TY - JOUR
T1 - Multidisciplinary recommendations regarding post-vaccine adenopathy and radiologic imaging
T2 - Radiology scientific expert panel
AU - Becker, Anton S.
AU - Perez-Johnston, Rocio
AU - Chikarmane, Sona A.
AU - Chen, Melissa M.
AU - El Homsi, Maria
AU - Feigin, Kimberly N.
AU - Gallagher, Katherine M.
AU - Hanna, Ehab Y.
AU - Hicks, Marshall
AU - Ilica, Ahmet T.
AU - Mayer, Erica L.
AU - Shinagare, Atul B.
AU - Yeh, Randy
AU - Mayerhoefer, Marius E.
AU - Hricak, Hedvig
AU - Vargas, H. Alberto
N1 - Funding Information:
A.S.B., R.P.J., M.E.H, K.N.F., K.M.G., A.T.I., R.Y., M.E.M., H.H., and H.A.V. supported in part by the National Institutes of Health/National Cancer Institute Cancer Center Support Grant (P30 CA008748).
Funding Information:
disclosed no relevant relationships. S.A.C. disclosed no relevant relationships. M.M.C. disclosed no relevant relationships. M.E.H. disclosed no relevant relationships. K.N.F. Activities related to the present article: disclosed no relevant relationships. Activities not related to the present article: is a consultant for Covera Health. Other relationships: disclosed no relevant relationships. K.M.G. disclosed no relevant relationships. E.Y.H. disclosed no relevant relationships. M.H. disclosed no relevant relationships. A.T.I. disclosed no relevant relationships. E.L.M. Activities related to the present article: disclosed no relevant relationships. Activities not related to the present article: is a consultant for Lilly, Novartis, Pfizer, Sanofi, and AstraZeneca. Other relationships: institution receives research funding from Pfizer. A.B.S. Activities related to the present article: disclosed no relevant relationships. Activities not related to the present article: is a consultant for Arog Pharmaceuticals and Virtualscopics. Other relationships: disclosed no relevant relationships. R.Y. disclosed no relevant relationships. M.E.M. Activities related to the present article: disclosed no relevant relationships. Activities not related to the present article: has grants/grants pending with Siemens; received payment for lectures including service on speakers bureaus from Siemens, Bristol Myers Squibb. Other relationships: disclosed no relevant relationships. H.H. Activities related to the present article: disclosed no relevant
Publisher Copyright:
© RSNA, 2021
PY - 2021/8
Y1 - 2021/8
N2 - Vaccination-associated adenopathy is a frequent imaging finding after administration of COVID-19 vaccines that may lead to a diagnostic conundrum in patients with manifest or suspected cancer, in whom it may be indistinguishable from malignant nodal involvement. To help the medical community address this concern in the absence of studies and evidence-based guidelines, this special report offers recommendations developed by a multidisciplinary panel of experts from three of the leading tertiary care cancer centers in the United States. According to these recommendations, some routine imaging examinations, such as those for screening, should be scheduled before or at least 6 weeks after the final vaccination dose to allow for any reactive adenopathy to resolve. However, there should be no delay of other clinically indicated imaging (eg, for acute symptoms, short-interval treatment monitoring, urgent treatment planning or complications) due to prior vaccination. The vaccine should be administered on the side contralateral to the primary or suspected cancer, and both doses should be administered in the same arm. Vaccination information—date(s) administered, injection site(s), laterality, and type of vaccine—should be included in every preimaging patient questionnaire, and this information should be made readily available to interpreting radiologists. Clear and effective communication between patients, radiologists, referring physician teams, and the general public should be considered of the highest priority when managing adenopathy in the setting of COVID-19 vaccination.
AB - Vaccination-associated adenopathy is a frequent imaging finding after administration of COVID-19 vaccines that may lead to a diagnostic conundrum in patients with manifest or suspected cancer, in whom it may be indistinguishable from malignant nodal involvement. To help the medical community address this concern in the absence of studies and evidence-based guidelines, this special report offers recommendations developed by a multidisciplinary panel of experts from three of the leading tertiary care cancer centers in the United States. According to these recommendations, some routine imaging examinations, such as those for screening, should be scheduled before or at least 6 weeks after the final vaccination dose to allow for any reactive adenopathy to resolve. However, there should be no delay of other clinically indicated imaging (eg, for acute symptoms, short-interval treatment monitoring, urgent treatment planning or complications) due to prior vaccination. The vaccine should be administered on the side contralateral to the primary or suspected cancer, and both doses should be administered in the same arm. Vaccination information—date(s) administered, injection site(s), laterality, and type of vaccine—should be included in every preimaging patient questionnaire, and this information should be made readily available to interpreting radiologists. Clear and effective communication between patients, radiologists, referring physician teams, and the general public should be considered of the highest priority when managing adenopathy in the setting of COVID-19 vaccination.
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U2 - 10.1148/radiol.2021210436
DO - 10.1148/radiol.2021210436
M3 - Article
C2 - 33625298
AN - SCOPUS:85103427149
SN - 0033-8419
VL - 300
SP - E323-E327
JO - Radiology
JF - Radiology
IS - 2
ER -