High and typical 18F-FDG bowel uptake in patients treated with metformin.
OBJECTIVE
This prospective and bi-centric study was conducted in order to determine the impact of antidiabetic treatments (AD) on (18)F-FDG bowel uptake in type 2 diabetic patients.


METHODS
Fifty-five patients with previously diagnosed and treated type 2 diabetes mellitus (group 1) were divided in two subgroups: AD treatment including metformin (n=32; group 1a) and AD treatment excluding metformin (n=23; group 1b). The 95 patients without diabetes mellitus made up controls (group 2). (18)F-FDG uptake in small intestine and colon was visually graded and semi-quantitatively measured using the maximum standardized uptake value.


RESULTS
(18)F-FDG bowel uptake was significantly increased in AD patients (group 1) as compared to controls (group 2) (p<0.001). Bowel uptake was significantly higher in AD patients including metformin (group 1a) as compared to AD patients excluding metformin (group 1b) (p<0.01), whose bowel uptake was not significantly different from controls (group 2). A metformin treatment was predictive of an increased bowel uptake in the small intestine (odds ratio OR=16.9, p<0.0001) and in the colon (OR=95.3, p<0.0001), independently of the other factors considered in the multivariate analysis. Bowel uptake pattern in the patients treated with metformin was typically intense, diffuse and continuous along the bowel, strongly predominant in the colon, in both the digestive wall and lumen.


CONCLUSIONS
This study emphasizes that metformin significantly increases (18)F-FDG uptake in colon and, to a lesser extent, in small intestine. It raises the question of stopping metformin treatment before an (18)F-FDG PET/CT scan is performed for intra-abdominal neoplasic lesion assessment.
Gontier
Eric
E
Department of Nuclear Medicine, Military Hospital Val-de-Grâce, 74, Bd de Port Royal, 75230, Paris, cedex 05, France. gontierweb@hotmail.fr
Fourme
Emmanuelle
E
Wartski
Myriam
M
Blondet
Cyrille
C
Bonardel
Gerald
G
Le Stanc
Elise
E
Mantzarides
Marina
M
Foehrenbach
Herve
H
Pecking
Alain-Paul
AP
Alberini
Jean-Louis
JL
D016022:Case-Control Studies; D003106:Colon / Q000187:drug effects / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000378:metabolism*; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D006801:Humans; D007004:Hypoglycemic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D007413:Intestinal Mucosa / Q000378:metabolism*; D007421:Intestine, Small / Q000187:drug effects / Q000378:metabolism; D007422:Intestines / Q000187:drug effects*; D008687:Metformin / Q000494:pharmacology / Q000627:therapeutic use*; D014018:Tissue Distribution / Q000187:drug effects