Mahsa Eskian1,2, Abass Alavi3,4, MirHojjat Khorasanizadeh1,2, Benjamin L Viglianti5,6, Hans Jacobsson7, Tara D Barwick8,9, Alipasha Meysamie10, Sun K Yi11, Shingo Iwano12, Bohdan Bybel13, Federico Caobelli14, Filippo Lococo15, Joaquim Gea16, Antonio Sancho-Muñoz16, Jukka Schildt17, Ebru Tatcı18, Constantin Lapa19, Georgia Keramida20, Michael Peters21, Raef R Boktor22,23, Joemon John24, Alexander G Pitman25, Tomasz Mazurek26, Nima Rezaei1,2,27. 1. Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran. 2. Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran. 3. University of Pennsylvania, Philadelphia, PA, USA. Abass.Alavi@uphs.upenn.edu. 4. Division of Nuclear Medicine, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA. Abass.Alavi@uphs.upenn.edu. 5. Department of Nuclear Medicine and Molecular Imaging University of Michigan, Ann Arbor, MI, USA. 6. Department of Veterans Affairs Healthcare System, Nuclear Medicine Service, Ann Arbor, MI, USA. 7. Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. 8. Department of Imaging, Imperial College Healthcare NHS Trust, London, England. 9. Department of Surgery and Cancer, Imperial College, London, England. 10. Department of Community and Preventive Medicine, Faculty of Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 11. Department of Radiation Oncology, University of Arizona, Tucson, AZ, USA. 12. Department of Radiology Nagoya University Graduate School of Medicine, Nagoya, Japan. 13. Department of Radiology University of Manitoba, Winnipeg, Canada. 14. Department of Nuclear Medicine, Clinic of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland. 15. Department of Thoracic Surgery, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy. 16. Hospital del Mar - IMIM. CIBERES, ISCiii, Barcelona, Spain. 17. Department of Nuclear Medicine, HUS Medical Imaging Center, Helsinki University Central Hospital, Helsinki, Finland. 18. Department of Nuclear Medicine, Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey. 19. Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany. 20. Department of Nuclear Medicine, Royal Brompton and Harefield Hospital, London, England. 21. Brighton and Sussex University Hospitals, NHS Trust, Brighton, England. 22. Lake Imaging, St. John of God Hospital, Ballarat, VIC, Australia. 23. National Cancer Institute, Cairo University, Giza, Egypt. 24. Superintendent Radiographer & RPS PET Centre, Thomas' Hospital, London, England. 25. University of Notre Dame, Sydney, NSW, Australia. 26. Department of Cardiology, Medical University of Warsaw, Warsaw, Poland. 27. Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Abstract
OBJECTIVES: To evaluate the effect of pre-scan blood glucose levels (BGL) on standardized uptake value (SUV) in 18F-FDG-PET scan. METHODS: A literature review was performed in the MEDLINE, Embase, and Cochrane library databases. Multivariate regression analysis was performed on individual datum to investigate the correlation of BGL with SUVmax and SUVmean adjusting for sex, age, body mass index (BMI), diabetes mellitus diagnosis, 18F-FDG injected dose, and time interval. The ANOVA test was done to evaluate differences in SUVmax or SUVmean among five different BGL groups (< 110, 110-125, 125-150, 150-200, and > 200 mg/dl). RESULTS: Individual data for a total of 20,807 SUVmax and SUVmean measurements from 29 studies with 8380 patients was included in the analysis. Increased BGL is significantly correlated with decreased SUVmax and SUVmean in brain (p < 0.001, p < 0.001,) and muscle (p < 0.001, p < 0.001) and increased SUVmax and SUVmean in liver (p = 0.001, p = 0004) and blood pool (p = 0.008, p < 0.001). No significant correlation was found between BGL and SUVmax or SUVmean in tumors. In the ANOVA test, all hyperglycemic groups had significantly lower SUVs compared with the euglycemic group in brain and muscle, and significantly higher SUVs in liver and blood pool. However, in tumors only the hyperglycemic group with BGL of > 200 mg/dl had significantly lower SUVmax. CONCLUSION: If BGL is lower than 200 mg/dl no interventions are needed for lowering BGL, unless the liver is the organ of interest. Future studies are needed to evaluate sensitivity and specificity of FDG-PET scan in diagnosis of malignant lesions in hyperglycemia.
OBJECTIVES: To evaluate the effect of pre-scan blood glucose levels (BGL) on standardized uptake value (SUV) in 18F-FDG-PET scan. METHODS: A literature review was performed in the MEDLINE, Embase, and Cochrane library databases. Multivariate regression analysis was performed on individual datum to investigate the correlation of BGL with SUVmax and SUVmean adjusting for sex, age, body mass index (BMI), diabetes mellitus diagnosis, 18F-FDG injected dose, and time interval. The ANOVA test was done to evaluate differences in SUVmax or SUVmean among five different BGL groups (< 110, 110-125, 125-150, 150-200, and > 200 mg/dl). RESULTS: Individual data for a total of 20,807 SUVmax and SUVmean measurements from 29 studies with 8380 patients was included in the analysis. Increased BGL is significantly correlated with decreased SUVmax and SUVmean in brain (p < 0.001, p < 0.001,) and muscle (p < 0.001, p < 0.001) and increased SUVmax and SUVmean in liver (p = 0.001, p = 0004) and blood pool (p = 0.008, p < 0.001). No significant correlation was found between BGL and SUVmax or SUVmean in tumors. In the ANOVA test, all hyperglycemic groups had significantly lower SUVs compared with the euglycemic group in brain and muscle, and significantly higher SUVs in liver and blood pool. However, in tumors only the hyperglycemic group with BGL of > 200 mg/dl had significantly lower SUVmax. CONCLUSION: If BGL is lower than 200 mg/dl no interventions are needed for lowering BGL, unless the liver is the organ of interest. Future studies are needed to evaluate sensitivity and specificity of FDG-PET scan in diagnosis of malignant lesions in hyperglycemia.
Entities:
Keywords:
18F-FDG; Blood glucose level; Diabetes mellitus; PET quantification; PET scan; SUV
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