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• W2278752803 endingPage "1967" @default.
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• W2278752803 abstract "1967 Objectives Since unintended physiological FDG uptake can mask pathological FDG uptake in the myocardium and adjacent structure, fasting more than 6 hours is generally recommended. However, it is not uncommon to notice FDG uptake in the myocardium even after overnight fasting. In this study, we investigated the effect of underlying physiology related to fasting such as endogenous gluconeogenesis in the liver on myocardial FDG uptake. Methods A total of 305 patients with F-18 FDG PETCT were prospectively included. Patient history was asked for diabetes history and any diabetes medication. Out of the 305 patients, 62 patients had diabetes and were on metformin, an inhibitor of hepatic glucose production. PET images of diabetic patients taking metformin were analyzed to see the effect of the inhibition of hepatic glucose production on myocardial FDG uptake, with non-diabetic patients as a control group. A semi-quantitative analysis was performed by drawing multiple region of interest (ROIs) to measure SUVmax of the myocardium along the left ventricle and SUVmean of the liver. The SUV ratios of the myocardium to liver (M/L ratio) were correlated with fasting time and different patients groups. Results The fasting times of the patients were categorized into two groups: Group I ≤12 hours, Group II >12 hours. Using a myocardial to liver ratio SUV cut-off ratio of 1.5, the proportion of Group II non-DM having higher M/L ratio was higher than Group II DM patients (24.5% (39/159) vs 8.6% (3/35), p = 0.038). Group I DM patients on metformin showed higher proportion of M/L ratio compared to Group II DM patients on metformin (27.6% (8/27) vs 8.6% (3/35), p = 0.031). Conclusions Patients on metformin, a known inhibitor of hepatic gluconeogenesis, and patients with relatively long fasting times have relatively lower proportion of patients with elevated M/L ratio compared to their respective control groups. The reason for the visualization of myocardial uptake in patients with prolonged fasting times with depleted exogenous glucose is likely due to the increased hepatic gluconeogenesis." @default.
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• W2278752803 date "2014-05-01" @default.
• W2278752803 modified "2023-09-27" @default.
• W2278752803 title "The effect of hepatic physiology related to fasting on 18F-FDG uptake in the myocardium on PETCT" @default.
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