{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T02:07:46Z","timestamp":1760234866640,"version":"build-2065373602"},"reference-count":35,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2021,7,3]],"date-time":"2021-07-03T00:00:00Z","timestamp":1625270400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003711","name":"Ministry of Science and Technology","doi-asserted-by":"publisher","award":["MOST 109-2221-E-037-001-MY3"],"award-info":[{"award-number":["MOST 109-2221-E-037-001-MY3"]}],"id":[{"id":"10.13039\/501100003711","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>During the coronavirus disease 2019 (COVID-19) pandemic, several case studies demonstrated that many asymptomatic patients with COVID-19 underwent fluorine-18 fluorodeoxyglucose ([18F]FDG) positron emission tomography\/computed tomography (PET\/CT) examination for various indications. However, there is a lack of literature to characterize the pattern of [18F]FDG PET\/CT imaging on asymptomatic COVID-19 patients. Therefore, a systematic review to analyze the pulmonary findings of [18F]FDG PET\/CT on asymptomatic COVID-19 patients was conducted. This systematic review was performed under the guidelines of PRISMA. PubMed, Medline, and Web of Science were used to search for articles for this review. Articles with the key words: \u201casymptomatic\u201d, \u201cCOVID-19\u201d, \u201c[18F]FDG PET\/CT\u201d, and \u201cnuclear medicine\u201d were searched for from 1 January 2020 to 20 May 2021. Thirty asymptomatic patients with COVID-19 were included in the eighteen articles. These patients had a mean age of 62.25 \u00b1 14.85 years (male: 67.71 \u00b1 12.00; female: 56.79 \u00b1 15.81). [18F]FDG-avid lung lesions were found in 93.33% (28\/30) of total patients. The major lesion was [18F]FDG-avid multiple ground-glass opacities (GGOs) in the peripheral or subpleural region in bilateral lungs, followed by the consolidation. The intensity of [18F]FDG uptake in multiple GGOs was 5.605 \u00b1 2.914 (range from 2 to 12) for maximal standardized uptake value (SUVmax). [18F]FDG-avid thoracic lymph nodes (LN) were observed in 40% (12\/40) of the patients. They mostly appeared in both mediastinal and hilar regions with an SUVmax of 5.8 \u00b1 2.93 (range from 2.5 to 9.6). The [18F]FDG uptake was observed in multiple GGOs, as well as in the mediastinal and hilar LNs. These are common patterns in PET\/CT of asymptomatic patients with COVID-19.<\/jats:p>","DOI":"10.3390\/pathogens10070839","type":"journal-article","created":{"date-parts":[[2021,7,4]],"date-time":"2021-07-04T22:34:36Z","timestamp":1625438076000},"page":"839","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Pulmonary Findings of [18F]FDG PET\/CT Images on Asymptomatic COVID-19 Patients"],"prefix":"10.3390","volume":"10","author":[{"given":"Tzu-Chuan","family":"Ho","sequence":"first","affiliation":[{"name":"Department of Medical Imaging and Radiological Sciences, Kaohsiung Medical University, Kaohsiung 807, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4618-0927","authenticated-orcid":false,"given":"Chin-Chuan","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan"},{"name":"School of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan"},{"name":"Neuroscience Research Center, Kaohsiung Medical University, Kaohsiung 807, Taiwan"},{"name":"Department of Electrical Engineering, I-Shou University, Kaohsiung 840, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9741-5824","authenticated-orcid":false,"given":"Hung-Pin","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying-Fong","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging and Radiological Sciences, Kaohsiung Medical University, Kaohsiung 807, Taiwan"},{"name":"Department of Nuclear Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi-Ming Arthur","family":"Chen","sequence":"additional","affiliation":[{"name":"Graduate Institute of Biomedical and Pharmaceutical Science, Fu Jen Catholic University, New Taipei City 242, Taiwan"},{"name":"National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Miaoli County 350, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kuo-Pin","family":"Chuang","sequence":"additional","affiliation":[{"name":"Graduate Institute of Animal Vaccine Technology, National Pingtung University of Science and Technology, Pingtung 900, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8543-3862","authenticated-orcid":false,"given":"Che-Hsin","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Biological Science, National Sun Yat-sen University, Kaohsiung 804, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheng-Hui","family":"Yuan","sequence":"additional","affiliation":[{"name":"Mass Spectrometry Laboratory, Department of Chemistry, National University of Singapore, Singapore 119077, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu-Zhen","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging and Radiological Sciences, Kaohsiung Medical University, Kaohsiung 807, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5856-0498","authenticated-orcid":false,"given":"Ming-Hui","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan"},{"name":"Center of General Education, Shu-Zen Junior College of Medicine and Management, Kaohsiung 821, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1917-5893","authenticated-orcid":false,"given":"Yu-Chang","family":"Tyan","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging and Radiological Sciences, Kaohsiung Medical University, Kaohsiung 807, Taiwan"},{"name":"School of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan"},{"name":"Graduate Institute of Animal Vaccine Technology, National Pingtung University of Science and Technology, Pingtung 900, Taiwan"},{"name":"Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan"},{"name":"Institute of Medical Science and Technology, National Sun Yat-sen University, Kaohsiung 804, Taiwan"},{"name":"Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan"},{"name":"Center for Cancer Research, Kaohsiung Medical University, Kaohsiung 807, Taiwan"},{"name":"Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,7,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1016\/S0140-6736(20)30183-5","article-title":"Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China","volume":"395","author":"Huang","year":"2020","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1016\/S0140-6736(20)30251-8","article-title":"Genomic characterisation and epidemiology of 2019 novel coronavirus: Implications for virus origins and receptor binding","volume":"395","author":"Lu","year":"2020","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1056\/NEJMoa2001017","article-title":"China Novel Coronavirus Investigating and Research Team. A Novel Coronavirus from Patients with Pneumonia in China, 2019","volume":"382","author":"Zhu","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_4","unstructured":"World Health Organization (2021, June 23). Coronavirus Disease (COVID-19) Outbreak. Available online: https:\/\/www.who.int."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1449","DOI":"10.1002\/jmv.26424","article-title":"Epidemiology of COVID-19: A systematic review and meta-analysis of clinical characteristics, risk factors, and outcomes","volume":"93","author":"Li","year":"2021","journal-title":"J. Med. Virol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e174","DOI":"10.3346\/jkms.2020.35.e174","article-title":"Prevalence and Duration of Acute Loss of Smell or Taste in COVID-19 Patients","volume":"35","author":"Lee","year":"2020","journal-title":"J. Korean Med. Sci."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1007\/s11427-020-1661-4","article-title":"Clinical characteristics of 24 asymptomatic infections with COVID-19 screened among close contacts in Nanjing, China","volume":"63","author":"Hu","year":"2020","journal-title":"Sci. China Life Sci."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1016\/j.jinf.2020.05.035","article-title":"Asymptomatic infection and atypical manifestations of COVID-19: Comparison of viral shedding duration","volume":"81","author":"Noh","year":"2020","journal-title":"J. Infect."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1844","DOI":"10.1200\/JCO.2010.32.5225","article-title":"Role of functional imaging in the management of lymphoma","volume":"29","author":"Cheson","year":"2011","journal-title":"J. Clin. Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"4746","DOI":"10.1200\/JCO.2008.17.1496","article-title":"Preoperative staging of large primary breast cancer with [18F]fluorodeoxyglucose positron emission tomography\/computed tomography compared with conventional imaging procedures","volume":"26","author":"Fuster","year":"2008","journal-title":"J. Clin. Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"623036","DOI":"10.1155\/2013\/623036","article-title":"The use of 18F-FDG-PET\/CT for diagnosis and treatment monitoring of inflammatory and infectious diseases","volume":"2013","author":"Glaudemans","year":"2013","journal-title":"Clin. Dev. Immunol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"632","DOI":"10.2967\/jnumed.120.246256","article-title":"Incidental Findings Suggestive of COVID-19 in Asymptomatic Patients Undergoing Nuclear Medicine Procedures in a High-Prevalence Region","volume":"61","author":"Albano","year":"2020","journal-title":"J. Nucl. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1097\/RLU.0000000000003143","article-title":"18F-FDG PET\/CT in Hodgkin Lymphoma With Unsuspected COVID-19","volume":"45","author":"Garrastachu","year":"2020","journal-title":"Clin. Nucl. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1097\/MNM.0000000000001221","article-title":"Asymptomatic COVID-19 positive patient suspected on FDG-PET\/CT","volume":"41","author":"Castanheira","year":"2020","journal-title":"Nucl. Med. Commun."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1007\/s11604-020-01006-3","article-title":"18F-FDG PET\/CT in asymptomatic patients with COVID-19: The submerged iceberg surfaces","volume":"38","author":"Colandrea","year":"2020","journal-title":"Jpn. J. Radiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1111\/1754-9485.13099","article-title":"Early 18 F-FDG PET\/CT in COVID-19","volume":"64","author":"Cosma","year":"2020","journal-title":"J. Med. Imaging Radiat. Oncol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1813","DOI":"10.1016\/j.radcr.2020.07.035","article-title":"18-FDG PSEUDOTUMORAL LESION WITH QUICK FLOWERING TO A TYPICAL LUNG CT COVID-19","volume":"15","author":"Cabral","year":"2020","journal-title":"Radiol. Case Rep."