Lymph Node Activation by PET/CT Following Vaccination With Licensed Vaccines for Human Papillomaviruses

the VRC 900 Study Team

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

BACKGROUND: While PET using F-FDG is most commonly used for imaging malignant tumors, vaccination is known to cause transient inflammation of lymph nodes inducing positive findings on F-FDG PET scans. The pattern, magnitude, and duration of lymph node activation following vaccination have not been clearly defined. Furthermore, the addition of adjuvants to vaccines can further enhance the immune response. The presented study was designed to define lymph node activation following administration of the Food and Drug Administration–licensed human papillomavirus vaccines, Cervarix and Gardasil, which contain similar antigens with different adjuvants. METHODS: Twenty-seven women aged 18 to 25 years were randomized to receive either Cervarix or Gardasil in the clinical trial VRC 900. Fifteen subjects participated in the PET/CT portion of the trial and received scans of lymph node activation at prevaccination and “1 week” (8–14 days) and “1 month” (23–36 days) after the first or third vaccination. RESULTS: PET/CT scans revealed that all vaccine recipients had ipsilateral axillary lymph node activity. Three of 4 Cervarix recipients also showed contralateral lymph node activity 1 month after the first vaccination. For both Cervarix and Gardasil, the SUV activity resolved over time, with activity extended up to day 37 after the first and third vaccinations. CONCLUSIONS: Following intramuscular vaccination, there were no major differences between duration of uptake and intensity of SUV between Cervarix and Gardasil recipients in ipsilateral axillary lymph nodes. Contralateral node activation was detected up to 1 month after the first vaccination in Cervarix recipients only, possibly reflecting differences in vaccine adjuvant formulation.

Original languageEnglish (US)
JournalClinical Nuclear Medicine
DOIs
StateAccepted/In press - Mar 10 2017

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Papillomavirus Vaccines
Vaccination
Lymph Nodes
Vaccines
United States Food and Drug Administration
Positron-Emission Tomography
human papillomavirus vaccine, L1 type 16, 18
Clinical Trials
Inflammation
Antigens
Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Lymph Node Activation by PET/CT Following Vaccination With Licensed Vaccines for Human Papillomaviruses. / the VRC 900 Study Team.

In: Clinical Nuclear Medicine, 10.03.2017.

Research output: Contribution to journalArticle

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title = "Lymph Node Activation by PET/CT Following Vaccination With Licensed Vaccines for Human Papillomaviruses",
abstract = "BACKGROUND: While PET using F-FDG is most commonly used for imaging malignant tumors, vaccination is known to cause transient inflammation of lymph nodes inducing positive findings on F-FDG PET scans. The pattern, magnitude, and duration of lymph node activation following vaccination have not been clearly defined. Furthermore, the addition of adjuvants to vaccines can further enhance the immune response. The presented study was designed to define lymph node activation following administration of the Food and Drug Administration–licensed human papillomavirus vaccines, Cervarix and Gardasil, which contain similar antigens with different adjuvants. METHODS: Twenty-seven women aged 18 to 25 years were randomized to receive either Cervarix or Gardasil in the clinical trial VRC 900. Fifteen subjects participated in the PET/CT portion of the trial and received scans of lymph node activation at prevaccination and “1 week” (8–14 days) and “1 month” (23–36 days) after the first or third vaccination. RESULTS: PET/CT scans revealed that all vaccine recipients had ipsilateral axillary lymph node activity. Three of 4 Cervarix recipients also showed contralateral lymph node activity 1 month after the first vaccination. For both Cervarix and Gardasil, the SUV activity resolved over time, with activity extended up to day 37 after the first and third vaccinations. CONCLUSIONS: Following intramuscular vaccination, there were no major differences between duration of uptake and intensity of SUV between Cervarix and Gardasil recipients in ipsilateral axillary lymph nodes. Contralateral node activation was detected up to 1 month after the first vaccination in Cervarix recipients only, possibly reflecting differences in vaccine adjuvant formulation.",
author = "{the VRC 900 Study Team} and Coates, {Emily E.} and Costner, {Pamela J.} and Nason, {Martha C.} and Herrin, {Douglas M.} and Shielah Conant and Peter Herscovitch and Sarwar, {Uzma N.} and Lasonji Holman and Jillian Mitchell and Galina Yamshchikov and Koup, {Richard A.} and Graham, {Barney S.} and Millo, {Corina M.} and Ledgerwood, {Julie E.}",
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T1 - Lymph Node Activation by PET/CT Following Vaccination With Licensed Vaccines for Human Papillomaviruses

AU - the VRC 900 Study Team

AU - Coates, Emily E.

