Long fasting is effective in inhibiting physiological myocardial 18F-FDG uptake and for evaluating active lesions of cardiac sarcoidosis.
Long fasting is effective in inhibiting physiological myocardial 18F-FDG uptake and for evaluating active lesions of cardiac sarcoidosis.
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DOI：
10.1186/2191-219x-4-1
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发表时间：
2014-01-02
期刊：
影响因子：
3.2
通讯作者：
Hiroe M
中科院分区：
文献类型：
--
作者：
Morooka M;Moroi M;Uno K;Ito K;Wu J;Nakagawa T;Kubota K;Minamimoto R;Miyata Y;Okasaki M;Okazaki O;Yamada Y;Yamaguchi T;Hiroe M
氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）是一种很有前途的方式来检测活动性病变的心脏结节病（CS）。然而，由于心肌细胞的代谢变化，确定心肌中的18F-FDG摄取是否是生理性的具有挑战性。尽管已经提出了抑制生理性心肌18F-FDG摄取的方法，但不存在标准方法。因此，本研究旨在比较18小时禁食（长时间禁食（LF））与肝素负荷加12小时禁食（HEP）在18 F-FDG PET扫描前的效果。我们分析了LF和HEP对健康受试者（HEP组18例，LF组19例）和已知或疑似CS患者（HEP组96例，LF组69例）生理性心肌18F-FDG摄取抑制的影响。在CS中，评价了心肌中18F-FDG的低摄取。采用四点视觉量表评估心肌18F-FDG摄取与肝脏摄取的比较（1例较低，2例相似，3例略高，4例明显较高）。正常对照组LF和HEP心肌18F-FDG摄取分别为1.68 ± 1.06和3.17 ± 1.16（p < 0.0001），CS患者LF和HEP心肌18F-FDG摄取分别为1.48 ± 0.99和2.48 ± 1.33（p < 0.0001）。Logistic回归和回归树显示LF抑制心肌18F-FDG摄取最有效。此外，静脉注射18F-FDG时的血清游离脂肪酸水平是可能的生物标志物。LF可有效抑制心肌18F-FDG摄取，因此，LF可用于评价18F-FDG PET显像中CS活动性病变。
F-fluorodeoxyglucose (FDG) positron emission tomography (PET) is a promising modality for detecting active lesions of cardiac sarcoidosis (CS). However, determining whether 18F-FDG uptake in the myocardium is physiological is challenging due to metabolic shift in myocardial cells. Although methods for inhibiting physiological myocardial 18F-FDG uptake have been proposed, no standard methods exist. This study therefore aimed to compare the effect of an 18-h fast (long fasting (LF)) with heparin loading plus a 12-h fast (HEP) before 18F-FDG PET scan. We analyzed the effects of LF and HEP on the inhibition of physiological myocardial 18F-FDG uptake in healthy subjects (18 in HEP and 19 in LF) and in patients with known or suspected CS (96 in HEP and 69 in LF). In CS, the lower uptake of 18F-FDG in the myocardium was evaluated. A visual four-point scale was used to assess myocardial 18F-FDG uptake in comparison with hepatic uptake (1 lower, 2 similar, 3 somewhat higher, 4 noticeably higher). Myocardial 18F-FDG uptake was 1.68 ± 1.06 in LF and 3.17 ± 1.16 in HEP in healthy subjects (p < 0.0001), whereas it was 1.48 ± 0.99 in LF and 2.48 ± 1.33 in HEP in CS patients (p < 0.0001). Logistic regression and regression trees revealed the LF was the most effective in inhibiting myocardial 18F-FDG uptake. In addition, serum free fatty acid levels on intravenous 18F-FDG injection were a possible biomarker. LF is effective in inhibiting myocardial 18F-FDG uptake, and consequently, it could be useful for evaluating active lesions of CS in 18F-FDG PET images.