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Additional Heparin Preadministration Improves Cardiac Glucose Metabolism Suppression over Low-Carbohydrate Diet Alone in 18 F-FDG PET Imaging

2015; Society of Nuclear Medicine and Molecular Imaging; Volume: 57; Issue: 4 Linguagem: Inglês

10.2967/jnumed.115.166884

1535-5667

Asbjørn M. Scholtens, Hein J. Verberne, Ricardo P.J. Budde, Marnix G. E. H. Lam,

Infective Endocarditis Diagnosis and Management

Adequate suppression of cardiac glucose metabolism increases the interpretability and diagnostic reliability of (18)F-FDG PET studies performed to detect cardiac inflammation and infection. There are no standardized guidelines, though prolonged fasting (>6 h), carbohydrate-restricted diets, fatty meals, and heparin loading all have been proposed. The aim of this study was to compare the 3 preparatory protocols used in our institution.(18)F-FDG PET scans were selected and grouped according to 3 preparatory protocols (50 consecutive scans per group): 6-h fast (group 1), low-carbohydrate diet plus 12-h fast (group 2), and low-carbohydrate diet plus 12-h fast plus intravenous heparin preadministration (50 IU/kg) (group 3). Consecutive scans were retrospectively included from time frames during which the particular protocol was used. Group 1 included oncologic indications, and groups 2 and 3 infection or inflammation detection. Cardiac segments for which inflammation or infection foci had been confirmed on other imaging modalities were excluded from the analysis. (18)F-FDG uptake in normal myocardium was scored according to a scale ranging from 0 (uptake less than that in left ventricle blood pool) to 4 (diffuse uptake greater than that in liver). Adequate suppression was defined as uptake less than that in liver and without any focus (scores 0-2).Adequate suppression differed significantly between groups: 28% in group 1, 54% in group 2, and 88% in group 3 (P< 0.0001 for all comparisons).Single-dose heparin administration before (18)F-FDG PET in addition to a low-carbohydrate diet significantly outperforms a low-carbohydrate diet alone in adequately suppressing cardiac glucose metabolism.