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Patient preparation for cardiac fluorine-18 fluorodeoxyglucose positron emission tomography imaging of inflammation

  • CME Article Review Article
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Journal of Nuclear Cardiology Aims and scope

Abstract

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 to 18F-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.

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Abbreviations

FDG:

Fluorodeoxyglucose

PET:

Positron emission tomography

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Disclosure

Dr Murthy owns stock in General Electric, Cardinal Health and Mallinckrodt. Drs Osborne, Hulten, Skali, Taqueti, Dorbala, DiCarli and Blankstein have no disclosures or conflicts of interest related to this publication. The opinions and assertions contained herein are the authors’ alone and do not represent the views of the Walter Reed National Military Medical Center, the US Army, or the Department of Defense.

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Authors and Affiliations

  1. Cardiology Division, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA

    Michael T. Osborne MD

  2. 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

    Michael T. Osborne MD, Hicham Skali MD, Viviany R. Taqueti MD, MPH, Sharmila Dorbala MD, MPH, Marcelo F. DiCarli MD & Ron Blankstein MD

  3. Cardiology Service, Division of Medicine, Walter Reed National Military Medical Center and Uniformed Services University of Health Sciences, Bethesda, MD, USA

    Edward A. Hulten MD, MPH

  4. Division of Cardiovascular Medicine, Department of Medicine, University of Michigan, Ann Arbor, MI, USA

    Venkatesh L. Murthy MD, PhD

  5. Divisions of Nuclear Medicine and Cardiothoracic Imaging, Department of Radiology, University of Michigan, Ann Arbor, MI, USA

    Venkatesh L. Murthy MD, PhD

Authors
  1. Michael T. Osborne MD
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  2. Edward A. Hulten MD, MPH
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Corresponding author

Correspondence to Michael T. Osborne MD.

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See related editorial, doi:10.1007/s12350-016-0508-1

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Osborne, M.T., Hulten, E.A., Murthy, V.L. et al. Patient preparation for cardiac fluorine-18 fluorodeoxyglucose positron emission tomography imaging of inflammation. J. Nucl. Cardiol. 24, 86–99 (2017). https://doi.org/10.1007/s12350-016-0502-7

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  • DOI: https://doi.org/10.1007/s12350-016-0502-7

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