Advertisement

Effect of drugs containing glucose on FDG-PET image quality

  • Shozo OkamotoEmail author
  • Takuya Toyonaga
  • Katsura Matsuzawa
  • Mikiya Aizawa
  • Toshiaki Mouri
  • Youko Suzuki
  • Noriyuki Miyamoto
  • Masayuki Inubushi
Original Article
  • 19 Downloads

Abstract

Objective

Patients often take prescription drugs for various diseases or complications that contain several grams of glucose. However, the effect of these glucose-containing medications on the image quality of F-18 fluorodeoxyglucose positron emission tomography (FDG-PET) has not been established. This study aimed to evaluate the effect of taking drugs containing glucose before an FDG-PET on the PET image quality.

Methods

In total, 736 continuously enrolled patients who underwent FDG-PET were retrospectively analysed. We investigated the total glucose content in the prescription drugs that each patient took during fasting before the FDG injection, and we divided the patients into three groups according to the amount of glucose in their drugs: group A did not take any drugs containing glucose, group B took sugar-coated tablets (containing trace amounts of glucose), and group C took prescription drugs with glucose an ingredient. Visual scores and quantitative variables with standard uptake value (SUV) for the brain, myocardium, blood, liver, and muscle in the FDG-PET images were analysed and statistically compared across the three groups.

Results

In group C, the amount of glucose was 0.63 ± 0.86 g (maximum 4.9 g). For the visual scores, there were no significant differences among the three groups. For the quantitative variables, significant differences were present in the brain SUVmax, muscle SUVmean, brain/blood ratio, brain/liver ratio, and brain/muscle ratio. However, a multivariate analysis showed that the group indicator was not significantly associated with any of the quantitative variables. On the other hand, blood glucose was significantly associated with the visual and quantitative variables. In group C, the correlation coefficient between the amount of glucose and the blood glucose level, the visual scores and the quantitative variables were in the range of − 0.121 to 0.100 and were not significant.

Conclusions

There were no significant differences between glucose-containing medications before FDG-PET and the visual scores and quantitative variables for FDG-PET image. Several grams of glucose in drugs before FDG-PET can be ignored.

Keywords

FDG-PET Glucose SUV Quality 

Notes

Acknowledgements

We thank the radiologic technologists Yuuji Takashiba, Takuya Ito, and Yuuya Tarumi for their excellent technical assistance and PET scanning, the nurses Chihiro Hatakeyama and Kiyomi Hattori, the office work for Hiromi Hoshi. We also thank Makoto Sato and Yasutaka Tsujimura for the synthesis of FDG.

