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A Journal on Nuclear Medicine and Molecular Imaging


A Journal on Nuclear Medicine and Molecular Imaging
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The Quarterly Journal of Nuclear Medicine and Molecular Imaging 2017 Mar 29

DOI: 10.23736/S1824-4785.17.02912-0

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Evaluation of 2 diuretic 18Fluorine-Fluorodeoxyglucose positron emission tomography/computed tomography imaging protocols for intra-pelvic cancer

Lawrence O., DIERICKX 1, 2, Laurent DERCLE 1, Leonor CHALTIEL 1, Olivier CASELLES 1, 2, Séverine BRILLOUET 1, Slimane ZERDOUD 1, Frédéric COURBON 1

1 Department of Nuclear Medicine, Institut Universitaire Cancer Toulouse Oncopole, Toulouse, France; 2 Laboratoire de Recherche LU50 SIMAD, Université Paul Sabatier Toulouse III, Toulouse, France


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BACKGROUND: 18F-Fluorodeoxyglucose (FDG) PET/CT plays an important part in the oncological evaluation of the abdomen and pelvis, but the interpretation and quantification is often hampered by intense physiological urinary activity. We evaluate 2 different diuretic imaging protocols by comparing intensity of urinary activity and we look at the impact of multiple variables on the final urinary activity.
METHODS: Comparative analysis of 102 patients (median age: 64) having intra-pelvic carcinoma. After full body acquisition, 58 patients were administered 20 mg of furosemide 90 min post injection of FDG (P90). For 44 patients, 20 mg of furosemide was administered 30 min post injection of FDG (P30). Comparisons between groups were performed using the Mann- Whitney test and Chi-square. The BMI, creatinine, clearance, age, injected activity, diuretic protocol, gender and glycaemia were evaluated with multivariate analysis for their impact on the final urinary activity.
RESULTS: Concerning the comparison of the urinary activity we observe a significant difference (p 0.0029) between P90 and P30 for the SUVmax (median 4.3 (range 1.6: 17.7) vs. 6.0 (range 2.9: 15.1)), and for the SUVmean (p<0.001) (median 2.4 (range 1.1; 9.9) vs. 3.8 (range 2.0; 10.1)). For 2 patients of P30, the acquisition was interrupted because the patient needed to void. Multivariate analysis shows that creatinine and creatinine clearance do not have a significant independent impact on the final bladder activity.
CONCLUSIONS: By comparing the 2 diuretic imaging protocols, we found a significant lower urinary activity for the P90 protocol and the regression decision tree shows that the P90 protocol is mostly superior. The P30 protocol, which seems to be less well tolerated, is adequate in the group of patients with an injected activity of less than 240 MBq and older than 65 years, if P90 is not feasible. For most patients with injected activity >= 240 MBq or BMI of >=25 and a glycaemia > 120 mg/dl, a significant amount of residual urinary activity remains for both protocols.


KEY WORDS: Diuretic protocol - PET/CT - FDG - Intra-pelvic cancer

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Cite this article as

Lawrence O, Dercle L, Chaltiel L, Caselles O, Brillouet S, et al. Evaluation of 2 diuretic 18Fluorine-Fluorodeoxyglucose positron emission tomography/computed tomography imaging protocols for intra-pelvic cancer. Q J Nucl Med Mol Imaging 2017 Mar 29. DOI: 10.23736/S1824-4785.17.02912-0 

Corresponding author e-mail

dierickxlawrence@hotmail.com