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Suppression of Myocardial 18F-FDG Uptake by Preparing Patients with a High-Fat, Low-Carbohydrate Diet

Gethin Williams1 and Gerald M. Kolodny

1 Both authors: Division of Nuclear Medicine, Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Ave., Boston, MA 02215-5400.


Figure 1
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  		Fig. 1 —Quantitation of minimum standardized uptake value (SUVmin) and maximum standardized uptake value (SUVmax) in patients prepared by fasting of qualitative (visually assessed) 18F-FDG uptake using a Likert scale: 0 = minimal uptake, 1 = mostly minimal or mild uptake, 2 = mostly intense or moderate uptake, and 3 = homogeneously intense.

 

Figure 2
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  		Fig. 2 —Qualitative (visually assessed) 18F-FDG and glucose uptake at time from ingestion of very high-fat, low-carbohydrate, protein-permitted meal to FDG injection.

 

Figure 3
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  		Fig. 3 —Comparison of maximum standardized uptake value (SUVmax) between patients prepared by fasting (n = 101; mean SUVmax ± SD, 8.8 ± 5.7) and by very high-fat, low-carbohydrate, protein-permitted (VHFLCPP) diet (n = 60; SUVmax, 3.9 ± 3.6). P(T ≤ t) one-tail < 0.000001.

 

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  		Fig. 4A —Example of minimal myocardial uptake facilitating definition of mediastinal abnormality in 58-year-old woman with metastatic breast cancer. Lateral (A) and frontal (B) views of maximum-intensity-projection scan from PET study show several metastases close to heart that are clearly delineated as result of suppression of myocardial 18F-FDG uptake.

 

Figure 5
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  		Fig. 4B —Example of minimal myocardial uptake facilitating definition of mediastinal abnormality in 58-year-old woman with metastatic breast cancer. Lateral (A) and frontal (B) views of maximum-intensity-projection scan from PET study show several metastases close to heart that are clearly delineated as result of suppression of myocardial 18F-FDG uptake.

 

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