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Administration of unfractionated heparin with prolonged fasting could reduce physiological 18F-fluorodeoxyglucose
Atsuro Masuda1, Masanao Naya2, Osamu Manabe1
1Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Insights
Unfractionated heparin (UFH) combined with prolonged fasting effectively suppresses physiological 18F-fluorodeoxyglucose (FDG) uptake in the heart. This method aids in the accurate diagnosis of cardiac diseases and tumors.
Area of Science:
- Cardiology
- Nuclear Medicine
- Medical Imaging
Background:
- Physiological 18F-fluorodeoxyglucose (FDG) uptake in the heart can impede the diagnosis of cardiac inflammatory diseases.
- Unfractionated heparin (UFH) may reduce myocardial FDG uptake by altering metabolism.
Purpose of the Study:
- To evaluate the efficacy of unfractionated heparin (UFH) in suppressing physiological cardiac FDG uptake.
- To determine if UFH administration improves diagnostic accuracy for cardiac conditions.
Main Methods:
- Compared myocardial FDG uptake in patients with varying fasting durations ( <18h vs. >18h) and those administered UFH after fasting (>18h).
- Measured free fatty acid, triglyceride, insulin, and blood glucose levels post-UFH administration.
- Assessed FDG uptake visually and via maximum standardized uptake value (SUVmax).
Main Results:
- UFH administration increased free fatty acid levels, with no significant changes in glucose or insulin.
- FDG uptake decreased significantly in the UFH group (22%) compared to shorter fasting (69%) or longer fasting (38%) groups.
- SUVmax was significantly lower in the UFH group, indicating reduced physiological cardiac FDG uptake.
Conclusions:
- Both prolonged fasting (>18h) and UFH administration effectively suppress physiological cardiac FDG uptake.
- This combined approach offers a valuable method for detecting inflammatory cardiac diseases and tumors using FDG PET/CT.
Background:
The physiological uptake of 18F-fluorodeoxyglucose (FDG) in the heart often interferes with the accurate diagnosis of inflammatory cardiac diseases (CDs). Unfractionated heparin (UFH) administration may suppress its uptake through the alteration of myocardial metabolism.
Purpose:
To clarify the effectiveness of UFH administration to suppress the physiological FDG uptake in the heart.
Material And Methods:
The physiological FDG uptake in the heart was compared among 178 patients who fasted less than 18 h, 37 patients who fasted more than 18 h, and 64 patients who fasted more than 18 h and were administered UFH (UFH-CD group) prior to FDG PET/CT. Free fatty acid (FFA), triglyceride, insulin, and blood glucose levels were measured after UFH administration. Myocardial FDG uptake was evaluated by visual assessment and on the basis of maximum standardized uptake value (SUVmax).
Results:
In the UFH-CD group, the FFA level increased 15 min after UFH administration (P < 0.01). Blood glucose and insulin levels remained unchanged (P = NS). FDG physiological uptake was observed in 69% of the patients who fasted less than 18 h, 38% of the patients fasted more than 18 h, and 22% of the UFH-CD group (P < 0.01 for trend). SUVmax decreased in the UFH-CD group compared with the patients who fasted less than 18 h (P < 0.01) and the patients who fasted more than 18 h (P = 0.029).
Conclusion:
UFH administration and fasting more than 18 h could effectively suppress FDG physiological uptake in the heart and can be a useful method of detecting inflammatory CDs and tumors.
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