title: Effects of varying serum glucose levels on 18F-FDG biodistribution.
abstract: OBJECTIVE
  Hyperglycemia has been shown to influence fluorine-18 fluorodeoxyglucose ((18)F-FDG) uptake in tumor cells. Therefore, patients are instructed to fast for 6 h, while maintaining serum glucose levels at an acceptable range. The study was performed to evaluate the effect of fasting blood glucose levels on the biodistribution of (18)F-FDG in various tissues including the liver, heart, bone marrow, skeletal muscle, and tumors.
  
  
  METHODS
  Fingerstick fasting blood glucose is routinely measured on the morning of the procedure. The maximum standardized uptake value (SUV(max)) in the right and left hepatic lobes, left ventricle, sacrum, thigh, and tumor was measured in 229 consecutive patients undergoing (18)F-FDG PET/computed tomography for tumor. Patients were divided into three groups depending on their serum glucose levels: low (<100; n = 53), medium (100-160; n = 149), and high (160-201; n = 27). A retrospective analysis of the relationship between glucose levels and standardized uptake value was performed.
  
  
  RESULTS
  There was a statistically significant increase in the average SUV(max) in the right and left hepatic lobes as glucose levels increased (right lobe P=0.00144; left lobe P = 0.03889). Subsequently, pairwise analysis was performed, revealing a statistically significant increase in SUV(max) in the right hepatic lobe between low-glucose and medium-glucose groups and in both hepatic lobes between low and high groups (P < 0.017). No significant difference was observed in any of the other measured tissues.
  
  
  CONCLUSIONS
  This study shows a directly proportional relationship between blood glucose levels and nonpathologic (18)F-FDG biodistribution in the right and left hepatic lobes. The influence of blood glucose on expected biodistribution patterns, particularly in the liver, should be considered during interpretation.
authors.affiliation: Department of Radiology, Staten Island University Hospital, New York, New York, USA.
authors.forename: Ryan L
authors.initials: RL
authors.lastname: Webb
authors.forename: Elliot
authors.initials: E
authors.lastname: Landau
authors.forename: Daniel
authors.initials: D
authors.lastname: Klein
authors.forename: Jason
authors.initials: J
authors.lastname: DiPoce
authors.forename: Dmitry
authors.initials: D
authors.lastname: Volkin
authors.forename: Jonathan
authors.initials: J
authors.lastname: Belman
authors.forename: Nicholas
authors.initials: N
authors.lastname: Voutsinas
authors.forename: Arnold
authors.initials: A
authors.lastname: Brenner
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D006801:Humans; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics*; D012189:Retrospective Studies; D014018:Tissue Distribution; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D001786:Blood Glucose; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18