Normal veya Normale Yakın PET/BT Görüntülerinde Kan Glukoz Düzeyi ile Dokulardaki FDG Uptake Arasındaki İlişki

Amaç: Bu çalışmanın amacı, normal veya normale yakın PET/BT görüntülerinde dokulardaki 18F-FDG tutulumunun kan glukoz düzeyi ile ilişkisini değerlendirmektir.Gereç ve Yöntemler: Yeni kanser tanı almış ve ilk evreleme amacıyla 18F-FDG PET/BT yapılan hastalar geriye dönük olarak değerlendirildi. Normal veya normale yakın FDG dağılımı olan 65 hasta 47 kadın, 18 erkek çalışmaya dahil edildi. Beyin, kalp, mediasten, pankreas, dalak, iskelet kası ve kemik iliği ortalama standardize uptake değerleri ölçüldü. FDG enjeksiyonundan hemen önce ölçülen kan glukoz düzeyleri değerlendirmede kullanıldı.Bulgular: Kan glukoz düzeyi ile karaciğer ve kas FDG tutulum düzeyleri arasında istatistiksel anlamlı pozitif korelasyon vardı. Beyin FDG tutulumu glukoz düzeyi ile negatif olarak korele idi. Diğer dokulardaki FDG tutulumu ile kan glukoz düzeyi arasında ilişki yoktu. Kan glukoz düzeyi yüksek olan hastalar, normal kan glukoz düzeyi olan hastalardan daha yüksek kas ve daha düşük beyin FDG tutulumu gösterdi.Sonuç: 18F-FDG PET/BT görüntülerinde hipergliseminin normal dokularda etkisi değişkendir. İskelet kası ve beyin en çok etkilenen dokular iken, karaciğer klinik olarak önemsiz şekilde daha düşük oranda etkilenmektedir

Anahtar Kelimeler:

Florodeoksiglukoz, Pozitron emisyon tomografi/bilgisayarlı tomografi, hiperglisemi, kan glukoz

The Relation Between the Blood Glucose Level and the FDG Uptake of Tissues at Normal or Near-Normal PET/CT Imaging

Objective: The aim of this study was to evaluate the relation between the blood glucose level and 18F-FDG uptake in tissues at normal or near-normal PET/CT examinations.Material and Methods: Patients with newly diagnosed cancer who underwent 18F-FDG PET/CT for initial staging were evaluated retrospectively. Sixty five patients 47 female, 18 male with a normal or near normal FDG distribution were included this study. Mean standardized uptake value of the brain, heart, lung, mediastinum, pancreas, liver, spleen, skeletal muscle and bone marrow were calculated. Blood glucose levels measured immediately prior to administration of FDG were used.Results: There was a statistically significant positive correlation between the blood glucose level and liver and muscular FDG uptake. Brain FDG uptake value was negatively correlated with the glucose level. There was no correlation between the blood glucose level and other tissues' FDG uptake values. The patients with increased blood glucose levels showed significantly higher muscular and lower brain FDG uptake compared with patients with normal glucose levels.Conclusion: Effect of hyperglycemia during 18F FDG PET/CT imaging on normal tissues is variable. While skeletal muscle and brain are the most affected tissues, the liver is slightly affected in a clinically insignificant manner

Keywords:

Fluorodeoxyglucose, Positron emission tomography/computerized tomography, hyperglycemia, blood glucose,

