The influences of blood glucose and duration of fasting on myocardial glucose uptake of [18F]fluoro-2-deoxy-D-glucose

Abstract

During the study of chest using positron emission tomography (PET) with [18F]fluoro-2-deoxy-d-glucose (FDG), a significant myocardial FDG uptake can prevent detection of the lesion that is located either behind or closely attached to the heart border. Two well-known and possible factors of myocardial FDG uptake are blood glucose level and fasting duration before FDG PET scanning. This study investigates whether the two factors are related to myocardial FDG uptake. Our study also explores the possibility of eliminating myocardial FDG uptake by controlling patients' blood glucose level and/or fasting duration. Whole-body FDG PET scans performed on 270 consecutive patients performed were reviewed. The study subjects were classified into four grades of myocardial FDG uptake according to the visual interpretation of the FDG PET image hard-copy films. For all study subjects, the blood sugar level and fasting duration before FDG injection were recorded. Then, the blood sugar levels and fasting duration were compared to the visual grade of myocardial FDG uptake for each study subject. About half of the study subjects showed graded 0 myocardial FDG uptake when the blood glucose levels were < or = 120 mg x dl(-1) or when the fasting duration was between 5 and 12 h. One hundred and thirty-one of the 142 (92%) patients with graded 0 uptake were asked to fast for> or = 4 h and had blood glucose levels < or = 120 mg x dl(-1). Based on our findings, we conclude that controlling the patients' blood glucose levels to < or = 120 mg x dl(-1) and at least 5 h fasting should be recommended to decrease myocardial FDG uptake.

Comparison of myocardial F-18 FDG uptake between overnight and non-overnight fasting in non-diabetic healthy subjects

“…No relationship was seen between blood glucose level and myocardial FDG uptake, which is in agreement with a previous report [2]. While de Groot et al [1] reported that a high glucose level (>135 mg/dl) always resulted in absent or minor FDG uptake in the myocardium, of the five subjects in the present study with high blood glucose >135 mg/dl, three (60 %) showed myocardial uptake that was grade 0, one (20 %) had uptake that was grade 1, and one (20 %) had uptake that was grade 2.…”

“…Previous reports have suggested that the degree of myocardial uptake is related to free fatty acid (FFA) and serum glucose levels [1,2]. Feeding may increase the expression of insulin-sensitive glucose transporter (GLUT)-4, which leads to an increase in myocardial FDG uptake.…”

Effectiveness of prolonged fasting 18f-FDG PET-CT in the detection of cardiac sarcoidosis

“…Studies have been performed with short and long fasting periods with variable results; however, the latter did show better suppression. 5,6 To our knowledge, there is no published data on the effectiveness of FDG PET-CT with prolonged, greater than 18 hours of fasting (PF-PET). Accordingly, we retrospectively compared the sensitivity, specificity, and accuracy of PF-PET and Gallium scintigraphy for detection of suspected cardiac sarcoidosis at our institution.…”

Effects of food intake and anesthetic on cardiac imaging and uptake of BMS747158-02 in comparison with FDG

“…Our results are in agreement with the findings in the literature. 10,13,15 Cardiac imaging and uptake of BMS747158-02 were also evaluated in rats under the same fasting condition. In contrast to FDG, heart uptake of BMS747158-02 was similar in fasted and nonfasted rats (Table 2 and Figure 3), indicating that cardiac imaging with this agent is not influenced by food deprivation and altered cardiac glucose uptake and utilization.…”

“…FDG is a glucose analog and heart uptake of FDG has been reported to be affected by factors, such as feeding state and anesthetic used. [10][11][12][13][14][15] BMS747158-02, however, has not been evaluated under these conditions. Thus, this study was to examine the impacts of feeding state and anesthetic on cardiac imaging and uptake of BMS747158-02 in rats in comparison with FDG.…”