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

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dc.authoridSarikaya, Ismet/0000-0002-1087-580X
dc.authorwosidSarikaya, Ismet/G-7881-2015
dc.contributor.authorSarikaya, Ismet
dc.contributor.authorElgazzar, A. H.
dc.contributor.authorAlfeeli, M. A.
dc.contributor.authorSharma, P. N.
dc.contributor.authorSarikaya, A.
dc.date.accessioned2024-06-12T11:02:03Z
dc.date.available2024-06-12T11:02:03Z
dc.date.issued2018
dc.departmentTrakya Üniversitesien_US
dc.description.abstractObjective: F-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. Methods: Patients 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). Results: Seventy-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%, p = 0.008). This finding was also more frequent in diabetic than nondiabetic patients (53% vs. 31.8%), but the difference was not significant (p = 0.160). Conclusions: In 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. (C) 2017 The Authors. Production and hosting by Elsevier B.V. on behalf of King Saud University.en_US
dc.identifier.doi10.1016/j.jsha.2017.07.001
dc.identifier.endpage85en_US
dc.identifier.issn1016-7315
dc.identifier.issn2212-5043
dc.identifier.issue2en_US
dc.identifier.pmid29910577en_US
dc.identifier.scopus2-s2.0-85026392571en_US
dc.identifier.scopusqualityQ3en_US
dc.identifier.startpage75en_US
dc.identifier.urihttps://doi.org/10.1016/j.jsha.2017.07.001
dc.identifier.urihttps://hdl.handle.net/20.500.14551/21132
dc.identifier.volume30en_US
dc.identifier.wosWOS:000428298900002en_US
dc.identifier.wosqualityN/Aen_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherElsevier Science Bven_US
dc.relation.ispartofJournal Of The Saudi Heart Associationen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectFluorodeoxyglucoseen_US
dc.subjectGlucose Loadingen_US
dc.subjectInsulin Loadingen_US
dc.subjectMyocardial Viabilityen_US
dc.subjectPositron Emission Tomographyen_US
dc.subjectPositron-Emission-Tomographyen_US
dc.subjectCoronary-Artery-Diseaseen_US
dc.subjectEuglycemic Hyperinsulinemic Clampen_US
dc.subjectDependent Diabetes-Mellitusen_US
dc.subjectViable Myocardiumen_US
dc.subjectMismatch Patternen_US
dc.subjectBlood-Flowen_US
dc.subjectFdg-Peten_US
dc.subjectMetabolismen_US
dc.subjectInfarctionen_US
dc.titleStatus of F-18 fluorodeoxyglucose uptake in normal and hibernating myocardium after glucose and insulin loadingen_US
dc.typeArticleen_US

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