From the Department of Diagnostic Radiology, Hyogo Prefectural Amagasaki General Medical Center, Hyogo.
Department of Radiology, Kindai University Faculty of Medicine, Osaka.
Clin Nucl Med. 2023 Dec 1;48(12):1015-1020. doi: 10.1097/RLU.0000000000004856. Epub 2023 Sep 18.
The possibility of steroid administration inducing the extensive skeletal muscle uptake (ESMU) of FDG in PET scans was investigated.
From 8923 consecutive 18 F-FDG PET/CT scans taken at our hospital, 23 scans (15 patients) met adult age and ESMU-positive inclusion criteria. Among the 15 patients, 13 with both ESMU-positive and -negative scans were examined for association with steroid administration.
Extensive skeletal muscle uptake was associated with a history of steroid administration ( χ2 test: P = 0.001). Notably, 20 ESMU-positive scans and 11 ESMU-negative scans were significantly different, with 0 to 95 days (median, 18.5 days) and 0 to 708 days (median, 319.0 days) since the last steroid administration, respectively (Mann-Whitney U test, P = 0.003). A significant correlation was observed between mean skeletal muscle SUV max and the number of days since the last steroid administration (Spearman rank correlation coefficient, ρ = -0.501, P = 0.004). Specifically, the degree of ESMU tended to decrease over time, after steroid administration. From multiple regression analysis, the number of days since the last steroid administration was significantly associated with mean SUV max ( P = 0.007), but the blood glucose level was not significant ( P = 0.204), revealing that the number of days since the last steroid administration was an independent risk factor. Multicollinearity was low (the variance inflation factor was 1.007 for both the number of days since the last steroid administration and blood glucose levels).
Steroid administration within months before PET may be one cause of ESMU.
研究在 PET 扫描中给予类固醇是否会导致 FDG 在广泛骨骼肌摄取（ESMU）。
从我院连续进行的 8923 例 18F-FDG PET/CT 扫描中，有 23 例（15 例患者）符合成人年龄和 ESMU 阳性纳入标准。在这 15 例患者中，检查了 13 例同时具有 ESMU 阳性和阴性扫描的患者，以研究其与类固醇给药的关系。
广泛骨骼肌摄取与类固醇给药史有关（卡方检验：P = 0.001）。值得注意的是，20 例 ESMU 阳性扫描和 11 例 ESMU 阴性扫描之间存在显著差异，分别有 0 至 95 天（中位数，18.5 天）和 0 至 708 天（中位数，319.0 天），自上次类固醇给药以来（Mann-Whitney U 检验，P = 0.003）。观察到平均骨骼肌 SUV max 与上次类固醇给药后天数之间存在显著相关性（Spearman 秩相关系数，ρ=-0.501，P=0.004）。具体而言，ESMU 程度倾向于在类固醇给药后随时间逐渐降低。来自多元回归分析，上次类固醇给药后天数与平均 SUV max 显著相关（P=0.007），但血糖水平不显著（P=0.204），表明上次类固醇给药后天数是一个独立的危险因素。多重共线性较低（上次类固醇给药和血糖水平的方差膨胀因子分别为 1.007）。
PET 检查前几个月内给予类固醇可能是导致 ESMU 的原因之一。
