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Open Access 01-12-2014 | Original research

Long fasting is effective in inhibiting physiological myocardial ¹⁸F-FDG uptake and for evaluating active lesions of cardiac sarcoidosis

Authors: Miyako Morooka, Masao Moroi, Kimiichi Uno, Kimiteru Ito, Jin Wu, Takashi Nakagawa, Kazuo Kubota, Ryogo Minamimoto, Yoko Miyata, Momoko Okasaki, Osamu Okazaki, Yoshihito Yamada, Tetsuo Yamaguchi, Michiaki Hiroe

Published in: EJNMMI Research | Issue 1/2014

Abstract

Background

F-fluorodeoxyglucose (FDG) positron emission tomography (PET) is a promising modality for detecting active lesions of cardiac sarcoidosis (CS). However, determining whether ¹⁸F-FDG uptake in the myocardium is physiological is challenging due to metabolic shift in myocardial cells. Although methods for inhibiting physiological myocardial ¹⁸F-FDG uptake have been proposed, no standard methods exist. This study therefore aimed to compare the effect of an 18-h fast (long fasting (LF)) with heparin loading plus a 12-h fast (HEP) before ¹⁸F-FDG PET scan.

Methods

We analyzed the effects of LF and HEP on the inhibition of physiological myocardial ¹⁸F-FDG uptake in healthy subjects (18 in HEP and 19 in LF) and in patients with known or suspected CS (96 in HEP and 69 in LF). In CS, the lower uptake of ¹⁸F-FDG in the myocardium was evaluated. A visual four-point scale was used to assess myocardial ¹⁸F-FDG uptake in comparison with hepatic uptake (1 lower, 2 similar, 3 somewhat higher, 4 noticeably higher).

Results

Myocardial ¹⁸F-FDG uptake was 1.68 ± 1.06 in LF and 3.17 ± 1.16 in HEP in healthy subjects (p < 0.0001), whereas it was 1.48 ± 0.99 in LF and 2.48 ± 1.33 in HEP in CS patients (p < 0.0001). Logistic regression and regression trees revealed the LF was the most effective in inhibiting myocardial ¹⁸F-FDG uptake. In addition, serum free fatty acid levels on intravenous ¹⁸F-FDG injection were a possible biomarker.

Conclusions

LF is effective in inhibiting myocardial ¹⁸F-FDG uptake, and consequently, it could be useful for evaluating active lesions of CS in ¹⁸F-FDG PET images.

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Title: Long fasting is effective in inhibiting physiological myocardial 18F-FDG uptake and for evaluating active lesions of cardiac sarcoidosis
Authors: Miyako Morooka
Masao Moroi
Kimiichi Uno
Kimiteru Ito
Jin Wu
Takashi Nakagawa
Kazuo Kubota
Ryogo Minamimoto
Yoko Miyata
Momoko Okasaki
Osamu Okazaki
Yoshihito Yamada
Tetsuo Yamaguchi
Michiaki Hiroe
Publication date: 01-12-2014
Publisher: Springer Berlin Heidelberg
Published in: EJNMMI Research / Issue 1/2014
Electronic ISSN: 2191-219X
DOI: https://doi.org/10.1186/2191-219X-4-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Long fasting is effective in inhibiting physiological myocardial ¹⁸F-FDG uptake and for evaluating active lesions of cardiac sarcoidosis

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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