Intravenous furosemide injection during 18F-FDG PET acquisition.
Urinary-system elimination of (18)F-FDG can be mistaken for pathologic uptake. Furosemide helps eliminate this artifact. Unnecessary administration should be avoided. Our approach obviates furosemide administration and other invasive procedures in many cases.


METHODS
Thirty-seven cancer patients referred for PET to evaluate treatment response or suspected recurrence were prospectively studied using whole-body scanning, with (18)F-FDG injected via dorsal hand catheter beforehand. The catheter was left in place to enable injection of furosemide while the patient was inside the scanner. After abdominopelvic scanning, physicians evaluated the need to inject furosemide. Thirty minutes after furosemide injection, another abdominopelvic scan was obtained to detect postinjection urinary tract changes.


RESULTS
Postfurosemide images showed effects due to physiologic elimination in 24 patients (64.9%), of whom 11 patients (45.8%) had more than one inconclusive prefurosemide finding. In 13 patients (35.1%), delayed images confirmed persistent lymph node uptake, including 3 patients (23.1%) with 1 lesion.


CONCLUSIONS
Furosemide injection during scanning reduces artifacts, shortens examinations, and helps avoid invasive procedures.
López-Gandul
Sergi
S
CETIR Grup Mèdic, UNITAT PET, Esplugues de Llobregat, Barcelona, Spain. slopezgandul@cetir.es
Pérez-Moure
Gumer
G
García-Garzón
J R
JR
Soler-Peter
Marina
M
Simó-Perdigó
Marc
M
Lomeña
Francisco
F
D000008:Abdominal Neoplasms / Q000000981:diagnostic imaging*; D004232:Diuretics / Q000008:administration & dosage; D004338:Drug Combinations; D005260:Female; D019788:Fluorodeoxyglucose F18; D005665:Furosemide / Q000008:administration & dosage*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D010386:Pelvic Neoplasms / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
D004232:Diuretics; D004338:Drug Combinations; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D005665:Furosemide