title: Effect of hyperglycemia on brain and liver18F-FDG standardized uptake value (FDG SUV) measured by quantitative positron emission tomography (PET) imaging.
abstract: OBJECTIVE
  Blood glucose is routinely measured prior to18F-fluorodeoxyglucose (FDG) administration in positron emission tomography (PET) imaging to identify hyperglycemia that may affect image quality. In this study we explore the effects of blood glucose levels upon semi-quantitative standardized uptake value (SUV) measurements of target organs and tissues of interest and in particular address the relationship of blood glucose to FDG accumulation in the brain and liver.
  
  
  METHODS
  436 FDG PET/CT consecutive studies performed for oncology staging in 229 patients (226 male) at the Ann Arbor Veterans Administration Healthcare System were reviewed. All patients had blood glucose measured (112.4±34.1mg/dL) prior to injection of 466.2±51.8MBq (12.6±1.4mCi) of FDG. SUV measurements of brain, aortic arch blood-pool, liver, and spleen were obtained at 64.5±10.2min' post-injection.
  
  
  RESULTS
  We found a negative inverse relationship of brain SUV with increasing plasma glucose, levels for both absolute and normalized (either to blood-pool or liver) values. Higher blood glucose levels had a mild effect upon liver and blood-pool SUV. By contrast, spleen SUV was independent of blood glucose, but demonstrated the greatest variability (deviation on linear regression). In contrast to other tissues, liver and spleen SUV normalized to blood-pool SUV were not dependent upon blood glucose levels.
  
  
  CONCLUSIONS
  The effects of hyperglycemia upon FDG uptake in brain and liver, over a range of blood glucose values generally considered acceptable for clinical PET imaging, may have measurable effects on semi-quantitative image analysis.
authors.affiliation: Division of Nuclear Medicine, Department of Radiology, University of Michigan, Ann Arbor, MI, USA; Nuclear Medicine Service, Department of Veterans Affairs Healthcare System, Ann Arbor, MI, USA. Electronic address: bviglia@med.umich.edu.
authors.forename: Benjamin L
authors.initials: BL
authors.lastname: Viglianti
authors.affiliation: Division of Nuclear Medicine, Department of Radiology, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Ka Kit
authors.initials: KK
authors.lastname: Wong
authors.affiliation: Nuclear Medicine Service, Department of Veterans Affairs Healthcare System, Ann Arbor, MI, USA.
authors.forename: Stephanie M
authors.initials: SM
authors.lastname: Wimer
authors.affiliation: Michigan Institute for Clinical and Health Research (MICHR), University of Michigan, Ann Arbor, MI, USA.
authors.forename: Aishwarya
authors.initials: A
authors.lastname: Parameswaran
authors.affiliation: Department of Biostatistics, University of Michigan, School of Public Health, Ann Arbor, MI, USA.
authors.forename: Bin
authors.initials: B
authors.lastname: Nan
authors.affiliation: University of Michigan School of Medicine, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Christy
authors.initials: C
authors.lastname: Ky
authors.affiliation: Department of Drug Discovery and Pharmaceutical Sciences, Medical University of Southern Carolina, USA.
authors.forename: Danyelle M
authors.initials: DM
authors.lastname: Townsend
authors.affiliation: Department of Nuclear Medicine, Radiology, NeuroRadiology, Medical Physics, Clinical Laboratory, Microbiology, Pathology, Santa Maria della Misericordia Hospital, Rovigo, Italy. Electronic address: domenico.rubello@libero.it.
authors.forename: Domenico
authors.initials: D
authors.lastname: Rubello
authors.affiliation: Division of Nuclear Medicine, Department of Radiology, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Kirk A
authors.initials: KA
authors.lastname: Frey
authors.affiliation: Division of Nuclear Medicine, Department of Radiology, University of Michigan, Ann Arbor, MI, USA; Nuclear Medicine Service, Department of Veterans Affairs Healthcare System, Ann Arbor, MI, USA.
authors.forename: Milton D
authors.initials: MD
authors.lastname: Gross
mesh_terms: D001479:Basal Ganglia / Q000000981:diagnostic imaging; D001786:Blood Glucose / Q000378:metabolism; D001921:Brain / Q000000981:diagnostic imaging*; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism*; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000000981:diagnostic imaging*; D016014:Linear Models; D008099:Liver / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D049268:Positron-Emission Tomography / Q000379:methods*
chemical_list: D001786:Blood Glucose; D019788:Fluorodeoxyglucose F18
keywords: (18)F-FDG biodistribution; Alzheimer’s; Hyperglycemia; PERCIST; PET; Quantitative imaging