Abstract
Objectives
Physiological myocardial uptake of 18F-FDG during positron emission tomography can mask adjacent abnormal uptake in mediastinal malignancy and inflammatory cardiac diseases. Myocardial uptake is unpredictable and variable. This study evaluates the impact of a low-carbohydrate diet in reducing myocardial FDG uptake.
Method
Patients attending for clinically indicated oncological FDG PET were asked to have an “Atkins-style” low-carbohydrate diet (less than 3 g) the day before examination and an overnight fast. A total of 120 patients following low-carbohydrate diet plus overnight fast were compared with 120 patients prepared by overnight fast alone. Patients having an Atkins-style diet also completed a diet compliance questionnaire. SUVmax and SUVmean for myocardium, blood pool and liver were measured in both groups.
Results
Myocardial SUVmax fell from 3.53 ± 2.91 in controls to 1.77 ± 0.91 in the diet-compliant group. 98 % of diet-compliant patients had a myocardial SUVmax less than 3.6 compared with 67 % of controls. Liver and blood pool SUVmax rose from 2.68 ± 0.49 and 1.82 ± 0.30 in the control group to 3.14 ± 0.57 and 2.06 ± 0.30.
Conclusion
An Atkins-style diet the day before PET, together with an overnight fast, effectively suppresses myocardial FDG uptake.
Key Points
• Low-carbohydrate diet (LCD) the day before PET suppresses myocardial FDG uptake.
• LCD before PET increases liver and blood pool SUV max and SUV mean .
• Suppression of myocardial uptake may improve PET imaging of thoracic disease.
• Suppression of myocardial uptake may help imaging cardiac inflammatory disease with PET.
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Coulden, R., Chung, P., Sonnex, E. et al. Suppression of myocardial 18F-FDG uptake with a preparatory “Atkins-style” low-carbohydrate diet. Eur Radiol 22, 2221–2228 (2012). https://doi.org/10.1007/s00330-012-2478-2
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DOI: https://doi.org/10.1007/s00330-012-2478-2