Preparation methods prior to PET/CT scanning that decrease uptake of 18F-FDG by myocardium, brown adipose tissue, and skeletal muscle

Abstract

Background The hypermetabolic environment of the myocardium, brown adipose tissue (BAT), and muscle will have an effect on the diagnostic accuracy of 18F-fluorodeoxyglucose (18F-FDG) positron-emission tomography (PET)/computed tomography (CT). A low carbohydrate, high fat, and protein-permitted diet before PET/CT scanning can reduce the degree of 18F-FDG uptake by the myocardium, brown adipose tissue, and skeletal muscle. Purpose To determine the effect of a low carbohydrate, high fat and protein-permitted diet on 18F-FDG uptake by myocardium, BAT, and muscle during PET/CT. Material and Methods A total of 126 patients who adhered to two meals before PET/CT scanning (that were prepared using a low carbohydrate, high fat, and protein-permitted diet), i.e. the diet group, were compared with 126 patients who fasted for at least 12 h prior to scanning (i.e. the fasting group). The degree of 18F-FDG uptake within the myocardium, BAT, and muscle were stratified into four grades (range, 0–3) with 0 for negligible uptake, and 3 for intense uptake. Correlations between the diet and fasting groups with respect to degree of 18F-FDG uptake within the myocardium, BAT, and muscle were analyzed. Results The degree of 18F-FDG uptake within the myocardium, BAT, and muscle in the diet group was significantly lower compared with the 18F-FDG uptake within myocardium, BAT, and muscle in the fasting group ( P < 0.001, P = 0.001, P < 0.001). Conclusion A low carbohydrate/high fat diet before 18F-FDG injection can suppress uptake of 18F-FDG within the myocardium, BAT, and skeletal muscle.