Oral Administration of F-18 FDG To Evaluate a Single Pulmonary Nodule by Positron Emission Tomography in a Patient with Poor Intravenous Access

Franc, Benjamin L.; Carlisle, Marie; Segall, George M.

doi:10.1097/00003072-200307000-00001

Cited by 9 publications

(7 citation statements)

References 8 publications

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“…In a rodent model, 48 h of fasting and use of a hypotonic solution as a diluent for 18 F-FDG yielded better absorption of 18 F-FDG from the gut. Franc et al reported a case of a lung cancer patient who had to receive 18 F-FDG orally because of nonpalpable veins (14). They observed high uptake in the mouth, esophagus, stomach, and bowel.…”

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Human Radiation Dosimetry for Orally and Intravenously Administered ¹⁸F-FDG

et al. 2019

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Intravenous access is difficult in some patients referred for 18 F-FDG PET imaging. Extravasation at the injection site and accumulation in central catheters can lead to limited tumor 18 F-FDG uptake, erroneous quantitation, and significant image artifacts. In this study, we compared the human biodistribution and dosimetry for 18 F-FDG after oral and intravenous administrations sequentially in the same subjects to ascertain the dosimetry and potential suitability of orally administered 18 F-FDG as an alternative to intravenous administration. We also compared our detailed intravenous 18 F-FDG dosimetry with older dosimetry data. Methods: Nine healthy volunteers (6 male and 3 female; aged 19-32 y) underwent PET/CT imaging after oral and intravenous administration of 18 F-FDG. Identical preparation and imaging protocols (except administration route) were used for oral and intravenous studies. During each imaging session, 9 whole-body PET scans were obtained at 5, 10, 20, 30, 40, 50, 60, 120, and 240 min after 18 F-FDG administration (370 ± 16 MBq). Source organ contours drawn using CT were overlaid onto registered PET images to extract time-activity curves. Time-integrated activity coefficients derived from time-activity curves were given as input to OLINDA/EXM for dose calculations. Results: Blood uptake after orally administered 18 F-FDG peaked at 45-50 min after ingestion. The oral-to-intravenous ratios of 18 F-FDG uptake for major organs at 45 min were 1.07 ± 0.24 for blood, 0.94 ± 0.39 for heart wall, 0.47 ± 0.12 for brain, 1.25 ± 0.18 for liver, and 0.84 ± 0.24 for kidneys. The highest organ-absorbed doses (μGy/MBq) after oral 18 F-FDG administration were observed for urinary bladder (75.9 ± 17.2), stomach (48.4 ± 14.3), and brain (29.4 ± 5.1), and the effective dose was significantly higher (20%) than after intravenous administration (P 5 0.002). Conclusion: 18 F-FDG has excellent bioavailability after oral administration, but peak organ activities occur later than after intravenous injection. These data suggest PET at 2 h after oral 18 F-FDG administration should yield images that are comparable in biodistribution to conventional clinical images acquired 1 h after injection. Oral 18 F-FDG is a palatable alternative to intravenous 18 F-FDG when venous access is problematic.

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Human Radiation Dosimetry for Orally and Intravenously Administered ¹⁸F-FDG

et al. 2019

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“…Repeated studies in patients with poor intravenous access often result in a multiplicity of unsatisfactory studies, which are a burden both on the patient and on the center doing the studies. Stray reports (1) have indicated that oral administration may meet the needs of PET imaging. We therefore undertook a study of a diversity of cases to determine whether the lesions detected after oral administration of 18 F-FDG might be identical to those detected after intravenous administration and whether oral administration might thus be an adequate substitute for intravenous.…”

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Substitution of Oral 18F-FDG for Intravenous 18F-FDG in PET Scanning

Nair¹,

Agrawal²,

Jaiswar³

2007

Journal of Nuclear Medicine Technology

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“…Interestingly, indirect support for the alternative pathway where 18 FDG is delivered from the blood comes from observations made in the rare instances when 18 FDG has had to be given orally because of poor venous access [ 16 ]. Images acquired 40 minutes after drinking the isotope show activity in the brain, heart, liver and bladder.…”

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Quantification of 18FDG in the Normal Colon—A First Step in Investigating Whether Its Presence Is a Marker of a Physiological Process

et al. 2016

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The visibility of the colon in positron emission tomography (PET) scans of patients without gastrointestinal disease indicating the presence of 18F Fluorodeoxyglucose (18FDG) is well recognised, but unquantified and unexplained. In this paper a qualitative scoring system was applied to PET scans from 30 randomly selected patients without gastrointestinal disease to detect the presence of 18FDG in 4 different sections of the colon and then both the total pixel value and the pixel value per unit length of each section of the colon were determined to quantify the amount of 18FDG from a randomly selected subset of 10 of these patients. Analysis of the qualitative scores using a non-parametric ANOVA showed that all sections of the colon contained 18FDG but there were differences in the amount of 18FDG present between sections (p<0.05). Wilcoxon matched-pair signed-rank tests between pairs of segments showed statistically significant differences between all pairs (p<0.05) with the exception of the caecum and ascending colon and the descending colon. The same non-parametric statistical analysis of the quantitative measures showed no difference in the total amount of 18FDG between sections (p>0.05), but a difference in the amount/unit length between sections (p<0.01) with only the caecum and ascending colon and the descending colon having a statistically significant difference (p<0.05). These results are consistent since the eye is drawn to focal localisation of the 18FDG when qualitatively scoring the scans. The presence of 18FDG in the colon is counterintuitive since it must be passing from the blood to the lumen through the colonic wall. There is no active mechanism to achieve this and therefore we hypothesise that the transport is a passive process driven by the concentration gradient of 18FDG across the colonic wall. This hypothesis is consistent with the results obtained from the qualitative and quantitative measures analysed.

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Oral Administration of F-18 FDG To Evaluate a Single Pulmonary Nodule by Positron Emission Tomography in a Patient with Poor Intravenous Access

Cited by 9 publications

References 8 publications

Human Radiation Dosimetry for Orally and Intravenously Administered ¹⁸F-FDG

Human Radiation Dosimetry for Orally and Intravenously Administered ¹⁸F-FDG

Substitution of Oral 18F-FDG for Intravenous 18F-FDG in PET Scanning

Quantification of 18FDG in the Normal Colon—A First Step in Investigating Whether Its Presence Is a Marker of a Physiological Process

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Oral Administration of F-18 FDG To Evaluate a Single Pulmonary Nodule by Positron Emission Tomography in a Patient with Poor Intravenous Access

Cited by 9 publications

References 8 publications

Human Radiation Dosimetry for Orally and Intravenously Administered 18F-FDG

Human Radiation Dosimetry for Orally and Intravenously Administered 18F-FDG

Substitution of Oral 18F-FDG for Intravenous 18F-FDG in PET Scanning

Quantification of 18FDG in the Normal Colon—A First Step in Investigating Whether Its Presence Is a Marker of a Physiological Process

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Human Radiation Dosimetry for Orally and Intravenously Administered ¹⁸F-FDG

Human Radiation Dosimetry for Orally and Intravenously Administered ¹⁸F-FDG