Chandekar KR, Satapathy S, Singh H, Bhattacharya A. Molecular imaging as a tool for evaluation of COVID-19 sequelae – A review of literature. World J Radiol 2022; 14(7): 194-208 [PMID: 36160629 DOI: 10.4329/wjr.v14.i7.194]
Corresponding Author of This Article
Swayamjeet Satapathy, MBBS, MD, Doctor, Department of Nuclear Medicine, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh 160012, India. swayamjeet.satapathy@gmail.com
Research Domain of This Article
Radiology, Nuclear Medicine & Medical Imaging
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Radiol. Jul 28, 2022; 14(7): 194-208 Published online Jul 28, 2022. doi: 10.4329/wjr.v14.i7.194
Molecular imaging as a tool for evaluation of COVID-19 sequelae – A review of literature
Kunal R Chandekar, Swayamjeet Satapathy, Harmandeep Singh, Anish Bhattacharya
Kunal R Chandekar, Swayamjeet Satapathy, Harmandeep Singh, Anish Bhattacharya, Department of Nuclear Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
Author contributions: Chandekar KR wrote the initial draft of the manuscript and prepared the figures; Satapathy S was responsible for idea conception and design of the manuscript; Singh H was in charge of editing the manuscript; and Bhattacharya A provided critical inputs and helped in the final revision.
Conflict-of-interest statement: All authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Swayamjeet Satapathy, MBBS, MD, Doctor, Department of Nuclear Medicine, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh 160012, India. swayamjeet.satapathy@gmail.com
Received: February 22, 2022 Peer-review started: February 22, 2022 First decision: April 28, 2022 Revised: May 17, 2022 Accepted: July 11, 2022 Article in press: July 11, 2022 Published online: July 28, 2022
Abstract
Coronavirus disease 2019 (COVID-19) is caused by the novel viral pathogen, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 primarily involves the lungs. Nucleic acid testing based on reverse-transcription polymerase chain reaction of respiratory samples is the current gold standard for the diagnosis of SARS-CoV-2 infection. Imaging modalities have an established role in triaging, diagnosis, evaluation of disease severity, monitoring disease progression, extra-pulmonary involvement, and complications. As our understanding of the disease improves, there has been substantial evidence to highlight its potential for multi-systemic involvement and development of long-term sequelae. Molecular imaging techniques are highly sensitive, allowing non-invasive visualization of physiological or pathological processes at a cellular or molecular level with potential for detection of functional changes earlier than conventional radiological imaging. The purpose of this review article is to highlight the evolving role of molecular imaging in evaluation of COVID-19 sequelae. Though not ideal for diagnosis, the various modalities of molecular imaging play an important role in assessing pulmonary and extra-pulmonary sequelae of COVID-19. Perfusion imaging using single photon emission computed tomography fused with computed tomography (CT) can be utilized as a first-line imaging modality for COVID-19 related pulmonary embolism. 18F-fluorodeoxyglucose positron emission tomography (PET)/CT is a sensitive tool to detect multi-systemic inflammation, including myocardial and vascular inflammation. PET in conjunction with magnetic resonance imaging helps in better characterization of neurological sequelae of COVID-19. Despite the fact that the majority of published literature is retrospective in nature with limited sample sizes, it is clear that molecular imaging provides additional valuable information (complimentary to anatomical imaging) with semi-quantitative or quantitative parameters to define inflammatory burden and can be used to guide therapeutic strategies and assess response. However, widespread clinical applicability remains a challenge owing to longer image acquisition times and the need for adoption of infection control protocols.
Core Tip: Despite extensive global efforts, coronavirus disease 2019 (COVID-19) remains the largest public health problem of modern times. As our understanding of the disease and its manifestations improve, we must recognize and explore the potential utility of molecular imaging modalities in evaluating the long-term sequelae of COVID-19. Molecular imaging tools can be incorporated into routine clinical practice by identifying appropriate and specific indications and addressing limitations to their practical application.
