title: Proposal for an optimized protocol for intravenous administration of insulin in diabetic patients undergoing (18)F-FDG PET/CT.
abstract: The objective of this study was to evaluate the usefulness and impact of insulin administration before an F-FDG PET/computed tomography (CT) examination in diabetic patients in order to propose an optimized protocol that can reduce blood glucose levels without increasing muscular F-FDG uptake. A total of 130 patients underwent an F-FDG PET/CT. Twenty patients had glucose levels greater than 180 mg/dl and received endovenous insulin before F-FDG injection (group 1); 10 patients had glucose levels greater than 160 mg/dl and lower than 200 mg/dl and received no insulin (group 2); 100 patients were euglycemic (group 3). Biodistribution was adequate in 19 of 20 patients in group 1. Values of standardized uptake value in the gluteal muscle were 0.50±0.18 for group 1, 0.48±0.10 for group 2, and 0.49±0.08 for group 3; no significant differences in muscular F-FDG uptake could be found among the three groups. No adverse events were recorded. In conclusion, our protocol has been demonstrated to be safe and effective, with only a minor impact on glucose biodistribution and apparently without affecting PET accuracy.
authors.affiliation: Department of Nuclear Medicine, Poliambulanza Foundation, Brescia, Italy. fedefournier@libero.it
authors.forename: Federico
authors.initials: F
authors.lastname: Caobelli
authors.forename: Claudio
authors.initials: C
authors.lastname: Pizzocaro
authors.forename: Barbara
authors.initials: B
authors.lastname: Paghera
authors.forename: Ugo P
authors.initials: UP
authors.lastname: Guerra
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D003920:Diabetes Mellitus / Q000188:drug therapy*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007275:Injections, Intravenous / Q000379:methods*; D007328:Insulin / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D009132:Muscles / Q000378:metabolism; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D013997:Time Factors; D014018:Tissue Distribution; D014057:Tomography, X-Ray Computed
chemical_list: D001786:Blood Glucose; D007328:Insulin; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18