Clinical Experience with a Commercially Available Negative Oral Contrast Medium in PET/CT

Ka, Hausegger; Reinprecht, Peter; Kau, Thomas; Igerc, I.; Lind, P

doi:10.1055/s-2005-858197

Cited by 17 publications

(5 citation statements)

References 6 publications

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“…Oral CT contrast material was used in most patients by 46% of sites. This preference for oral over intravenous contrast material is striking because oral contrast material may yield artifactual uptake patterns and bias in attenuation-corrected PET, much like focal concentrations of intravenous contrast material (26), unless a water-based oral agent (27,28) is used. However, only 26% of the respondents who use oral contrast agents use a water-based agent.…”

Section: Discussionmentioning

confidence: 99%

Variations in Clinical PET/CT Operations: Results of an International Survey of Active PET/CT Users

Beyer¹,

Czernin²,

Freudenberg³

2011

J Nucl Med

116

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This study gathered information about clinical PET/CT operations worldwide to help guide discussions on the use and standardization of clinical PET/CT. Methods: A Web-based survey of PET/CT users was initiated in November 2009 through e-mail advertising using Academy of Molecular Imaging databases. Recipients were asked 58 questions related to demographics (e.g., location, number of PET/CT systems, and staffing), PET/CT operations and use, and variations in 18 F-FDG oncology imaging protocols. Results: The responders were from centers in the Americas (71%), Europe (22%), AsiaPacific (6%), and Middle East (1%), with most responding sites representing public health care institutions (60%). PET/CT systems were most frequently installed in nuclear medicine departments (59%). Of the sites operating a PET/CT system, 16% had 10 y or more of stand-alone PET experience. About 40% of all sites operated at least 2 PET/CT systems. PET/CT was most frequently used for applications in torso or whole-body oncology (87%), radiation therapy planning (4%), cardiology (4%), and neurology (5%). The average interval of fasting before an 18 F-FDG PET/CT examination was 7 6 3 h (range, 4-12 h). Blood glucose levels were measured at 99% of sites, but acceptable maximal glucose levels varied substantially (an upper limit of 200 mg/dL was applied at .50% of the institutions). A weight-based radioactivity dose injection was performed at 44% of sites. The mean 18 F-FDG activity injected was 390 MBq (range, 110-585 MBq) for 3-dimensional PET of a 75-kg patient. The mean uptake time was 64 6 14 min (range, 20-90 min). Split protocols involving patient repositioning and adapted imaging parameters were used at 51% of sites. Only 41% used patient positioning aids. Intravenous or oral CT contrast material was used at 52% of sites in up to 25% of patients. Most sites (90%) measured maximum standardized uptake value as an index of tissue glucose use. Only 62% of sites provided a fully integrated PET/CT report. Conclusion: An international survey among clinical PET/CT users revealed significant variations in standard 18 F-FDG PET/CT protocols. This finding illustrates the need for continuous training and ongoing standardization in an effort to optimize PET/CT in oncology.

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Section: Discussionmentioning

confidence: 99%

Variations in Clinical PET/CT Operations: Results of an International Survey of Active PET/CT Users

Beyer¹,

Czernin²,

Freudenberg³

2011

J Nucl Med

116

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“…Moreover, increase of SUV seemed to be mostly observed in the ascending colon [46]. An interesting alternative might be the use of negative oral contrast agents, which do not affect the accuracy of CT-based attenuation correction, and is therefore a promising possibility for PET-CT studies [47,48]. Use of negative oral contrast will hopefully be of sufficient quality for diagnostic use, which needs to be assessed by the radiology community.…”

Section: Limitations Observations and Open Issuesmentioning

confidence: 99%

The Netherlands protocol for standardisation and quantification of FDG whole body PET studies in multi-centre trials

Boellaard

Oyen²,

Hoekstra

et al. 2008

Eur J Nucl Med Mol Imaging

361

244

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“…Simethicone-coated cellulose has shown to provide adequate distension of bowel on CT [14]. Recently, Antoch et al [7] have shown locust bean gummannitol, a low-density contrast agent, and Hausegger et al [19] have shown Mukofalk, a negative oral contrast, to be effective in PET/CT although they are not readily available.…”

Section: Discussionmentioning

confidence: 97%

Evaluation of the effects of oral water and low-density barium sulphate suspension on bowel appearance on FDG-PET/CT

et al. 2009

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The purpose of this study is to assess which of five bowel preparation regimes offers superior bowel distension and to assess if these regimes adversely affect FDG activity on PET/CT imaging. The study conformed to HIPAA regulations. Ninety patients were divided into five groups of 18 who received no oral contrast agent (group A); 900 ml of water orally (group B); or 900, 1,350, or 1,800 ml of LDB (groups C, D, E, respectively). PET/CT examinations were assessed quantitatively (bowel diameter, SUV) and qualitatively (visual assessment grading scale) for bowel distension and FDG activity by two blinded readers. ANOVA was utilized to determine if a statistically significant difference (SSD) existed between the groups in terms of distension and FDG uptake. Qualitatively superior bowel distension was observed in group C (LDB) compared to B (water) and greater distension was noted with increased volumes of LDB in C, D, and E. Quantitatively there was an SSD in mean distension between groups C and B (P < 0.001 except duodenum). Qualitatively and quantitatively there was no significant difference in bowel FDG uptake among the groups (P > 0.05). LDB as an oral contrast agent provides superior bowel distension over water and does not induce increased FDG bowel activity.

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Clinical Experience with a Commercially Available Negative Oral Contrast Medium in PET/CT

Abstract: Mukofalk can be used as a negative oral contrast medium in PET/CT studies.

Cited by 17 publications

References 6 publications

Variations in Clinical PET/CT Operations: Results of an International Survey of Active PET/CT Users

Variations in Clinical PET/CT Operations: Results of an International Survey of Active PET/CT Users

The Netherlands protocol for standardisation and quantification of FDG whole body PET studies in multi-centre trials

Evaluation of the effects of oral water and low-density barium sulphate suspension on bowel appearance on FDG-PET/CT

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