title: Suppression of myocardial 18F-FDG uptake with a preparatory "Atkins-style" low-carbohydrate diet.
abstract: OBJECTIVE
  Physiological myocardial uptake of 18F-FDG during positron emission tomography can mask adjacent abnormal uptake in mediastinal malignancy and inflammatory cardiac diseases. Myocardial uptake is unpredictable and variable. This study evaluates the impact of a low-carbohydrate diet in reducing myocardial FDG uptake.
  
  
  METHODS
  Patients attending for clinically indicated oncological FDG PET were asked to have an "Atkins-style" low-carbohydrate diet (less than 3 g) the day before examination and an overnight fast. A total of 120 patients following low-carbohydrate diet plus overnight fast were compared with 120 patients prepared by overnight fast alone. Patients having an Atkins-style diet also completed a diet compliance questionnaire. SUV(max) and SUV(mean) for myocardium, blood pool and liver were measured in both groups.
  
  
  RESULTS
  Myocardial SUV(max) fell from 3.53 ± 2.91 in controls to 1.77 ± 0.91 in the diet-compliant group. 98 % of diet-compliant patients had a myocardial SUV(max) less than 3.6 compared with 67 % of controls. Liver and blood pool SUV(max) rose from 2.68 ± 0.49 and 1.82 ± 0.30 in the control group to 3.14 ± 0.57 and 2.06 ± 0.30.
  
  
  CONCLUSIONS
  An Atkins-style diet the day before PET, together with an overnight fast, effectively suppresses myocardial FDG uptake.
  
  
  CONCLUSIONS
  • Low-carbohydrate diet (LCD) the day before PET suppresses myocardial FDG uptake.                         • LCD before PET increases liver and blood pool SUV                            (                               max                            )                            and                            SUV                            (                               mean                            ).                         • Suppression of myocardial uptake may improve PET imaging of thoracic disease.                                                  • Suppression of myocardial uptake may help imaging cardiac inflammatory disease with PET.
authors.affiliation: Department Radiology & Diagnostic Imaging, University of Alberta Hospitals, 2C2.09 WMC, 8440-112 Street, Edmonton, Alberta, T6G 2B7, Canada. coulden@ualberta.ca
authors.forename: Richard
authors.initials: R
authors.lastname: Coulden
authors.forename: Peter
authors.initials: P
authors.lastname: Chung
authors.forename: Emer
authors.initials: E
authors.lastname: Sonnex
authors.forename: Quazi
authors.initials: Q
authors.lastname: Ibrahim
authors.forename: Conor
authors.initials: C
authors.lastname: Maguire
authors.forename: Jon
authors.initials: J
authors.lastname: Abele
mesh_terms: D000368:Aged; D050528:Diet, Carbohydrate-Restricted; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism*; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics*; D012189:Retrospective Studies
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18