Optimizing 18F-FDG PET/CT imaging of vessel wall inflammation: the impact of 18F-FDG circulation time, injected dose, uptake parameters, and fasting blood glucose levels

  • Jan Bucerius
  • Venkatesh Mani
  • Colin Moncrieff
  • Josef Machac
  • Valentin Fuster
  • Michael E. Farkouh
  • Ahmed Tawakol
  • James H. F. Rudd
  • Zahi A. FayadEmail author
Original Article



18F-FDG PET is increasingly used for imaging of vessel wall inflammation. However, limited data are available on the impact of methodological variables, i.e. prescan fasting glucose, FDG circulation time and injected FDG dose, and of different FDG uptake parameters, in vascular FDG PET imaging.


Included in the study were 195 patients who underwent vascular FDG PET/CT of the aorta and the carotids. Arterial standardized uptake values (meanSUVmax), target-to-background ratios (meanTBRmax) and FDG blood-pool activity in the superior vena cava (SVC) and the jugular veins (JV) were quantified. Vascular FDG uptake values classified according to the tertiles of prescan fasting glucose levels, the FDG circulation time, and the injected FDG dose were compared using ANOVA. Multivariate regression analyses were performed to identify the potential impact of all variables described on the arterial and blood-pool FDG uptake.


Tertile analyses revealed FDG circulation times of about 2.5 h and prescan glucose levels of less than 7.0 mmol/l, showing a favorable relationship between arterial and blood-pool FDG uptake. FDG circulation times showed negative associations with aortic meanSUVmax values as well as SVC and JV FDG blood-pool activity, but positive correlations with aortic and carotid meanTBRmax values. Prescan glucose levels were negatively associated with aortic and carotid meanTBRmax and carotid meanSUVmax values, but were positively correlated with SVC blood-pool uptake. The injected FDG dose failed to show any significant association with vascular FDG uptake.


FDG circulation times and prescan blood glucose levels significantly affect FDG uptake in the aortic and carotid walls and may bias the results of image interpretation in patients undergoing vascular FDG PET/CT. The injected FDG dose was less critical. Therefore, circulation times of about 2.5 h and prescan glucose levels less than 7.0 mmol/l should be preferred in this setting.


FDG PET FDG dose FDG circulation time Prescan glucose Vessel wall inflammation 



The authors wish to thank Ash Rafique, RT, BS, CNMT, for his assistance with image acquisition. This work was partly supported by the NIHR Cambridge Biomedical Research Centre (J.H.F.R.). Partial support was provided by: NIH/NHLBI R01 HL071021 (Z.A.F.), NIH/NHLBI R01 HL078667 (Z.A.F and M.E.F.) and NIH/NCATS CTSA UL1TR000067 [Imaging Core] (Z.A.F.).

Conflicts of interest



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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Jan Bucerius
    • 1
    • 2
    • 3
    • 4
    • 5
  • Venkatesh Mani
    • 1
    • 2
    • 6
  • Colin Moncrieff
    • 1
    • 2
  • Josef Machac
    • 7
  • Valentin Fuster
    • 6
    • 8
  • Michael E. Farkouh
    • 6
    • 9
  • Ahmed Tawakol
    • 10
  • James H. F. Rudd
    • 11
  • Zahi A. Fayad
    • 1
    • 2
    • 6
    Email author
  1. 1.Translational and Molecular Imaging InstituteIcahn School of Medicine at Mount SinaiNew YorkUSA
  2. 2.Department of RadiologyMount Sinai School of MedicineNew YorkUSA
  3. 3.Department of Nuclear MedicineMaastricht University Medical CenterMaastrichtThe Netherlands
  4. 4.Cardiovascular Research Institute Maastricht (CARIM)Maastricht University Medical CenterMaastrichtThe Netherlands
  5. 5.Department of Nuclear MedicineUniversity Hospital, RWTH AachenAachenGermany
  6. 6.Department of Cardiology, Zena and Michael A. Weiner Cardiovascular Institute and Marie-Josée and Henry R. Kravis Cardiovascular Health CenterMount Sinai School of MedicineNew YorkUSA
  7. 7.Division of Nuclear Medicine, Department of RadiologyMount Sinai School of MedicineNew YorkUSA
  8. 8.The Centro Nacional de Investigaciones Cardiovasculares (CNIC)MadridSpain
  9. 9.Cardiovascular Imaging Clinical Trials UnitMount Sinai School of MedicineNew YorkUSA
  10. 10.Cardiac MR PET CT ProgramMassachusetts General Hospital, Harvard UniversityBostonUSA
  11. 11.Division of Cardiovascular MedicineCambridge UniversityCambridgeUK

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