Evidence map›Paper›PMID 29910577›Full record

ArticleJournal of the Saudi Heart Association2018

Status of F-18 fluorodeoxyglucose uptake in normal and hibernating myocardium after glucose and insulin loading.

Ismet Sarikaya, A H Elgazzar, M A Alfeeli, P N Sharma, A Sarikaya

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Article in Journal of the Saudi Heart Association, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

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3citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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3 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Ismet SarikayaDepartment of Nuclear Medicine, Faculty of Medicine, Kuwait University, Kuwait.
A H ElgazzarDepartment of Nuclear Medicine, Faculty of Medicine, Kuwait University, Kuwait.
M A AlfeeliDepartment of Nuclear Medicine, Mubarak Al-Kabeer Hospital, Ministry of Health, Kuwait.
P N SharmaDepartment of Nuclear Medicine, Faculty of Medicine, Kuwait University, Kuwait.
A SarikayaDepartment of Nuclear Medicine, Faculty of Medicine, Trakya University, Turkey.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveF-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) has been increasingly used in myocardial viability imaging. In routine PET viability studies, oral glucose and intravenous insulin loading is commonly utilized. In an optimal study, glucose and insulin loading is expected to cause FDG uptake both in hibernating and normal myocardium. However, in routine studies it is not uncommon to see absent or reduced FDG uptake in normal myocardium. In this retrospective study we further analyzed our PET viability images to evaluate FDG uptake status in myocardium under the oral glucose and intravenous insulin loading protocol that we use in our hospital.

methodsPatients who had both myocardial perfusion single photon emission computed tomography (SPECT) and FDG PET cardiac viability studies were selected for analysis. FDG uptake status in normal and abnormal myocardial segments on perfusion SPECT was evaluated. Based on SPECT and PET findings, patients were divided into two main groups and four subgroups. Group 1 included PET viable studies and Group 2 included PET-nonviable studies. Subgroups based on FDG uptake in normal myocardium were 1a and 2a (normal uptake) and 1b and 2b (absent or significantly reduced uptake).

resultsSeventy-one patients met the inclusion criteria. Forty-two patients were PET-viable and 29 were PET-nonviable. In 33 of 71 patients (46.4%) there was absent or significantly reduced FDG uptake in one or more normal myocardial segments, which was identified more in PET-viable than PET-nonviable patients (59.5% vs. 27.5%,

conclusionsIn nearly half of our patients, one or more normal myocardial segments showed absent or significantly reduced FDG uptake. This finding, particularly if it is diffuse, could be from suboptimal study, inadequacy of current glucose and insulin loading protocols, or various other patient-related causes affecting FDG uptake both in the normal and hibernating myocardium. In cases with significantly reduced FDG uptake in normal myocardium, PET images should be interpreted cautiously to prevent false-negative results for viability.

Indexed as

FluorodeoxyglucoseGlucose loadingInsulin loadingMyocardial viabilityPositron emission tomography

Identifiers

PMID29910577
PMCPMC6000987

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