Effects of hyperglycemia on fluorine-18-fluorodeoxyglucose biodistribution in a large oncology clinical practice. Issue 5 (May 2018)

• Record Type: Journal Article
• Authors: Rosica, Dillenia; Cheng, Su-Chun; Hudson, Margo; Sakellis, Christopher; Van den Abbeele, Annick D.; Kim, Chun K.; Jacene, Heather A.
• Is Part Of: Nuclear medicine communications. Volume 39:Issue 5(2018:May)
• Publication Date: 2018-05
• Subjects: fluorine-18-fluorodeoxyglucose biodistribution -- 18F-FDG PET -- hyperglycemia; Nuclear medicine -- Periodicals; 616.07575
• DOI: 10.1097/MNM.0000000000000829
• Languages: English
• ISSNs: 0143-3636

Abstract

Abstract : Aim: Suggested cutoff points of blood glucose levels (BGL) before 18 F-FDG PET/CT scanning vary between 120 and 200 mg/dl in current guidelines. This study's purpose was to compare the frequency of abnormal fluorine-18-fluorodeoxyglucose ( 18 F-FDG) biodistribution on PET/CT scans of patients with various ranges of abnormal BGL and to determine the effect of BGL greater than 200 mg/dl on 18 F-FDG uptake in various organs. Patients and methods: 18 F-FDG PET/CT scans were retrospectively reviewed for 325 patients with BGL greater than 120 mg/dl at the time of scan and 112 with BGL less than or equal to 120 mg/dl. 18 F-FDG biodistribution was categorized as normal, mildly abnormal, or abnormal by visual analysis of brain, background soft tissue, and muscle. Mean standardized uptake values (SUVmean ) in brain, liver, fat (flank), gluteal muscle, and blood pool (aorta) were recorded. 18 F-FDG biodistribution frequencies were assessed using a nonparametric χ 2 -test for trend. Normal organ SUVs were compared using Kruskal–Wallis tests using the following BGL groupings: ⩽120, 121–150, 151–200, and ≥201 mg/dl. Results: Although higher BGL were significantly associated with an increased proportion of abnormal biodistribution ( P <0.001), most patients with BGL less than or equal to 200 mg/dl had normal or mildly abnormal biodistribution. Average brain SUVmean significantly decreased with higher BGL groupings ( P <0.001). Average aorta, gluteal muscle, and liver SUVmean did not significantly differ among groups with BGL greater than 120 mg/dl ( P =0.66, 0.84, and 0.39, respectively), but were significantly lower in those with BGL less than or equal to 120 mg/dl ( P ⩽0.001). Flank fat SUVmean was not significantly different among BGL groups ( P =0.67). Conclusion: Abnormal 18 F-FDG biodistribution is associated with higher BGL at the time of scan, but the effects are negligible or mild in most patients with BGL less than 200 mg/dl. Although mildly increased soft tissue uptake is seen with BGL greater than 120 mg/dl, decline in brain metabolic activity correlated the most with various BGL.