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Zasadny KR, Wahl RL. Standardized uptake values of normal tissues at PET with 2-[fluorine-18]-fluoro- 2-deoxy-D-glucose: Variations with body weight and a method for correction. Radiology 1993; 189: 847-50.
Wahl RL, Henry CA, Ethier SP. Serum glucose: Effects on tumor and normal tissue accumulation of 2-[F-18]- fluoro-2-deoxy-d-glucose in rodents with mammary carcinoma. Radiology 1992; 3:643-7.
Lindholm P, Minn H, Leskinen-Kallio S, Bergman J, Ruotsalainen U, Joensuu H. Influence of the blood glucose concentration of FDG uptake in cancer - a PET study. J Nucl Med 1993; 3:1-6.
Langen K-J, Braun U, Rota Kops E, Herzog H, Kuwert T, Nebeling B, Feinendegen LE. The influence of plasma glucose levels on fluorine-18- fluorodeoxyglucose uptake in bronchial carcinomas. J Nucl Med 1993; 3:355-9.
Boellaard R, O’Doherty MJ, Weber WA, Mottaghy FM, Lonsdale MN, Stroobants SG, Oyen WJ, Kotzerke J, Hoekstra OS, Pruim J, Marsden PK, Tatsch K, Hoekstra CJ, Visser EP, Arends B, Verzijlbergen FJ, Zijlstra JM, Comans EF, Lammertsma AA, Paans AM, Willemsen AT, Beyer T, Bockisch A, Schaefer-Prokop C, Delbeke D, Baum RP, Chiti A, Krause BJ. FDG PET and PET/CT: EANM procedure guidelines for tumour PET imaging: Version 1.0. Eur J Nucl Med Mol Imaging 2010;3:181- 200.
Delbeke D, Coleman RE, Guiberteau MJ, Brown ML, Royal HD, Siegel BA, Townsend DW, Berland LL, Parker JA, Hubner K, Stabin MG, Zubal G, Kachelriess M, Cronin V, Holbrook S. Procedure guideline for tumor imaging with 18F-FDG PET/CT 1.0. J Nucl Med 2006; 3:885-95.
Huang SC. Anatomy of SUV. Standardized uptake value. Nucl Med Biol 2000; 27:643-6.
Sprinz C, Zanon M, Altmayer S, Watte G, Irion K, Marchiori E, Hochhegger B. Effects of blood glucose level on 18F fluorodeoxyglucose (18F-FDG) uptake for PET/ CT in normal organs: An analysis on 5623 patients. Sci Rep 2018; 8(1):2126.
Kawasaki K, Ishii K, Saito Y, Oda K, Kimura Y, Ishiwata K. Influence of mild hyperglycemia on cerebral FDG distribution patterns calculated by statistical parametric mapping. Ann Nucl Med 2008; 22(3):191-200.
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(7):1015-20.
Busing KA, Schönberg SO, Brade J, Wasser K. Impact of blood glucose, diabetes, insulin and obesity on standardized uptake values in tumors and healthy organs on FDG PET/CT. Nucl Med Biol 2013; 40:206-13.
Viglianti BL, Wong KK, Wimer SM, Parameswaran A, Nan B, Ky C, Townsend DM, Rubello D, Frey KA, Gross MD. Effect of hyperglycemia on brain and liver 18F-FDG standardized uptake value (FDG SUV) measured by quantitative positron emission tomography (PET) imaging. Biomed Pharmacother 2017; 88:1038-45.
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(6):501-5.
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(1):50.
Kuruva M, Mittal BR, Abrar ML, Kahsyap R, Bhattacharya A. Multivariate analysis of various factors affecting background liver and mediastinal standardized uptake values. Indian J Nucl Med 2012; 27:20-3.
Sprinz C, Altmayer S, Zanon M, Watte G, Irion K, Marchiori E, Hochhegger B. Effects of blood glucose level on 18F-FDG uptake for PET/CT in normal organs: A systematic review. PLoS One 2018; 13(2):e0193140.
Choi Y, Brunken RC, Hawkins RA, Huang SC, Buxton DB, Hoh CK, Phelps ME, Schelbert HR. Factors affecting myocardial 2-(F-18)fluoro-2-deoxy-Dglucose uptake in positron emission tomography studies of normal humans. Eur J Nucl Med 1993;20:308-18.
Opie LH, Hesse B. Radionuclide tracers in the evaluation of resting myocardial ischaemia and viability. Eur J Nucl Med 1997; 24:1183-93.
Sugden MC, Holness MJ, Liu YL, Smith DM, Fryer LG, Kruszynska YT. Mechanisms regulating cardiac fuel selection in hyperthyroidism. Biochem J 1992; 286: 513-7.
de Groot M, Meeuwis AP, Kok PJ, Corstens FH, Oyen WJ. Influence of blood glucose level, age and fasting period on non-pathological FDG uptake in heart and gut. Eur J Nucl Med Mol Imaging 2005; 32:98-101.
Kaneta T, Hakamatsuka T, Takanami K, Yamada T, Takase K, Sato A, Higano S, Kinomura S, Fukuda H, Takahashi S, Yamada S. 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.
Webb RL, Landau E, Klein D, Dipoce J, Volkin D, Belman J, Voutsinas N, Brenner A. Effects of varying serum glucose levels on 18F-FDG biodistribution. Nucl Med Commun 2015; 36:717-21.
Diederichs CG, Staib L, Glatting G, Beger HG, Reske SN. FDG PET: Elevated plasma glucose reduces both uptake and detection rate of pancreatic malignancies. J Nucl Med 1998; 39:1030-33.
Hara T, Higashi T, Nakamoto Y, Suga T, Saga T, Ishimori T, Ishizu K, Kawashima H, Kawase S, Matsumoto K, Togashi K. Significance of chronic marked hyperglycemia on FDG-PET: Is it really problematic for clinical oncologic imaging? Ann Nucl Med 2009; 23(7):657-69.