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18F-fluorodeoxyglucose use after cardiac transplant: A comparative study of suppression of physiological myocardial uptake

  • Renata Christian Martins Felix
  • Clécio Maria Gouvea
  • Christiane Cigagna Wiefels Reis
  • Jacqueline Sampaio dos Santos Miranda
  • Ligia Beatriz Chaves Espinoso Schtruk
  • Alexandre Siciliano Colafranceschi
  • Cláudio Tinoco Mesquita
Original Article

Abstract

Background

18F-fluorodeoxyglucose (FDG) has been useful in the evaluation of myocardial inflammatory processes. However, it is challenging to identify them due to physiological 18F-FDG uptake. There are no publications demonstrating the application of FDG in post-transplant rejection in humans yet. The aim of this study is to determine the feasibility of suppression of myocardial FDG uptake in post-transplant patients, comparing three different protocols of preparation.

Methods

Ten patients after heart transplantation were imaged by FDG associated with three endomyocardial biopsies (EMB), scheduled in the first year after the procedure. Before each imaging, patients were randomized to one of three preparations: (1) hyperlipidic-hypoglycemic diet; (2) fasting longer than 12 hours; and (3) fasting associated with intravenous heparin. All patients would undergo the three methods. FDG images were analyzed using visual analysis scores and relative radiotracer cardiac uptake (RRCU).

Results

The suppression rate of radiotracer activity ranged from 55% to 62%. Visual analysis showed that preparation 3 presented less efficacy in the suppression compared to the others. However, RRCU did not show difference between the preparations.

Conclusions

Suppression of physiological myocardial FDG uptake after cardiac transplantation is feasible. The usefulness of heparin in the suppression is unclear.

Keywords

Heart transplant PET 18F-FDG myocardial uptake 

Abbreviations

PET/CT

Positron emission tomography/computed tomography

FDG

Fluorodeoxyglucose

EMB

Endomyocardial biopsy

SPECT/CT

Single-photon emission computerized tomography/computed tomography

MBq

Megabecquerel

mCi

Millicurie

ROI

Region of interest

NAC

Non-attenuation-corrected

CTAC

Computed tomography attenuation correction

Notes

Acknowledgment

Acknowledgement of Grant support: National Institute of Cardiology, Brazil.

Disclosure

The authors have indicated that they have no financial conflict of interest.

Supplementary material

12350_2018_1309_MOESM1_ESM.pptx (2.7 mb)
Supplementary material 1 (PPTX 2736 kb)

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Copyright information

© American Society of Nuclear Cardiology 2018

Authors and Affiliations

  • Renata Christian Martins Felix
    • 1
  • Clécio Maria Gouvea
    • 2
  • Christiane Cigagna Wiefels Reis
    • 2
  • Jacqueline Sampaio dos Santos Miranda
    • 2
  • Ligia Beatriz Chaves Espinoso Schtruk
    • 2
  • Alexandre Siciliano Colafranceschi
    • 2
  • Cláudio Tinoco Mesquita
    • 1
  1. 1.Federal Fluminense UniversityNiteróiBrazil
  2. 2.National Institute of CardiologyRio de JaneiroBrazil

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