Researchers warn About Post COVID 19 Vaccine Impact on Imaging
Recommendations for Radiologists:
To help the medical community address this concern in the absence of studies and evidence-based guidelines, Dr Anton Becker, PhD, of Memorial Sloan Kettering Cancer Center in New York City and colleagues published a set of recommendations for considering COVID-19 vaccine effects on imaging. Following are the summary of 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.
- There should be no delay of other clinically indicated imaging (e.g., 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 pre-imaging 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.”(3)
REFERENCES:
- Mortazavi, Shabnam. “Coronavirus Disease (COVID-19) Vaccination Associated Axillary Adenopathy: Imaging Findings and Follow-Up Recommendations in 23 Women”. American Journal of Roentgenology,10.2214/AJR.21.25651.
- Özütemiz, Can, Krystosek, et al. “Lymphadenopathy in COVID-19 Vaccine Recipients: Diagnostic Dilemma in Oncology Patients”. Radiology; 2021;210275. doi:10.1148/radiol.2021210275.
- Becker, Anton S et al. “Multidisciplinary Recommendations Regarding Post-Vaccine Adenopathy and Radiologic Imaging: Radiology Scientific Expert Panel”. Radiology; 2021;210436. doi: 10.1148/radiol.2021210436.
The race to develop and execute effective COVID-19 vaccination programs is in full force, as the world grapples with staggering numbers of COVID-19 infections. The two COVID-19 vaccines (Moderna and Pfizer/BioNTech), both belonging to a novel class of mRNA vaccines is more extensively used in the western population. The overwhelmingly positive protective effect of vaccines is sometimes accompanied by unintended side effects, most of which are transient and minor. These include regional adenopathy which has been reported in some case reports. The researchers warned that the COVID-19 vaccine can manifest on imaging in ways that appear to be disease, according to two studies published in the American Journal of Roentgenology and Radiology.
Proper Vaccination History is Vital
As more people get vaccinated for COVID-19, radiologists must be familiar with how the vaccine may affect imaging results, wrote Dr Shabnam Mortazavi of the University of California, Los Angeles. Mortazavi conducted a study that included data from 23 women who underwent breast imaging after being vaccinated(1)."Radiologist familiarity and evidence-based guidelines are needed to avoid follow-up imaging and biopsies for reactive adenopathy after COVID-19 vaccination." She wrote in the article published in the American Journal of Roentgenology on February 24, 2021.
Mortazavi and colleagues evaluated data from 23 women who presented with axillary adenopathy on mammography, breast ultrasound, or breast MRI after being vaccinated for COVID-19 between December 2020 and February 2021. Of these, 13% underwent breast imaging because they were symptomatic, while 43% were undergoing screening and 43% were having imaging for other reasons. (1)
"This study highlights axillary adenopathy ipsilateral to the vaccinated arm with Pfizer-BioNTech or Moderna COVID-19 vaccine as a potential reactive process with which radiologists must be familiar," Mortazavi concluded. "Incorporating a patient's COVID-19 vaccination history, including vaccination date and laterality, is critical to optimize assessment and management of imaging-detected axillary adenopathy in women with otherwise normal breast imaging."(1)
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