Can you predict myocardial uptake of F-18 fluoro-deoxy-glucose (FDG) from fasting plasma glucose?Positron emission tomography positron emission tomography: see PET scan.
positron emission tomography (PET)
Imaging technique used in diagnosis and biomedical research. (PET) using F-18 fluoro-deoxyglucose (FDG FDG Fluorodeoxyglucose
FDG Fundação de Desenvolvimento Gerencial
FDG Franchise Development Group
FDG Function Dependence Graph
FDG Fraud Detection Group
FDG Functional Dependency Gate
FDG Front des Gaulois
FDG Falling Down Giggling ) has become a very powerful tool for myocardial myocardial /myo·car·di·al/ (-kahr´de-al) pertaining to the muscular tissue of the heart.
pertaining to the muscular tissue of the heart (the myocardium). viability determination. Plasma glucose is usually determined prior to myocardial imaging with FDG. Some centers routinely use insulin-clamp (insulin after a glucose load) while others rely on fasting glucose fasting glucose Fasting blood sugar, fasting plasma glucose Endocrinology Glucose obtained from a Pt who has had nothing–except water by mouth for 8+ hrs; FG is used in evaluating Pts for possible DM Ref range 65-115 mg/dL non-diabetic; 110-140 mg/dL, . The purpose of this investigation was to determine if the fasting glucose can predict myocardial uptake of FDG. This study population included 49 patients (mean age 60 [+ or -] 14 years) who had undergone FDG whole body PET scans PET scan (pĕt) or positron emission tomography (pŏz`ĭtrŏn' ĭmĭsh`ən təmŏg`rəfē) for variety of indications. The mean injected activity of FDG was 18 [+ or -] 2.5 mCi. These images were retrospectively analyzed to determine myocardial uptake of FDG. The LV region of interest was demarcated and average selective uptake value (SUV) was determined and correlated with the fasting plasma glucose levels. The data analysis showed no correlation between fasting glucose and average SUV. The fasting plasma glucose ranged from 50-354 mg/dl (mean of 103 [+ or -] 42). The SUV ranged from 1.14 to 9.71 (mean 2.92 [+ or -] 1.89). A regression coefficient Regression coefficient
Term yielded by regression analysis that indicates the sensitivity of the dependent variable to a particular independent variable. See: Parameter.
regression coefficient of -0.008 indicated no correlation between fasting glucose and average SUV. For further analysis, the patients (pts) were divided into two groups based on plasma glucose. In group A, there were 29 pts with glucose level 50-100, and in group B, there were 20 pts with glucose level 100-354. The mean SUV was 3.22 [+ or -] 2.17 and 2.49 [+ or -] 1.27 in groups A and B, respectively, and the difference was statistically significant (P = 0.03). However, this small difference in SUV is probably clinically insignificant. We conclude that fasting plasma glucose measured prior to myocardial imaging with FDG do not predict myocardial uptake of FDG. We question the usefulness of the practice of using fasting plasma glucose and prefer to use insulin clamp technique, with excellent results.
Amolak Singh, MD, FACP FACP Fellow of the American College of Physicians.
1. Fellow of the American College of Physicians
2. Fellow of the American College of Prosthodontists , FACNM, and Aju Thomas, MD. University of Missouri Health Care, Columbia, MO.