Abstract
Objective
The present study aimed to investigate the effect of 18F-fluorodeoxyglucose (FDG) extravasation on the time taken for tumoral uptake to reach a plateau.
Methods
For the animal experiment, FDG extravasation was conducted in the tails of HCT116 tumor-bearing xenograft mice models in three groups (no extravasation, 40 % extravasation, and 80 % extravasation; n = 5, each). Dynamic positron emission tomography (PET) images were acquired over a period of 2 h following injection. Time–activity curves for FDG in the tails and tumors were calculated. For the clinical experiment, 22 patients (male:female, 14:8; age range, 70.8 ± 9.2 years) were subjected to PET/computed tomography (PET/CT) 1 h after the injection of FDG. The inclusion criteria were as follows: (1) submitted to both whole-body and subsequent regional scanning; (2) entire extravasation activity visualized in the whole-body images; (3) tumor visualized on both whole-body and additional regional images; and (4) status of tumor either confirmed by biopsy or clinically suspected for malignancy. The standardized uptake values (SUVs) of the tumors (on the whole-body and additional PET images) and extravasation sites were recorded.
Results
There were no significant differences in the time taken for tumoral uptake to reach a plateau and that to reach minimum activity at the extravasation site among the three groups of mice. However, the mean tumoral activity and activity at the extravasation site were negatively correlated at 1 h post-injection. According to the clinical PET findings, the differences in SUV between the whole-body and regional images were not significantly correlated with the interval between injection of FDG and start of whole-body scanning, interval between the start of whole-body scanning and start of regional scanning, extravasation volume, maximum SUV of the extravasation site, or total activity at the extravasation site.
Conclusions
The time taken for tumoral uptake to reach a plateau is not affected by extravasation, even at extensive degrees. Thus, in routine practice, the imaging time of approximately 60 min post-injection need not be modified even if extravasation is identified. However, tumor SUV may be underestimated in cases of extravasation.
Similar content being viewed by others
References
Pitman AG, Binns DS, Ciavarella F, Hicks RJ. Inadvertent 2-deoxy-2-[18F]fluoro-d-glucose lymphoscintigraphy: a potential pitfall characterized by hybrid PET-CT. Mol Imaging Biol. 2002;4:276–8.
Chiang SB, Rebenstock A, Guan L, Burns J, Alavi A, Zhuang H. Potential false-positive FDG PET imaging caused by subcutaneous radiotracer infiltration. Clin Nucl Med. 2003;28:786–8.
Manohar K, Agrawal K, Bhattacharya A, Mittal BR. New axillary lymph nodal F-18 fluoro-deoxy glucose uptake in an interim positron emission tomography scan—not always a sign of disease progression. Indian J Nucl Med. 2011;26:192–3.
Wagner T, Brucher N, Julian A, Hitzel A. A false-positive finding in therapeutic evaluation: hypermetabolic axillary lymph node in a lymphoma patient following FDG extravasation. Nucl Med Rev Cent East Eur. 2011;14:109–11.
Sonoda LI, Ghosh-Ray S, Sanghera B, Dickson J, Wong WL. FDG injection site extravasation: potential pitfall of misinterpretation and missing metastases. Clin Nucl Med. 2012;37:1115–6.
Quantitative FDG-PET Technical Committee. UPICT oncology FDG-PET CT protocol. Quantitative Imaging Biomarkers Alliance. http://qibawiki.rsna.org/images/d/de/UPICT_Oncologic_FDG-PETCTProtocol_6-07-13.pdf. Accessed 28 Mar 2016.
Osman MM, Muzaffar R, Altinyay ME, Teymouri C. FDG dose extravasations in PET/CT: frequency and impact on SUV measurements. Front Oncol. 2011;1:41.
Silva-Rodriguez J, Aguiar P, Sanchez M, Mosquera J, Luna-Vega V, Cortes J, et al. Correction for FDG PET dose extravasations: Monte Carlo validation and quantitative evaluation of patient studies. Med Phys. 2014;41:052502.
Lasnon C, Dugue AE, Briand M, Dutoit S, Aide N. Quantifying and correcting for tail vein extravasation in small animal PET scans in cancer research: is there an impact on therapy assessment? EJNMMI Res. 2015;5:61.
Lowe VJ, DeLong DM, Hoffman JM, Coleman RE. Optimum scanning protocol for FDG-PET evaluation of pulmonary malignancy. J Nucl Med. 1995;36:883–7.
Boellaard R. Standards for PET image acquisition and quantitative data analysis. J Nucl Med. 2009;50(Suppl 1):11S–20S.
Ho D, Zhao X, Gao S, Hong C, Vatner DE, Vatner SF. Heart rate and electrocardiography monitoring in mice. Curr Protoc Mouse Biol. 2011;1:123–39.
Wahl RL, Jacene H, Kasamon Y, Lodge MA. From RECIST to PERCIST: evolving considerations for PET response criteria in solid tumors. J Nucl Med. 2009;50(Suppl 1):122S–50S.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
None to declare.
Research involving human participants and/or animals
This study was performed in accordance with the Helsinki Declaration and was approved by the Institutional Review Board of Asan Medical Center (S2016-0178). Each procedure and animal experiment followed regulations set forth by the Institutional Animal Care and Use Committee (IACUC) at the Asan Medical Center.
Informed consent
Informed consent was waived by the Institutional Review Board of Asan Medical Center.
Rights and permissions
About this article
Cite this article
Lee, J.J., Chung, J.H. & Kim, SY. Effect of 18F-fluorodeoxyglucose extravasation on time taken for tumoral uptake to reach a plateau: animal and clinical PET analyses. Ann Nucl Med 30, 525–533 (2016). https://doi.org/10.1007/s12149-016-1090-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12149-016-1090-y