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1803","DOI":"10.1016\/j.radcr.2020.07.032","article-title":"Incidental and simultaneous finding of pulmonary thrombus and COVID-19 pneumonia in a cancer patient derived to 18F-FDG PET\/CT. New pathophysiological insights from hybrid imaging","volume":"15","author":"Caro","year":"2020","journal-title":"Radiol. Case Rep."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1097\/RLU.0000000000003135","article-title":"Incidental Finding of COVID-19 Lung Infection in 18F-FDG PET\/CT: What Should We Do?","volume":"45","author":"Habouzit","year":"2020","journal-title":"Clin. Nucl. Med."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"L\u00f3pez-Mora, D.A., Fern\u00e1ndez, A., Duch, J., and Carrio, I. (2020). Follow-up 18F-FDG PET\/CT in an oncological asymptomatic COVID-19 patient. Rev. Esp. Med. Nucl. Imagen Mol.","DOI":"10.1016\/j.remnie.2021.03.005"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e383","DOI":"10.1097\/RLU.0000000000003175","article-title":"Atypical Presentation of COVID-19 Incidentally Detected at 18F-FDG PET\/CT in an Asymptomatic Oncological Patient","volume":"45","author":"Mattoli","year":"2020","journal-title":"Clin. Nucl. Med."},{"key":"ref_22","first-page":"58","article-title":"Asymptomatic COVID-19 cancer patients incidentally discovered during F18-FDG PET\/CT monitoring","volume":"94","author":"Piciu","year":"2021","journal-title":"Med. Pharm. Rep."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1177\/0300891620935983","article-title":"Unknown SARS-CoV-2 pneumonia detected by PET\/CT in patients with cancer","volume":"106","author":"Scarlattei","year":"2020","journal-title":"Tumori"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1097\/RLU.0000000000003144","article-title":"Incidental Discovery of a COVID-19 Infection on a Reevaluation FDG PET\/CT in a Patient Treated for Hodgkin Lymphoma","volume":"45","author":"Simand","year":"2020","journal-title":"Clin. Nucl. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e57","DOI":"10.1097\/RLU.0000000000003314","article-title":"Asymptomatic COVID-19 Infection Detected on 18F-FDG PET\/CT Scan Done for Multiple Myeloma","volume":"46","author":"Graham","year":"2021","journal-title":"Clin. Nucl. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1097\/RLU.0000000000003145","article-title":"FDG PET\/CT Findings in an Asymptomatic Case of Confirmed COVID-19","volume":"45","author":"Martineau","year":"2020","journal-title":"Clin. Nucl. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1097\/RLU.0000000000003141","article-title":"Laboratory-Proven Asymptomatic SARS-CoV-2 (COVID-19) Infection on 18F-FDG PET\/CT","volume":"45","author":"Krebs","year":"2020","journal-title":"Clin. Nucl. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1809","DOI":"10.1016\/j.radcr.2020.07.018","article-title":"COVID-19 in an asymptomatic patient undergoing FDG PET\/CT","volume":"15","author":"Johnson","year":"2020","journal-title":"Radiol Case Rep."},{"key":"ref_29","first-page":"e00981","article-title":"Transient 18FDG-avid hilar lymph node on PET\/CT imaging in asymptomatic COVID-19","volume":"22","author":"Khalili","year":"2020","journal-title":"ID Cases"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"876.e33","DOI":"10.1016\/j.crad.2020.07.025","article-title":"Chest CT findings in asymptomatic cases with COVID-19: A systematic review and meta-analysis","volume":"75","author":"Atalla","year":"2020","journal-title":"Clin. Radiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1016\/j.diii.2012.04.021","article-title":"Lung infections: The radiologist\u2019s perspective","volume":"93","author":"Godet","year":"2012","journal-title":"Diagn. Interv. Imaging"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1007\/s12149-015-1047-6","article-title":"18F-FDG and 18F-FLT PET\/CT imaging in the characterization of mediastinal lymph nodes","volume":"30","author":"Rayamajhi","year":"2016","journal-title":"Ann. Nucl. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"11","DOI":"10.4103\/1817-1737.74270","article-title":"Evaluation of mediastinal lymph nodes using F-FDG PET-CT scan and its histopathologic correlation","volume":"6","author":"Kumar","year":"2011","journal-title":"Ann. Thorac. Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/j.carj.2018.12.006","article-title":"Many Faces of Thoracic Histoplasmosis-Pictorial Essay","volume":"70","author":"Semionov","year":"2019","journal-title":"Can. Assoc. Radiol. J."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1230","DOI":"10.1016\/S1473-3099(20)30521-1","article-title":"Association of mediastinal lymphadenopathy with COVID-19 prognosis","volume":"20","author":"Sardanelli","year":"2020","journal-title":"Lancet Infect. Dis."}],"container-title":["Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-0817\/10\/7\/839\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:25:42Z","timestamp":1760163942000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-0817\/10\/7\/839"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,3]]},"references-count":35,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2021,7]]}},"alternative-id":["pathogens10070839"],"URL":"https:\/\/doi.org\/10.3390\/pathogens10070839","relation":{},"ISSN":["2076-0817"],"issn-type":[{"type":"electronic","value":"2076-0817"}],"subject":[],"published":{"date-parts":[[2021,7,3]]}}}