SARS-CoV-2 vaccination site as possible pitfall on somatostatin receptor imaging

Abstract

SARS-CoV-2 (COVID-19) vaccination numbers are globally increasing. Therefore, an increased chance exists that patients undergoing Peptide Receptor Radionuclide Therapy (PRRT) or diagnostic radionuclide imaging for Neuroendocrine Tumours (NETs) may have recently received vaccination. We report the imaging findings of two NETs patients, A—following [177Lu] Lu-DOTATATE PRRT post therapy planar scintigraphy and single photon emission computed tomography with computed tomography (SPECT/CT), and B—following [68 Ga]Ga-DOTA-NOC positron emission tomography with computed tomography (PET/CT) respectively. Both studies were done few days after COVID-19 vaccination. Patient A showed a new focus of uptake in the left deltoid muscle; and Patient B showed uptake in the left deltoid and a left axillary lymph node. Nuclear Physicians need to be aware of pitfalls with somatostatin receptor radionuclide imaging post-vaccination to ensure accurate interpretation, as well as dosimetric considerations with vaccine-related post-therapy uptake.