The influence of blood glucose levels on [18F]fluorodeoxyglucose (FDG) uptake in cancer: A pet study in liver metastases from colorectal carcinomas
The influence of blood glucose levels on [18F]fluorodeoxyglucose (FDG) uptake in cancer: A pet study in liver metastases from colorectal carcinomas
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DOI：
10.1177/030089169708300407
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发表时间：
1997-07-01
期刊：
影响因子：
--
通讯作者：
Bombardieri, E
中科院分区：
文献类型：
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作者：
Crippa, F;Gavazzi, C;Bombardieri, E
目的和背景：研究血糖水平对[18F]-2-氟-2-脱氧-D-葡萄糖（FDG）正电子发射断层扫描（PET）检测结直肠癌肝转移和分析肿瘤摄取 FDG 的临床可靠性的影响。方法：在知情同意后，8 例通过 CT 检测到 20 个肝转移瘤（平均大小 31.5 mm；范围 10-75 mm）的患者在禁食条件下接受第一次 FDG-PET 检查，2 天后静脉输注葡萄糖溶液（4 mg/kg/min，持续 2 小时）后接受第二次 FDG-PET 检查。考虑到转移灶的定位和病灶中 FDG 的摄取，对每名患者的两项研究结果进行了比较。使用非动力学方法计算标准化摄取值（SUV）。结果：在禁食条件下，所有 20 个转移灶在 FDG-PET 上均清晰可见。此外，FDG-PET 在 2 名患者中检测到许多未知的肝转移。输注葡萄糖后的血糖水平显着高于空腹条件下的水平，分别为158 +/- 13.8 mg/100 ml（平均值+/- sd）和92.4 +/- 10.2（P < 0.001），并且FDG-PET图像质量明显恶化。 FDG-PET 无法检测到 20 个病灶中的 6 个，另外 10 个病灶定位不太清楚。此外，80%的未知肝转移在葡萄糖负荷后未检测到。转移瘤的 SUV 从空腹条件下的 9.4 +/- 5.7（平均值 +/- 标准差）下降到葡萄糖负荷后的 4.3 +/- 8.3（P < 0.001）。结论：FDG-PET 研究在高血糖条件下可能特别不可靠。因此，进入FDG-PET研究的患者应禁食，并且在后续研究中评估FDG摄取时需要考虑血糖浓度。
Aims and background: To Study the influence of blood glucose levels on the clinical reliability of positron emission tomography (PET) with [18F]-2-fluoro-2-deoxy-D-glucose (FDG) in the detection of liver metastases from colorectal carcinomas and in the analysis of tumor uptake of FDG. Methods: After having given their informed consent, 8 patients with 20 liver metastases (mean size, 31.5 mm; range, 10-75 mm) detected by means of CT were submitted to a first FDG-PET examination under fasting conditions and, 2 days later, to a second FDG-PET examination performed after iv infusion of a glucose solution (4 mg/kg/min for 2 hrs). The results of the two studies were compared in each patient, considering both the localization of the metastases and the FDG uptake in the lesions. A non-kinetic method was used, calculating the Standardized Uptake Value (SUV). Results: All 20 metastases were clearly visible on FDG-PET under fasting conditions. Moreover, in 2 patients FDG-PET detected a number of unknown liver metastases. The blood glucose levels after glucose infusion were significantly higher than the levels under fasting conditions, 158 +/- 13.8 mg/100 ml (mean +/- sd) and 92.4 +/- 10.2, respectively (P < 0.001), and the quality of the FDG-PET images showed a marked deterioration. FDG-PET was unable to detect 6 of the 20 lesions and another 10 lesions were localized less clearly. Moreover, 80% of the unknown liver metastases were not detected after glucose loading. The SUVs of metastases decreased from 9.4 +/- 5.7 (mean +/- sd) under fasting conditions to 4.3 +/- 8.3 after glucose loading (P < 0.001). Conclusions: FDG-PET studies may be particularly unreliable under conditions of high levels of blood glucose. Therefore, patients entering FDG-PET studies should fast, and blood glucose concentration needs to be taken into account when evaluating FDG uptakes in follow-up studies.