between 1998 and 2021. Papers were divided in several sub-topics and summarized in the following paragraphs: clinical indications, image interpretation criteria, future perspectivess and new trends (for each single disease), while patient preparation, image acquisition, possible pitfalls and reporting modalities were described afterwards. Moreover, a specific section was dedicated to pediatric and PET/MRI indications. A collection of images was described for each indication. CONCLUSIONS: Currently, [18F]FDG PET/CT in oncology is globally accepted and standardized in main diagnostic algorithms for neoplasms. In recent years, the ever-closer collaboration among different European associations has tried to overcome the absence of a standardization also in the field of inflammation and infections. The collaboration of several nuclear medicine centers with a long experience in this field, as well as among different AIMN focus groups represents a further attempt in this direction. We hope that this document will be the basis for a "common nuclear physicians' language" throughout all the country. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40336-021-00445-w.

COVID-19 Surface Persistence: A Recent Data Summary and Its Importance for Medical and Dental Settings.

Recently, due to the coronavirus pandemic, many guidelines and anti-contagion strategies continue to report unclear information about the persistence of coronavirus disease 2019 (COVID-19) in the environment. This certainly generates insecurity and fear in people, with an important psychological component that is not to be underestimated at this stage of the pandemic. The purpose of this article is to highlight all the sources currently present in the literature concerning the persistence of the different coronaviruses in the environment as well as in medical and dental settings. As this was a current study, there are still not many sources in the literature, and scientific strategies are moving towards therapy and diagnosis, rather than knowing the characteristics of the virus. Such an article could be an aid to summarize virus features and formulate new guidelines and anti-spread strategies.

Subcutaneous Uptake on [18F]Florbetaben PET/CT: a Case Report of Possible Amyloid-Beta Immune-Reactivity After COVID-19 Vaccination.

Introduction: Large-scale worldwide COVID-19 vaccination programs are being rapidly deployed, and high-risk patients with comorbidity are now receiving the first doses of the vaccine. Physicians should be, therefore, aware of new pitfalls associated with the current pandemic vaccination program, also in the case of [18F]Florbetaben PET/CT.Case PresentationWe described the first image of [18F]Florbetaben PET/CT in the evaluation of a 70-year-old male with suspicious Alzheimer disease and unclear history of heart disease. We detailed the diagnostic imaging PET/CT workup with different findings. Conclusion: In this case, [18F]Florbetaben PET/CT can demonstrate potential beta-amyloid immune-reactivity and deposition associated with the current COVID-19 pandemic vaccination programs.

Surveys on COVID-19 in nuclear medicine: what happened and what we learned.

INTRODUCTION: To summarize and comment the available surveys on the impact of COVID-19 on Nuclear Medicine (NM) departments. METHODS: Recent surveys about the impact of COVID-19 on Nuclear Medicine (NM) departments have been searched on available scientific database. RESULTS: Three surveys have been found and commented. Some differences among the surveys should be kept in mind. All studies agreed that COVID-19 had a relevant impact on NM departments. CONCLUSION: Surveys about the impact of COVID-19 in NM could improve the departments' daily activities, to find a compromise between the security protocols suggested by international guidelines.

SARS-CoV-2 Persistence: Data Summary up to Q2 2020

The coronavirus pandemic is causing confusion in the world. This confusion also affects the different guidelines adopted by each country. The persistence of Coronavirus, responsible for coronavirus disease 2019 (Covid-19) has been evaluated by different articles, but it is still not well-defined, and the method of diffusion is unclear. The aim of this manuscript is to underline new Coronavirus persistence features on different environments and surfaces. The scientific literature is still poor on this topic and research is mainly focused on therapy and diagnosis, rather than the characteristics of the virus. These data could be an aid to summarize virus features and formulate new guidelines and anti-spread strategies.

Impact of the COVID-19 pandemic in nuclear medicine departments: preliminary report of the first international survey.

PURPOSE: Coronavirus disease-19 (COVID-19) pandemic is challenging the availability of hospital resources worldwide. The Young Group of the Italian Association of Nuclear Medicine (AIMN) developed the first international survey to evaluate the impact of COVID-19 in nuclear medicine (NM). The aim of this study was to perform a preliminary report of the ongoing survey. METHODS: A questionnaire of thirty questions was prepared for all NM professionals addressing three main issues: (1) new scheduling praxes for NM diagnostic and therapeutic procedures, (2) assistance of patients with diagnosed or suspected COVID-19, and (3) prevention of COVID-19 spreading in the departments. An invitation to the survey was sent to the corresponding authors of NM scientific papers indexed in SCOPUS in 2019. Personal data were analysed per individual responder. Organisation data were evaluated per single department. RESULTS: Two-hundred and ninety-six individual responders from 220 departments were evaluated. Most of the responders were from Europe (199/296, 67%). Approximately, all departments already changed their scheduling praxes due to the pandemic (213/220, 97%). In most departments, scheduled diagnostic and therapeutic procedures were allowed but quantitatively reduced (112/220, 51%). A significant reduction of diagnostic and therapeutic procedures (more than 20%) affected 198/220 (90%) and 158/220 (72%) departments, respectively. Incidental COVID-19 signs in NM exams occurred in 106/220 departments (48%). Few departments were closed or shifted to assist patients with COVID-19 (36/220, 16%). Most of the responders thought that pandemic would not permanently change the work of NM departments in the future (189/296, 64%). CONCLUSIONS: According to this preliminary report of the first international survey, COVID-19 heavily impacted NM departments and professionals. New praxes for NM procedures, assistance, and prevention of COVID-19 have been applied during the pandemic.