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Normoglycemic plasma glucose levels affect F-18 FDG uptake in the brain

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Abstract

Objective

The aim of this study was to investigate whether normoglycemic glucose concentrations interfere with cerebral F-18 FDG uptake.

Methods

The analysis was based on 2 sets of paired PET scans in 94 patients who were in complete metabolic remission after the successful completion of treatment for lymphoma. For these 188 PET scans, 2 subgroups were defined according to the plasma glucose level at the time of scanning. Group 1 contained the PET images that were associated with the lower of both normoglycemic plasma glucose levels, whereas group 2 contained the PET images that were associated with the higher of both plasma glucose levels. SUVs (standard uptake values) in the cerebellum between both groups were compared using paired sample T test. Subsequently, SUVs were normalized to a standard glucose concentration and normalized SUVs were again compared. Further, we calculated the coefficient of variation of SUVs in group 1 and 2 both before and after the normalization step.

Results

Mean plasma glucose level was 86 mg/dL (SD of 9 mg/dL) in group 1 and 97 mg/dL (SD of 10 mg/dL) in group 2. Mean SUV was 3.8 (SD of 1.1) for group 1 and 3.5 (SD of 1.1) for group 2. Mean SUV in group 1 was slightly but statistically significantly higher than the mean SUV in group 2 (p < 0.01). Mean normalized SUV was 3.6 (SD of 1.1) in group 1 and 3.7 (SD of 1.3) in group 2. A paired comparison between normalized SUVs in both groups indicated that there was no statistically significant difference (p < 0.31). The coefficient of variation for the SUVs in group 1 and 2 before normalization was 29 and 30%, respectively. The coefficient of variation for the normalized SUVs in group 1 and 2 was 30 and 34%, respectively.

Conclusions

Our results indicated that plasma glucose levels that are within the normoglycemic range have a small but systematic effect on F-18 FDG uptake in the brain (following an inverse relationship). Normalizing plasma glucose levels to a standard glucose concentration successfully reduced the intra-subject variability of SUV measures. Inter-subject variability, however, remained high suggesting that other factors have an influence as well.

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References

  1. Reivich M, Kuhl D, Wolf A, Greenberg J, Phelps M, Ido T, et al. The [18F] fluorodeoxyglucose method for the measurement of local cerebral glucose utilization in man. Circ Res. 1979;44:127–37.

    CAS  PubMed  Google Scholar 

  2. Phelps ME, Huang SC, Hoffman EJ, Selin C, Sokoloff L, Kuhl DE. Tomographic measurement of local cerebral glucose metabolic rate in humans with (F-18) 2-fluoro-2-deoxy-d-glucose: validation of method. Ann Neurol. 1979;6:371–88.

    Article  CAS  PubMed  Google Scholar 

  3. Thie JA, Smith GT, Hubner KF. 2-deoxy-2-[F-18]fluoro-d-glucose-positron emission tomography sensitivity to serum glucose: a survey and diagnostic applications. Mol Imaging Biol. 2005;7:361–8.

    Article  PubMed  Google Scholar 

  4. Dunn JT, Anthony K, Amiel SA, Marsden PK. Correction for the effect of rising plasma glucose levels on quantification of MR(glc) with FDG-PET. J Cereb Blood Flow Metab. 2009;29:1059–67.

    Article  CAS  PubMed  Google Scholar 

  5. Ishizu K, Sadato N, Yonekura Y, Nishizawa S, Magata Y, Tamaki N, et al. Enhanced detection of brain tumors by [18F] fluorodeoxyglucose PET with glucose loading. J Comput Assist Tomogr. 1994;18:12–5.

    Article  CAS  PubMed  Google Scholar 

  6. Ishizu K, Nishizawa S, Yonekura Y, Sadato N, Magata Y, Tamaki N, et al. Effects of hyperglycemia on FDG uptake in human brain and glioma. J Nucl Med. 1994;35:1104–9.

    CAS  PubMed  Google Scholar 

  7. Buchert R, Santer R, Brenner W, Apostolova I, Mester J, Clausen M, et al. Computer simulations suggest that acute correction of hyperglycaemia with an insulin bolus protocol might be useful in brain FDG PET. Nuklearmedizin. 2009;48:44–54.

    CAS  PubMed  Google Scholar 

  8. Kawasaki K, Ishii K, Saito Y, Oda K, Kimura Y, Ishiwata K. Influence of mild hyperglycemia on cerebral FDG distribution patterns calculated by statistical parametric mapping. Ann Nucl Med. 2008;22:191–200.

    Article  PubMed  Google Scholar 

  9. Boellaard R, O’Doherty MJ, Weber WA, Mottaghy FM, Lonsdale MN, Stroobants SG, et al. FDG PET and PET/CT: EANM procedure guidelines for tumour PET imaging: version 1.0. Eur J Nucl Med Mol Imaging. 2010;37(1):181–200.

