Effect of hyperglycemia on brain and liver 18F-FDG standardized uptake value (FDG SUV) measured by quantitative positron emission tomography (PET) imaging
Open accessAbstract
Purpose Blood glucose is routinely measured prior to 18 F-fluorodeoxyglucose (FDG) administration in positron emission tomography (PET) imaging to identify hyperglycemia that may affect image quality. In this study we explore the effects of blood glucose levels upon semi-quantitative standardized uptake value (SUV) measurements of target organs and tissues of interest and in particular address the relationship of blood glucose to FDG accumulation in the brain and liver.Methods 436 FDG PET/CT consecutive studies performed for oncology staging in 229 patients (226 male) at the Ann Arbor Veterans Administration Healthcare System were reviewed. All patients had blood glucose measured (112.4±34.1mg/dL) prior to injection of 466.2±51.8MBq (12.6±1.4mCi) of FDG. SUV measurements of brain, aortic arch blood-pool, liver, and spleen were obtained at 64.5±10.2min' post-injection.Results We found a negative inverse relationship of brain SUV with increasing plasma glucose, levels for both absolute and normalized (either to blood-pool or liver) values. Higher blood glucose levels had a mild effect upon liver and blood-pool SUV. By contrast, spleen SUV was independent of blood glucose, but demonstrated the greatest variability (deviation on linear regression). In contrast to other tissues, liver and spleen SUV normalized to blood-pool SUV were not dependent upon blood glucose levels.Conclusion The effects of hyperglycemia upon FDG uptake in brain and liver, over a range of blood glucose values generally considered acceptable for clinical PET imaging, may have measurable effects on semi-quantitative image analysis.
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Several studies suggested that the blood pool is a more optimal and stable reference tissue than the liver, as it is much less dependent than the liver on glycemia and other variables.
“Several studies suggested that the blood pool is a more optimal and stable reference tissue than the liver,[1,3,25,39,41] as it is much less dependent than the liver on glycemia and other variables.[10]”
From Intrapatient variability of 18F-FDG uptake in normal tissues (2022) · cites this paper as [10]
The Results and Discussion report that blood-pool SUV had less overall variability than liver SUV, including variability associated with glucose and patient-specific factors. But the Discussion says the glucose effects on blood and liver were not statistically different, so the claim that blood pool is much less dependent on glycemia overstates this source. (LLM, conf=0.87)
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Regional differences in the reduction of cerebral FDG uptake induced by the ketogenic dietPreprint
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- Authors
- Viglianti, B. L., Wong, K. K., Wimer, S. M., Parameswaran, A., Nan, B., Ky, C., Townsend, D. M., Rubello, D., Frey, K. A., & Gross, M. D.
- Affiliations
- University of Michigan (US)
- VA Ann Arbor Healthcare System (US)
- Medical University of South Carolina (US)
- Ospedale Santa Maria della Misericordia di Rovigo (IT)
- Corresponding author
- Viglianti, Benjamin L.
- Rubello, Domenico
- Venue
- Biomedicine & Pharmacotherapy
- Publisher
- Elsevier BV
- Published
- 2017-04
- Volume
- 88
- Pages
- 1038-1045
- ISSN
- 0753-3322 (ISSN-L)
- PMC
- PMC5553544
- OpenAlex
- W2587668340
- Cited by
- 48
- References
- 23
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 5 · 2023: 6 · 2022: 6 · 2021: 2 · 2020: 9 · 2019: 4 · 2018: 9 · 2017: 1
- FWCI
- 4.82
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- Locations
- Biomedicine & Pharmacotherapy (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- Siemens Medical Solutions USA
- National Institutes of Health (UL1TR002240)
- National Institute of General Medical Sciences (P20GM103542)
- National Center for Research Resources (P20RR024485)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Medical Imaging Techniques and Applications
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Diagnosis and Treatment
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiopharmaceutical Chemistry and Applications
- Keywords
- hyperglycemia, blood glucose, 18F-FDG PET, PET image quality
- MeSH terms
- Basal Ganglia, Blood Glucose, Brain, Female, Humans, Hyperglycemia, Liver, Male, Middle Aged, Multivariate Analysis, Linear Models, Fluorodeoxyglucose F18, Positron-Emission Tomography
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