Author + information
- Howard Martin Julien,
- Albert DeLuca,
- Jeffrey Lin and
- Sabahat Bokhari
Background: Patients typically undergoing myocardial viability assessment with positron emission tomography (PET) are given a 25-100G oral glucose load prior to radioisotope administration and metabolic imaging. Current guidelines do not have specific recommendations for glucose load dosing in diabetic patients. Furthermore, this load is often not well tolerated.
Methods: Following a six hour minimum fast, patients undergoing cardiac PET with N13 Ammonia and F18 flurodeoxyglucose (FDG) for myocardial viability received a reduced dose glucose load protocol from 10 to 40G based on fasting blood sugar and history of diabetes. Images were obtained 45 minutes after FDG administration. Image quality was independently assessed by two nuclear cardiologists who rated images as either poor, fair, good or excellent in a blinded fashion.
Results: Images were retrospectively obtained from 55 patients 42 male (76%). 27 (49%) patients were diabetic. Mean glucose dose administered to all patients was 22.8 G (±11.7) and mean dose of FDG was 10.63mCi (±0.65). Both raters gave scores of excellent or good to 49 patients (89%). Agreement between raters across the four strata of image quality was calculated using the Kappa statistic k=0.651; p<0.001. Mean glucose dose for the subset of diabetic patients was 14.1G (±4.6). For diabetic patients, both raters gave scores of excellent or good to 24 patients (89%). Agreement between raters for the subset of diabetic patients was k=0.599; p<0.001.
Conclusions: Myocardial PET viability imaging can be performed reliably with a low glucose challenge in both diabetic and non-diabetic patients yielding excellent image quality with shorter testing time and infrequent need for exogenous insulin administration. A reduced glucose load protocol should be considered as an alternative when patients are not tolerant of standard oral glucose loading doses.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Nuclear Cardiology: Beyond Perfusion
Abstract Category: 30. Non Invasive Imaging: Nuclear
Presentation Number: 1196-204
- 2017 American College of Cardiology Foundation