AU - Costner, Pamela J.

AU - Nason, Martha C.

AU - Herrin, Douglas M.

AU - Conant, Shielah

AU - Herscovitch, Peter

AU - Sarwar, Uzma N.

AU - Holman, Lasonji

AU - Mitchell, Jillian

AU - Yamshchikov, Galina

AU - Koup, Richard A.

AU - Graham, Barney S.

AU - Millo, Corina M.

AU - Ledgerwood, Julie E.

PY - 2017/3/10

Y1 - 2017/3/10

N2 - BACKGROUND: While PET using F-FDG is most commonly used for imaging malignant tumors, vaccination is known to cause transient inflammation of lymph nodes inducing positive findings on F-FDG PET scans. The pattern, magnitude, and duration of lymph node activation following vaccination have not been clearly defined. Furthermore, the addition of adjuvants to vaccines can further enhance the immune response. The presented study was designed to define lymph node activation following administration of the Food and Drug Administration–licensed human papillomavirus vaccines, Cervarix and Gardasil, which contain similar antigens with different adjuvants. METHODS: Twenty-seven women aged 18 to 25 years were randomized to receive either Cervarix or Gardasil in the clinical trial VRC 900. Fifteen subjects participated in the PET/CT portion of the trial and received scans of lymph node activation at prevaccination and “1 week” (8–14 days) and “1 month” (23–36 days) after the first or third vaccination. RESULTS: PET/CT scans revealed that all vaccine recipients had ipsilateral axillary lymph node activity. Three of 4 Cervarix recipients also showed contralateral lymph node activity 1 month after the first vaccination. For both Cervarix and Gardasil, the SUV activity resolved over time, with activity extended up to day 37 after the first and third vaccinations. CONCLUSIONS: Following intramuscular vaccination, there were no major differences between duration of uptake and intensity of SUV between Cervarix and Gardasil recipients in ipsilateral axillary lymph nodes. Contralateral node activation was detected up to 1 month after the first vaccination in Cervarix recipients only, possibly reflecting differences in vaccine adjuvant formulation.

AB - BACKGROUND: While PET using F-FDG is most commonly used for imaging malignant tumors, vaccination is known to cause transient inflammation of lymph nodes inducing positive findings on F-FDG PET scans. The pattern, magnitude, and duration of lymph node activation following vaccination have not been clearly defined. Furthermore, the addition of adjuvants to vaccines can further enhance the immune response. The presented study was designed to define lymph node activation following administration of the Food and Drug Administration–licensed human papillomavirus vaccines, Cervarix and Gardasil, which contain similar antigens with different adjuvants. METHODS: Twenty-seven women aged 18 to 25 years were randomized to receive either Cervarix or Gardasil in the clinical trial VRC 900. Fifteen subjects participated in the PET/CT portion of the trial and received scans of lymph node activation at prevaccination and “1 week” (8–14 days) and “1 month” (23–36 days) after the first or third vaccination. RESULTS: PET/CT scans revealed that all vaccine recipients had ipsilateral axillary lymph node activity. Three of 4 Cervarix recipients also showed contralateral lymph node activity 1 month after the first vaccination. For both Cervarix and Gardasil, the SUV activity resolved over time, with activity extended up to day 37 after the first and third vaccinations. CONCLUSIONS: Following intramuscular vaccination, there were no major differences between duration of uptake and intensity of SUV between Cervarix and Gardasil recipients in ipsilateral axillary lymph nodes. Contralateral node activation was detected up to 1 month after the first vaccination in Cervarix recipients only, possibly reflecting differences in vaccine adjuvant formulation.

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