Kaneta Tomohiro, Hakamatsuka Takashi, Takanami Kentaro, Yamada Takayuki, Takase Kei, Sato Akihiro, Higano Shuichi, Kinomura Shigeo, Fukuda Hiroshi, Takahashi Shoki, Yamada Shogo
Department of Radiology, Graduate School of Medicine, Tohoku University, Sendai, Japan.
Ann Nucl Med. 2006 Apr;20(3):203-8. doi: 10.1007/BF03027431.
Positron emission tomography (PET) with fluorodeoxyglucose (FDG) is widely used for evaluation of cancer and ischemic heart disease. Recently, increased myocardial FDG uptake has been reported to be related to some types of heart disease, such as sarcoidosis. However, the physiological increased FDG uptake in the heart often mimics the abnormal high uptake in these cases. In this study, we investigated the relationships between myocardial uptake and age, blood glucose level, fasting period, and hospitalization status (inpatient vs. outpatient).
A total of 159 non-diabetic patients were enrolled in the present study. Patients were imaged on a PET/CT scanner, and a three-dimensional region of interest (ROI) was drawn on the fused PET/CT image to measure the maximum standardized uptake value (SUV(max)) of the whole left ventricle.
No significant relationships were observed between myocardial uptake and age or fasting period. Blood glucose level showed a significant relationship (p = 0.025) with myocardial uptake, but the R-square was extremely small (r2 = 0.03). With an SUV(max) threshold of 3.0, there was no significant difference between inpatients and outpatients. However, outpatients showed a significantly higher frequency of myocardial uptake over SUV(max) of 5.0 (chi2 test: p = 0.046).
It is difficult to predict the degree of physiological uptake in the heart from data regarding age, fasting period, or blood glucose level. Outpatients tend to show higher myocardial uptake than inpatients, which may make it difficult to detect abnormally increased uptake in the heart. A long fasting period, such as overnight fasting, is an inadequate means to reduce the physiological uptake of FDG in the heart.
氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）广泛用于癌症和缺血性心脏病的评估。最近，有报道称心肌FDG摄取增加与某些类型的心脏病有关，如结节病。然而，心脏中生理性的FDG摄取增加在这些病例中常与异常的高摄取相似。在本研究中，我们调查了心肌摄取与年龄、血糖水平、禁食期和住院状态（住院患者与门诊患者）之间的关系。
本研究共纳入159例非糖尿病患者。患者在PET/CT扫描仪上进行成像，并在融合的PET/CT图像上绘制三维感兴趣区（ROI），以测量整个左心室的最大标准化摄取值（SUV(max)）。
未观察到心肌摄取与年龄或禁食期之间存在显著关系。血糖水平与心肌摄取呈显著关系（p = 0.025），但决定系数极小（r2 = 0.03）。以SUV(max)阈值为3.0时，住院患者和门诊患者之间无显著差异。然而，门诊患者心肌摄取超过SUV(max) 5.0的频率显著更高（卡方检验：p = 0.046）。
根据年龄、禁食期或血糖水平的数据难以预测心脏中生理性摄取的程度。门诊患者的心肌摄取往往高于住院患者，这可能使得难以检测到心脏中异常增加的摄取。长时间禁食，如过夜禁食，并不是减少心脏中FDG生理性摄取的充分方法。
