Patient preparation for cardiac fluorine-18 fluorodeoxyglucose positron emission tomography imaging of inflammation.
Although the number of clinical applications for fluorine-18 fluorodeoxyglucose (18F-FDG) cardiac positron emission tomography (PET) has continued to grow, there remains a lack of consensus regarding the ideal method of suppressing normal myocardial glucose utilization for image optimization. This review describes various patient preparation protocols that have been used as well as the success rates achieved in different studies. Collectively, the available literature supports using a high-fat, no-carbohydrate diet for at least two meals with a fast of 4-12 hours prior to18F-FDG PET imaging and suggests that isolated fasting for less than 12 hours and supplementation with food or drink just prior to imaging should be avoided. Each institution should adopt a protocol and continuously monitor its effectiveness with a goal to achieve adequate myocardial suppression in greater than 80% of patients.
Cardiology Division, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. mosborne@partners.org.|Non-Invasive Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA, 02115, USA. mosborne@partners.org.
Michael T
MT
Osborne
Cardiology Service, Division of Medicine, Walter Reed National Military Medical Center and Uniformed Services University of Health Sciences, Bethesda, MD, USA.
Edward A
EA
Hulten
Division of Cardiovascular Medicine, Department of Medicine, University of Michigan, Ann Arbor, MI, USA.|Divisions of Nuclear Medicine and Cardiothoracic Imaging, Department of Radiology, University of Michigan, Ann Arbor, MI, USA.
Venkatesh L
VL
Murthy
Non-Invasive Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA, 02115, USA.
Hicham
H
Skali
Non-Invasive Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA, 02115, USA.
Viviany R
VR
Taqueti
Non-Invasive Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA, 02115, USA.
Sharmila
S
Dorbala
Non-Invasive Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA, 02115, USA.
Marcelo F
MF
DiCarli
Non-Invasive Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA, 02115, USA.
Ron
R
Blankstein
D057791:Cardiac Imaging Techniques / Q000379:methods* / Q000592:standards; D050528:Diet, Carbohydrate-Restricted / Q000379:methods*; D005215:Fasting; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007089:Image Enhancement / Q000379:methods* / Q000592:standards; D009205:Myocarditis / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography / Q000379:methods* / Q000592:standards; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
PET imaging; fluorodeoxyglucose (FDG); inflammation; metabolism