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

References

  1. 1.
    Chen J, Cheong JH, Yun MJ, Kim J, Lim JS, Hyung WJ, et al. Improvement in preoperative staging of gastric adenocarcinoma with positron emission tomography. Cancer. 2005;103:2383–90.CrossRefGoogle Scholar
  2. 2.
    Anderson CD, Rice MH, Pinson CW, Chapman WC, Chari RS, Delbeke D, et al. Fluorodeoxyglucose PET imaging in the evaluation of gallbladder carcinoma and cholangiocarcinoma. J Gastrointest Surg. 2004;8:90–7.CrossRefGoogle Scholar
  3. 3.
    Wakabayashi H, Akamoto S, Yachida S, Okano K, Izuishi K, Nishiyama Y, et al. Significance of fluorodeoxyglucose PET imaging in the diagnosis of malignancies in patients with biliary stricture. EJSO. 2005;31:1175–9.CrossRefGoogle Scholar
  4. 4.
    Kluge R, Schmidt F, Caca K, Barthel H, Hesse S, Georgi P, et al. Positron emission tomography with [18F]Fluoro-2-deoxy-d-glucose for diagnosis and staging of bile duct cancer. Hepatology. 2001;33:1029–35.CrossRefGoogle Scholar
  5. 5.
    Böhm B, Voth M, Geoghegan J, Hellfritzsch H, Petrovich A, Scheele J, et al. Impact of positron emission tomography on strategy in liver resection for primary and secondary liver tumors. J Cancer Res Clin Oncol. 2004;130:266–72.CrossRefGoogle Scholar
  6. 6.
    Hatano E, Ikai I, Higashi T, Teramukai S, Torizuka T, Saga T, et al. Preoperative positron emission tomography withfluorine-18-fluorodeoxyglucose is predictive of prognosis in patients with hepatocellular carcinoma after resection. World J Surg. 2006;30:1736–41.CrossRefGoogle Scholar
  7. 7.
    Shvarts O, Han KR, Seltzer M, Pantuck AJ, Belldegrun AS. Positron emission tomography in urologic oncology. Cancer Control. 2002;9:335–42.CrossRefGoogle Scholar
  8. 8.
    Hillner BE, Siegel BA, Liu D, Shields AF, Gareen IF, Hanna L, et al. Impact of positron emission tomography/computed tomography and positron emission tomography (PET) alone on expected management of patients with cancer: Initial results from the national oncologic PET registry. J Clin Oncol. 2008;26:2155–61.CrossRefGoogle Scholar
  9. 9.
    Kaneta T, Takahashi S, Fukuda H, Arisaka Y, Oriuchi N, Hayashi T, et al. Clinical significance of performing 18F-FDG PET on patients with gastrointestinal stromal tumors: a summary of a Japanese multicenter study. Ann Nucl Med. 2009;23:459–64.CrossRefGoogle Scholar
  10. 10.
    Nakamoto Y, Togashi K, Kaneta T, Fukuda H, Nakajima K, Kitajima K, et al. Clinical value of whole-body FDG-PET for recurrent gastric cancer: a multicenter study. Jpn J Clin Oncol. 2009;39:297–302.CrossRefGoogle Scholar
  11. 11.
    Tateishi U, Hosono A, Makimoto A, Nakamoto Y, Kaneta T, Fukuda H, et al. Comparative study of FDG PET/CT and conventional imaging in the staging of rhabdomyosarcoma. Ann Nucl Med. 2009;23:155–61.CrossRefGoogle Scholar
  12. 12.
    Kitajima K, Murakami K, Kanegae K, Tamaki N, Kaneta T, Fukuda H, et al. Clinical impact of whole body FDG-PET for recurrent biliary cancer: a multicenter study. Ann Nucl Med. 2009;23:709–15.CrossRefGoogle Scholar
  13. 13.
    Delbeke D, Coleman RE, Guiberteau MJ, Brown ML, Royal HD, Siegel BA, et al. Procedure guideline for tumor imaging with 18F-FDG PET/CT 1.0. J Nucl Med. 2006;47:885–95.Google Scholar
  14. 14.
    Boellaard R, Delgado-Bolton R, Oyen WJ, Giammarile F, Tatsch K, Eschner W, et al. European Association of Nuclear Medicine (EANM). FDG PET/CT: EANM procedure guidelines for tumour imaging: version 2.0. Eur J Nucl Med Mol Imaging. 2015;42:328–54.CrossRefGoogle Scholar
  15. 15.
    Hosono M, Saga T, Ito K, Kumita S, Sasaki M, Senda M, et al. Guidelines for clinical use of FDG PET, PET/CT 2012. Jpn J Nucl Med (Kaku Igaku). 2012;49:391–401.Google Scholar
  16. 16.
    Peiro Valgañon V, Alonso Farto JC. Normal blood glucose level and (18)F-FDG PET/CT. Rev Esp Med Nucl Imagen Mol. 2012;31:210–2.Google Scholar
  17. 17.
    Panin VY, Kehren F, Michel C, Casey M. Fully 3-D PET reconstruction with system matrix derived from point source measurements. IEEE Trans Med Imaging. 2006;25:907–21.CrossRefGoogle Scholar
  18. 18.
    Claeys J, Mertens K, D'Asseler Y, Goethals I. Normoglycemic plasma glucose levels affect F-18 FDG uptake in the brain. Ann Nucl Med. 2010;24:501–5.CrossRefGoogle Scholar
  19. 19.
    Kaneta T, Hakamatsuka T, Takanami K, Yamada T, Takase K, Sato A, et al. Evaluation of the relationship between physiological FDG uptake in the heart and age, blood glucose level, fasting period, and hospitalization. Ann Nucl Med. 2006;20:203–8.CrossRefGoogle Scholar
  20. 20.
    Malladi A, Viner M, Jackson T, Mercier G, Subramaniam RM. PET/CT mediastinal and liver FDG uptake: effects of biological and procedural factors. J Med Imaging Radiat Oncol. 2013;57:169–75.CrossRefGoogle Scholar
  21. 21.
    Keramida G, Dizdarevic S, Bush J, Peters AM. Quantification of tumour (18) F-FDG uptake: normalise to blood glucose or scale to liver uptake? Eur Radiol. 2015;25:2701–8.CrossRefGoogle Scholar
  22. 22.
    Lindholm H, Brolin F, Jonsson C, Jacobsson H. The relation between the blood glucose level and the FDG uptake of tissues at normal PET examinations. EJNMMI Res. 2013;3:50.CrossRefGoogle Scholar
  23. 23.
    Sprinz C, Altmayer S, Zanon M, Watte G, Irion K, Marchiori E, et al. Effects of blood glucose level on 18F-FDG uptake for PET/CT in normal organs: a systematic review. PLoS ONE. 2018;13:0193140.CrossRefGoogle Scholar
  24. 24.
    Rabkin Z, Israel O, Keidar Z. Do hyperglycemia and diabetes affect the incidence of false-negative 18F-FDG PET/CT studies in patients evaluated for infection or inflammation and cancer? A Comparative analysis. J Nucl Med. 2010;51:1015–20.CrossRefGoogle Scholar

Copyright information

© The Japanese Society of Nuclear Medicine 2019

Authors and Affiliations

  • Shozo Okamoto
    • 1
    • 2
    Email author
  • Takuya Toyonaga
    • 2
  • Katsura Matsuzawa
    • 2
  • Mikiya Aizawa
    • 2
  • Toshiaki Mouri
    • 2
  • Youko Suzuki
    • 2
  • Noriyuki Miyamoto
    • 1
  • Masayuki Inubushi
    • 3
  1. 1.Department of RadiologyObihiro Kosei HospitalObihiroJapan
  2. 2.Department of RadiologyJapanese Red Cross Kitami HospitalKitamiJapan
  3. 3.Department of Nuclear MedicineKawasaki Medical SchoolKurashikiJapan

Personalised recommendations