Clearance of the high intestinal 18F-FDG uptake associated with metformin after stopping the drug
Clearance of the high intestinal 18F-FDG uptake associated with metformin after stopping the drug
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DOI：
10.1007/s00259-009-1330-7
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发表时间：
2010-05-01
影响因子：
9.1
通讯作者：
Ozpacaci, Tevfik
中科院分区：
文献类型：
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作者：
Ozulker, Tamer;Ozulker, Filiz;Ozpacaci, Tevfik
本研究旨在确定在F-18-FDG PET/CT显像前中断二甲双胍是否可以防止该药引起的F-18-FDG在肠道的摄取增加。本研究包括41例已知的2型糖尿病患者，他们被转介到我科评估各种肿瘤疾病。患者接受了两次F-18-FDG PET/CT扫描，第一次是在他们服用二甲双胍时，第二次是在他们停止服用二甲双胍后。在第二次研究开始前3天，停用二甲双胍，不服用任何其他口服降糖药物，必要时用胰岛素调节血糖水平，使其保持在5.55-8.33 mmol/l范围内。通过记录不同肠段的最大标准化摄取值（SUVmax），以四分制和半定量方式对FDG摄取进行视觉分级。采用配对样本t检验方法确定停药前后PET/CT扫描中SUVmax测量值与肠道代谢活性视觉分析评分之间是否存在显著差异。在患者停用二甲双胍后，在肠段观察到弥漫性和强烈的F-18-FDG摄取，并且在PET/CT扫描中，结肠活性在视觉和半定量上均显著降低（p < 0.05）。小肠活性明显降低（p < 0.05），但半定量测量显示十二指肠和空肠的SUVmax值未明显降低（p < 0.05）。二甲双胍导致肠道内F-18-FDG摄取增加，在PET/CT研究前停止二甲双胍可显著减少这种不必要的摄取，特别是在结肠中，有助于解释从腹部获得的图像并防止病变闭塞。
This study was done to determine whether interruption of metformin before F-18-FDG PET/CT imaging could prevent the increased F-18-FDG uptake in the intestine caused by this drug.Included in the study were 41 patients with known type 2 diabetes mellitus who were referred to our department for evaluation of various neoplastic diseases. Patients underwent two F-18-FDG PET/CT scans, the first while they were on metformin and the second after they had stopped metformin. They stopped metformin and did not take any other oral antidiabetic medication starting 3 days before the second study and their blood glucose level was regulated with insulin when necessary to keep it within the range 5.55-8.33 mmol/l. FDG uptake was graded visually according to a four-point scale and semiquantitatively by recording the maximum standardized uptake value (SUVmax) in different bowel segments. A paired-samples t-test method was used to determine whether there was a significant difference between SUVmax measurements and visual analysis scores of the metabolic activity of the bowel in the PET/CT scans before and after stopping metformin.Diffuse and intense F-18-FDG uptake was observed in bowel segments of patients, and the activity in the colon was significantly decreased both visually and semiquantitatively in PET/CT scans performed after patients stopped metformin (p < 0.05). There was a statistically significant decrease in activity in the small intestine on visual analysis (p < 0.05), but semiquantitative measurements did not show a significant decrease in the SUVmax values in the duodenum or jejunum (p > 0.05).Metformin causes an increase in F-18-FDG uptake in the bowel and stopping metformin before PET/CT study significantly decreased this unwanted uptake, especially in the colon, facilitating the interpretation of images obtained from the abdomen and preventing the obliteration of lesions.