Elsevier

Clinical Imaging

Volume 34, Issue 5, September–October 2010, Pages 348-350
Clinical Imaging

Impact of age on FDG uptake in the liver on PET scan

https://doi.org/10.1016/j.clinimag.2009.11.003Get rights and content

Abstract

Purpose

The intensity of physiological 18F-2-deoxy-D-glucose (FDG) uptake in the liver varies. It is important to be familiar with the varying degree of FDG accumulation in the liver that represents normal distribution and physiological changes, before attempting to interpret whole-body positron emission tomography (PET) imaging for malignancy detection. The aim of this study is to evaluate the possible factors influencing the intensity of physiological FDG uptake in the liver on FDG PET imaging.

Materials and Methods

From 2005 to 2007, a total of 339 consecutive healthy subjects, referred from the Department of Community Medicine and Health Examination Center of our hospital for health screening, were retrospectively recruited for analysis. Demographic data were collected from chart records. Whole body FDG PET imaging and serologic determination of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection status were performed on all subjects. The mean and maximum standard uptake values (SUVs) of the liver were calculated. The relationships between sex, age, HBV and HCV infection status, and SUVmax and SUVmean of the liver on FDG PET imaging were evaluated.

Results

There was no statistically significant relationship between sex, HBV and HCV infection status and maximum standard uptake value (SUVmax) or mean standard uptake value (SUVmean) of the liver. After adjusting for covariables, age was a statistically significant predictor of SUVmax (B=0.18; P= .001) and SUVmean (B=0.16; P= .004) of the liver on FDG PET imaging.

Conclusion

Age has a significant and positive impact on both maximum and mean standard uptake values of the liver on FDG PET imaging. High physiological background FDG uptake will reduce diagnostic sensitivity and accuracy for malignancy detection in the liver.

Introduction

Clinical use of positron emission tomography (PET) has grown rapidly due to its usefulness in cancer diagnosis, staging, and management. 18F-2-deoxy-D-glucose (FDG) PET is a functional imaging modality, which reflects cellular glucose metabolism. Accumulation and trapping of FDG allow the visualization of increased uptake in most malignant cells compared to normal cells. FDG is the most commonly used radiopharmaceutical for positron emission tomography studies in oncology and the tracer is a substrate of energy metabolism [1], [2]. However, increased FDG uptake is not limited to malignant tissue alone [3], [4], [5], [6], [7]. The intensity of physiological FDG uptake in the liver varies. It is important to be familiar with the varying degree of FDG accumulation that represents normal distribution and physiological changes, before attempting to interpret whole-body PET imaging for malignancy detection. The aim of this study is to evaluate the possible factors influencing the intensity of physiological FDG uptake in the liver on FDG PET imaging.

Section snippets

Subjects

From 2005 to 2007, a total of 339 consecutive healthy subjects, referred from the Department of Community Medicine and Health Examination Center of our hospital for health screening, were retrospectively recruited for analysis. Demographic data were collected from chart records. Whole body FDG PET imaging and serologic determination of hepatitis B virus (HBV) and hepatic C virus infection status were performed on all subjects. Infections with HBV and hepatitis C virus (HCV) were defined as

Results

A total of 339 subjects, 134 male and 205 female, were recruited in the study. The mean age of the subjects was 54.09 ± 9.96 years. The mean of the maximum standard uptake value (SUVmax) of the liver was 2.89±0.56. The mean of the mean standard uptake value (SUVmean) of the liver was 2.37±0.45 (Table 1). There was no statistically significant relationship between sex, HBV and HCV infection status, and SUVmax or SUVmean of the liver. After adjusting for covariables, age was a statistically

Discussion

Molecular imaging is the visualization, characterization, and measurement of biological processes at the molecular and cellular levels in a living system. PET is one of the most rapidly growing areas of medical imaging in the clinical management of patients with cancer [8]. However, some physiological FDG uptake can cause misinterpretation of a PET scan and, as a consequence, may lead to false-positive or false-negative reports, thus reducing the accuracy of the technique [9], [10], [11], [12].

Acknowledgments

We want to thank the grant support of the study projects (DMR-95-076 and DMR-95-077) in China Medical University Hospital.

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    S. S. Sun and C. H. Kao contributed equally to this work.

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