This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: jnmt.106.034918v1 35/2/80    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Botkin, C. D. Articles by Osman, M. M. Search for Related Content PubMed PubMed Citation Articles by Botkin, C. D. Articles by Osman, M. M.

Prevalence, Challenges, and Solutions for ¹⁸F-FDG PET Studies of Obese Patients: A Technologist's Perspective

¹ Nuclear Medicine Technology Program, Department of Medical Imaging and Radiation Therapeutics, Doisy College of Health Sciences, Saint Louis University, St. Louis, Missouri; and ² Division of Nuclear Medicine, Department of Radiology, Saint Louis University, St. Louis, Missouri

Correspondence: For correspondence or reprints contact: Medhat M. Osman, MD, PhD, Nuclear Medicine, Department of Radiology, 3635 Vista Ave., St. Louis, MO 63110. E-mail: osmanmm{at}slu.edu

Obesity has reached epidemic proportions in the United States; hence, it is frequently encountered in patients undergoing ¹⁸F-FDG PET studies. The purpose of the current study was to present a technologist's perspective on the prevalence of obesity and the challenges and solutions in imaging obese patients in our PET facility. Methods: From October 2002 to October 2003, whole-body ¹⁸F-FDG PET was performed on 1,164 patients with a known or suspected malignancy. Images were acquired 45–60 min after ¹⁸F-FDG injection (7.4 MBq [0.2 mCi]/kg, with a maximum of 925 MBq [25 mCi]) on a PET scanner using a 4-min emission and 3-min transmission time per bed position. A database was maintained of patient height and weight, and body mass index (BMI) was calculated. Patient obesity was classified as overweight (BMI 25 kg/m²), obese (BMI 30 kg/m²), or malignantly obese (BMI 40 kg/m²). In addition, PET technologists recorded any problems and attempted solutions related to the patient weight. Results: BMI calculations showed that 528 patients (45.4%) were overweight or obese (322 men and 206 women; mean age, 55 y). Of those, 201 (38%) were overweight, 270 (51%) were obese, and 57 (11%) were malignantly obese. Problems encountered in these patients included difficult intravenous access (15%), difficult patient positioning (10%), patient motion (7%), an incomplete study (emission only) (1%), and potentially higher radiation exposure to the technologist because of extra time spent near the patient. Attempted solutions included adjusting the schedule to allow more time per patient, adjusting the dose based on body weight, using varied positioning techniques, dividing the study to allow a respite between different image combinations, and dividing time spent with obese patients among the technologists involved. Conclusion: Excessive body weight and related problems have commonly been encountered in our PET facility. ¹⁸F-FDG PET studies of obese patients represent an ongoing challenge, which requires patient-tailored solutions to avoid compromising image quality and risking higher radiation exposure to the technologists.

Key Words: ¹⁸F-FDG; PET; obesity; overweight; BMI