    Google Scholar 

  10. Tsuchida T, Sadato N, Nishizawa S, Yonekura Y, Itoh H. Effect of postprandial hyperglycaemia in non-invasive measurement of cerebral metabolic rate of glucose in non-diabetic subjects. Eur J Nucl Med Mol Imaging. 2002;29:248–50.

    Article  PubMed  Google Scholar 

  11. Turcotte E, Leblanc M, Carpentier A, Benard F. Optimization of whole-body positron emission tomography imaging by using delayed 2-deoxy-2-[F-18]fluoro-d-glucose injection following I.V. Insulin in diabetic patients. Mol Imaging Biol. 2006;8:348–54.

    Article  PubMed  Google Scholar 

  12. Seo YS, Chung TW, Kim IY, Bom HS, Min JJ. Enhanced detectability of recurrent brain tumor using glucose-loading F-18 FDG PET. Clin Nucl Med. 2008;33:32–3.

    Article  PubMed  Google Scholar 

  13. Farid K, Sibon I, Fernandez P, Guyot M, Jeandot R, Allard M. Delayed acquisition and hyperglycemia improve brain metastasis detection on F-18 FDG PET. Clin Nucl Med. 2009;34:533–4.

    Article  PubMed  Google Scholar 

  14. Duara R, Gross-Glenn K, Barker WW, Chang JY, Apicella A, Loewenstein D, et al. Behavioral activation and the variability of cerebral glucose metabolic measurements. J Cereb Blood Flow Metab. 1987;7:266–71.

    CAS  PubMed  Google Scholar 

  15. Giordani B, Boivin MJ, Berent S, Betley AT, Koeppe RA, Rothley JM, et al. Anxiety and cerebral cortical metabolism in normal persons. Psychiatry Res. 1990;35:49–60.

    Article  CAS  PubMed  Google Scholar 

  16. Franck G, Salmon E, Poirrier R, Sadzot B, Franco G. Study of regional cerebral glucose metabolism, in man, while awake or asleep, by positron emission tomography. Rev Electroencephalogr Neurophysiol Clin. 1987;17:71–7.

    Article  CAS  PubMed  Google Scholar 

  17. Reivich M, Gur R, Alavi A. Positron emission tomographic studies of sensory stimuli, cognitive processes and anxiety. Hum Neurobiol. 1983;2:25–33.

    CAS  PubMed  Google Scholar 

  18. Gur RC, Gur RE, Resnick SM, Skolnick BE, Alavi A, Reivich M. The effect of anxiety on cortical cerebral blood flow and metabolism. J Cereb Blood Flow Metab. 1987;7:173–7.

    CAS  PubMed  Google Scholar 

  19. Warach S, Gur RC, Gur RE, Skolnick BE, Obrist WD, Reivich M. Decreases in frontal and parietal lobe regional cerebral blood flow related to habituation. J Cereb Blood Flow Metab. 1992;12:546–53.

    CAS  PubMed  Google Scholar 

  20. Hustinx R, Smith RJ, Benard F, Bhatnagar A, Alavi A. Can the standardized uptake value characterize primary brain tumors on FDG-PET? Eur J Nucl Med. 1999;26:1501–9.

    Article  CAS  PubMed  Google Scholar 

  21. Paquet N, Albert A, Foidart J, Hustinx R. Within-patient variability of (18)F-FDG: standardized uptake values in normal tissues. J Nucl Med. 2004;45:784–8.

    CAS  PubMed  Google Scholar 

  22. Wang GJ, Volkow ND, Wolf AP, Brodie JD, Hitzemann RJ. Intersubject variability of brain glucose metabolic measurements in young normal males. J Nucl Med. 1994;35:1457–66.

    CAS  PubMed  Google Scholar 

  23. Westerterp M, Pruim J, Oyen W, Hoekstra O, Paans A, Visser E, et al. Quantification of FDG PET studies using standardised uptake values in multi-centre trials: effects of image reconstruction, resolution and ROI definition parameters. Eur J Nucl Med Mol Imaging. 2007;34:392–404.

    Article  PubMed  Google Scholar 

  24. Boellaard R. Standards for PET image acquisition and quantitative data analysis. J Nucl Med. 2009;50(Suppl 1):11S–20S.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Nuclear Medicine, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium

    Jonas Claeys, Koen Mertens, Yves D’Asseler & Ingeborg Goethals

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  1. Jonas Claeys
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  2. Koen Mertens
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  3. Yves D’Asseler
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  4. Ingeborg Goethals
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Correspondence to Ingeborg Goethals.

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Claeys, J., Mertens, K., D’Asseler, Y. et al. Normoglycemic plasma glucose levels affect F-18 FDG uptake in the brain. Ann Nucl Med 24, 501–505 (2010). https://doi.org/10.1007/s12149-010-0359-9

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  • DOI: https://doi.org/10.1007/s12149-010-0359-9

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