OBJECTIVE

To compare an effectiveness of physiological 18F-FDG accumulation blockade after 3 different preparation protocols for PET/CT.

MATERIAL AND METHODS

We analyzed the results of 200 PET/CT in patients with suspected cardiac and vascular infection (n=100) and cancer without infection (n=100). All patients with suspected infection underwent special preparation protocol — strict carbohydrate-free diet for 48 hours and fasting over 15 hours before PET/CT. In 20 cases, additional intravenous administration of low molecular weight heparin (50U/kg) 15 min before 18F-FDG was performed. In the control group, preparation was standard for cancer patients — strict carbohydrate-free diet for 12 hours and fasting over 6 hours. Three groups were analyzed: 1) patients with suspected infection undergoing special preparation without heparin administration (n=80); 2) patients with suspected infection undergoing special preparation and heparin injection (n=20); 3) cancer patients with 6-hour fasting period (n=100).

RESULTS

Complete myocardial suppression was achieved in 90% (72/80), 75% (15/20) and 58% (58/100) of patients in all groups, respectively. Intensive physiological accumulation of 18F-FDG in the myocardium was detected only in the group without special preparation (29% (29/100)) that impaired assessment of intracardiac zones of interest in all cases.

CONCLUSION

Intensive physiological 18F-FDG accumulation in the myocardium reduces an accuracy of PET/CT in patients with suspected cardiac and vascular infection. Special preparation including a strict carbohydrate-free diet for 48 hours and a fasting period over 15 hours ensured complete myocardial suppression in 90% of cases. Effectiveness of additional use of heparin was not confirmed.