Preparation methods prior to PET/CT scanning that decrease uptake of 18F-FDG by myocardium, brown adipose tissue, and skeletal muscle

Acta Radiol. 2017 Jan;58(1):10-18. doi: 10.1177/0284185116633917. Epub 2016 Mar 2.

Abstract

Background: The hypermetabolic environment of the myocardium, brown adipose tissue (BAT), and muscle will have an effect on the diagnostic accuracy of 18F-fluorodeoxyglucose (18F-FDG) positron-emission tomography (PET)/computed tomography (CT). A low carbohydrate, high fat, and protein-permitted diet before PET/CT scanning can reduce the degree of 18F-FDG uptake by the myocardium, brown adipose tissue, and skeletal muscle.

Purpose: To determine the effect of a low carbohydrate, high fat and protein-permitted diet on 18F-FDG uptake by myocardium, BAT, and muscle during PET/CT.

Material and methods: A total of 126 patients who adhered to two meals before PET/CT scanning (that were prepared using a low carbohydrate, high fat, and protein-permitted diet), i.e. the diet group, were compared with 126 patients who fasted for at least 12 h prior to scanning (i.e. the fasting group). The degree of 18F-FDG uptake within the myocardium, BAT, and muscle were stratified into four grades (range, 0-3) with 0 for negligible uptake, and 3 for intense uptake. Correlations between the diet and fasting groups with respect to degree of 18F-FDG uptake within the myocardium, BAT, and muscle were analyzed.

Results: The degree of 18F-FDG uptake within the myocardium, BAT, and muscle in the diet group was significantly lower compared with the 18F-FDG uptake within myocardium, BAT, and muscle in the fasting group (P < 0.001, P = 0.001, P < 0.001).

Conclusion: A low carbohydrate/high fat diet before 18F-FDG injection can suppress uptake of 18F-FDG within the myocardium, BAT, and skeletal muscle.

Keywords: 18F-fluorodeoxyglucose (18F-FDG); adipose tissue; brown; carbohydrate-restricted; diet; muscles; myocardium; positron emission tomography (PET).

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adipose Tissue, Brown / metabolism*
  • Diet, Carbohydrate-Restricted*
  • Diet, High-Fat*
  • Dietary Carbohydrates / metabolism
  • Dietary Fats / metabolism
  • Dietary Proteins / metabolism*
  • Fasting / metabolism
  • Female
  • Fluorodeoxyglucose F18 / pharmacokinetics*
  • Humans
  • Male
  • Metabolic Clearance Rate
  • Middle Aged
  • Muscle, Skeletal / metabolism*
  • Myocardium / metabolism*
  • Organ Specificity
  • Positron Emission Tomography Computed Tomography / methods
  • Radiopharmaceuticals / pharmacokinetics
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Tissue Distribution

Substances

  • Dietary Carbohydrates
  • Dietary Fats
  • Dietary Proteins
  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18