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Updated: Oct 2, 2025

Determining Glucose Metabolism Kinetics Using 18F-FDG Micro-PET/CT
Published on: May 2, 2017
The detection of infectious endocarditis may be enhanced by a repeat FDG-PET while maintaining patients on a
Marine Germaini1, Caroline Boursier1, François Goehringer2
1Department of Nuclear Medicine and Nancyclotep molecular imaging platform, CHRU-Nancy, Université de Lorraine, 54000, Nancy, France.
Background:
This study aims to determine whether the suppression of myocardial FDG uptake and detection of infectious endocarditis (IE) may be enhanced when FDG-PET is repeated on the next day while maintaining patients on a ketogenic diet in the interim.
Methods:
Seventeen patients with definite IE underwent FDG-PET investigations both after a conventional metabolic preparation (> 12-hour fast after a low-carbohydrate evening meal) and a subsequent 12-hour extension of the low-carbohydrate diet followed by an additional > 12-hour fast.
Results:
Plasma biomarkers showed increased ketogenic metabolism between the two FDG-PET scans. A myocardial FDG uptake persisted on the 1st PET in 9 patients (53%) for whom myocardial FDG uptake decreased significantly on the 2nd PET (SUVmax: 6.05 ± 3.25 vs 4.32 ± 3.47, P = 0.021), resulting in an enhancement in the diagnostic confidence of IE in 6 cases. These enhancements were not documented in the 8 patients exhibiting a total suppression of myocardial FDG uptake on the 1st PET.
Conclusions:
Better suppression of myocardial uptake and enhanced detection of IE may be achieved when an FDG-PET, showing an incomplete suppression of the myocardial FDG uptake, is repeated as soon as the next day, while maintaining patients on a ketogenic diet in the interim.
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