18F-FDGPET/CT: diabetes and hyperglycaemia
Open accessAbstract
BACKGROUND: Some patients who undergo 18F-FDG PET/CTfor neoplastic or benign disease are also affected by diabetes or hyperglycaemia. We propose different preparation procedures inpatients (pts) with hyperglycaemia (acute, temporary or chronic)or diabetes (type 1 or 2) at the time of the 18F-FDG injection, in order to improve the diagnostic scheduling of 18F-FDG PET/CT. MATERIAL AND METHODS: We evaluated a sample of 13,063 pts, examined in two different PET/CT centres, one with a stationary scanner (94.4%) and the other with a mobile device (5.6%). High blood sugar was present in 1,698 patients (13%) at the time of the 18F-FDG injection (hyperglycaemia was defined as fasting blood glucose > 11.1 mmol/l). We considered all 18F-FDG PET/CT tests performed over a period of 4 years (2006-2009). In the first 2 years (6,236 tests), scheduling was done directly by the administrative secretary. In the next two years, 6,827 pts underwent a preliminary visit to assess the test indications, medical history, and therapy as well as pre-test preparation. We evaluated different preparation protocols for hyperglycaemic or diabetic pts, especially those recommended in the guidelines of the European Association of Nuclear Medicine (EANM) and Society of Nuclear Medicine (SNM). RESULTS: In the four-year period, 713/13,063 patients (5.45%)were rescheduled; of these, 78.8% were rescheduled in the two years before the implementation of our preparation protocols and 21.2% in the next two years.Before the implementation of our preparation protocols, 562 patients (9%) presented occasional, acute or chronic hyperglycaemia (56.7%), or diabetes (43.3%), requiring postponement of the test to a later date. The test was not performed in 17 of 6,236 pts (0.27%) because of blood glucose levels above 11.1 mmol/l for several days, while in 16/6236 pts (0.26%) the18F-FDG injection was performed despite high blood glucose levels, in view of the clinical urgency.After the implementation of the preparation protocols, 2.2% of pts were rescheduled because of occasional, acute or chronic hyperglycaemia (79%), or diabetes (21%); 0.1% of pts did not undergo the test because of chronic high blood glucose levels. Although the administration of insulin is recommended in theEANM and SNM guidelines, in our new preparation procedures experience it was not necessary, because we reduced the numbers of hyperglycaemic pts thanks to screening at the preliminary visit and a subsequent good preparation of the patient before scheduling. CONCLUSIONS: The application of our preparation protocols improves the on-time performance and diagnostic accuracy,and increases patients' compliance.
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A significant and increasing proportion of patients who undergo PET scan are in a hyperglycemic state.
“A significant and increasing proportion of patients who undergo PET scan are in a hyperglycemic state.Diabetes [32,33], medications such as corticosteroids [34,35] or chemotherapy agents [36,37], and anxiety [38] are the leading causes of high blood glucose levels (BGL) in patients undergoing PET-scan.”
From Effect of blood glucose level on standardized uptake value (SUV) in 18F-FDG PET-scan: a systematic review and meta-analysis of 20,807 individual SUV measurements (2019) · cites this paper as [32]
The Material and methods section reports hyperglycaemia in 1,698 of 13,063 PET/CT patients (13%), supporting a significant proportion. The Results section does not establish that the proportion among all PET/CT patients was increasing: its rise from 56.7% to 79% concerns the share of rescheduled patients with hyperglycaemia, while the overall rescheduling rate fell. Page numbers were not provided in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measuredIn a study of 13,063 patients who underwent FDG-PET scan, pre-scan BGL was higher than 200 mg/dl in 1,698 subjects (13%).
“In a study of 13,063 patients who underwent FDG-PET scan, pre-scan BGL was higher than 200 mg/dl in 1698 subjects (13%) [32].”
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Eskian, M., Alavi, A., Khorasanizadeh, M., Viglianti, B. L., Jacobsson, H., Barwick, T. D., Meysamie, A., Yi, S. K., Iwano, S., Bybel, B., et al. (2019) · European Journal of Nuclear Medicine and Molecular Imaging · doi:10.1007/s00259-018-4194-x · Cited by 109 · see citing works
- Authors
- Niccoli-Asabella, A., Iuele, F. I., Merenda, N., Pisani, A. R., Notaristefano, A., & Rubini, G.
- Affiliations
- University of Bari Aldo Moro (IT)
- Corresponding author
- Rubini, Giuseppe
- Venue
- Nuclear Medicine Review
- Publisher
- VM Media SP. zo.o VM Group SK
- Published
- 2013-08-13
- Volume
- 16
- Issue
- 2
- Pages
- 57-61
- ISSN
- 1506-9680 (ISSN-L)
- 1644-4345
- OpenAlex
- W2169423973
- Cited by
- 11
- References
- 24
- Citations by year
- 2025: 2 · 2020: 2 · 2019: 3 · 2018: 1 · 2016: 1 · 2015: 1 · 2014: 1
- FWCI
- 0.77
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- Nuclear Medicine Review (publishedVersion)
- PubMed (publishedVersion)
- CINECA IRIS Institutional Research Information System (University of Bari Aldo Moro) (submittedVersion)
- INFM-OAR (INFN Catania) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Medical Imaging Techniques and Applications
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiopharmaceutical Chemistry and Applications
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Diagnosis and Treatment
- Keywords
- 18F-FDG PET/CT, hyperglycemia, diabetes mellitus, glycemic control, type 1 diabetes, type 2 diabetes, fasting blood glucose, false positives, image quality
- MeSH terms
- Humans, Hyperglycemia, Lung Neoplasms, Tomography, X-Ray Computed, Fluorodeoxyglucose F18, Diabetes Complications, Positron-Emission Tomography, Multimodal Imaging
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