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Prospective Evaluation of Physiologic Uptake Detected with True Whole-Body ¹⁸F-FDG PET/CT in Healthy Subjects

¹ Department of Physical Therapy and Athletic Training, Edward and Margaret 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: Mark F. Reinking, Department of Physical Therapy and Athletic Training, Edward and Margaret Doisy College of Health Sciences, Saint Louis University, 3437 Caroline St., Saint Louis University, St. Louis, MO 63104. E-mail: reinking{at}slu.edu

PET is a molecular imaging modality used to assess metabolic activity. Little is known about the physiologic uptake of radiopharmaceuticals such as ¹⁸F-FDG in healthy subjects. This study was designed to identify and describe normal patterns of physiologic uptake of ¹⁸F-FDG in healthy adult subjects and to examine the influence of low-level muscle activity during the ¹⁸F-FDG uptake phase. Methods: Twenty healthy adults received an intravenous injection of ¹⁸F-FDG and were subsequently scanned with a combined PET/CT scanner. The CT scan was used to accurately identify the location of ¹⁸F-FDG uptake. Of the 20 subjects, 10 were randomly selected to perform a low-level muscle activity during the 1-h ¹⁸F-FDG uptake phase. The PET/CT images were fused, and the location and intensity of metabolic activity were described for all subjects. Results: Muscle activity during the ¹⁸F-FDG uptake phase affected the pattern of ¹⁸F-FDG distribution on PET scans. In addition, the tissue uptake of ¹⁸F-FDG, although variable, showed some consistency among tissue types. Conclusion: The data suggested that technologists should be aware of low-level muscle activity before and during uptake to avoid potential false-positive interpretations. The data also showed that there is some variability in the normal physiologic uptake of ¹⁸F-FDG across subjects. Finally, the results suggested that ¹⁸F-FDG uptake may be used for the evaluation of muscle activity.

Key Words: PET; ¹⁸F-FDG; skeletal muscle