18F-fluorodeoxyglucose use after cardiac transplant: A comparative study of suppression of physiological myocardial uptake

J Nucl Cardiol. 2020 Feb;27(1):173-181 doi: 10.1007/s12350-018-1309-5.
Abstract
BACKGROUND:

18F-fluorodeoxyglucose (FDG) has been useful in the evaluation of myocardial inflammatory processes. However, it is challenging to identify them due to physiological 18F-FDG uptake. There are no publications demonstrating the application of FDG in post-transplant rejection in humans yet. The aim of this study is to determine the feasibility of suppression of myocardial FDG uptake in post-transplant patients, comparing three different protocols of preparation.

METHODS:

Ten patients after heart transplantation were imaged by FDG associated with three endomyocardial biopsies (EMB), scheduled in the first year after the procedure. Before each imaging, patients were randomized to one of three preparations: (1) hyperlipidic-hypoglycemic diet; (2) fasting longer than 12 hours; and (3) fasting associated with intravenous heparin. All patients would undergo the three methods. FDG images were analyzed using visual analysis scores and relative radiotracer cardiac uptake (RRCU).

RESULTS:

The suppression rate of radiotracer activity ranged from 55% to 62%. Visual analysis showed that preparation 3 presented less efficacy in the suppression compared to the others. However, RRCU did not show difference between the preparations.

CONCLUSIONS:

Suppression of physiological myocardial FDG uptake after cardiac transplantation is feasible. The usefulness of heparin in the suppression is unclear.

Methodological quality
Jadad score 2
Allocation concealment NO
Data analysis PER PROTOCOL
Metadata
Funding: Non-industry funding
Publication type: Comparative Study, Randomized Controlled Trial, Randomised Controlled Trial
Organ: Heart
Language: English
Author email: renatafelix@cardiol.br
MeSH terms: Adult; Anticoagulants; Diet, Carbohydrate-Restricted; Diet, Diabetic; Fasting; Feasibility Studies; Female; Fluorodeoxyglucose F18; Heart Failure; Heart Transplantation; Heparin; Humans; Male; Middle Aged; Radiopharmaceuticals; Single Photon Emission Computed Tomography Computed Tomography; 0 (Anticoagulants); 0 (Radiopharmaceuticals); 0Z5B2CJX4D (Fluorodeoxyglucose F18); 9005-49-6 (Heparin)