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.
authors.affiliation: From the *Vaccine Research Center, National Institute of Allergy and Infectious Disease, †Biostatistics Research Branch, Division of Clinical Research, National Institute of Allergy and Infectious Disease, and ‡Positron Emission Tomography Department, Clinical Center, National Institutes of Health, Bethesda, MD.
authors.forename: Emily E
authors.initials: EE
authors.lastname: Coates
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Costner
authors.forename: Martha C
authors.initials: MC
authors.lastname: Nason
authors.forename: Douglas M
authors.initials: DM
authors.lastname: Herrin
authors.forename: Shielah
authors.initials: S
authors.lastname: Conant
authors.forename: Peter
authors.initials: P
authors.lastname: Herscovitch
authors.forename: Uzma N
authors.initials: UN
authors.lastname: Sarwar
authors.forename: Lasonji
authors.initials: L
authors.lastname: Holman
authors.forename: Jillian
authors.initials: J
authors.lastname: Mitchell
authors.forename: Galina
authors.initials: G
authors.lastname: Yamshchikov
authors.forename: Richard A
authors.initials: RA
authors.lastname: Koup
authors.forename: Barney S
authors.initials: BS
authors.lastname: Graham
authors.forename: Corina M
authors.initials: CM
authors.lastname: Millo
authors.forename: Julie E
authors.initials: JE
authors.lastname: Ledgerwood
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D000068857:Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18 / Q000276:immunology*; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000378:metabolism*; D027383:Papillomaviridae; D053918:Papillomavirus Vaccines / Q000276:immunology*; D000072078:Positron Emission Tomography Computed Tomography; D014611:Vaccination; D055815:Young Adult
chemical_list: D000068857:Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18; D053918:Papillomavirus Vaccines; C510352:human papillomavirus vaccine, L1 type 16, 18