Metformin discontinuation less than 72 h is suboptimal for F-18 FDG PET/CT interpretation of the bowel

• Published in: Annals of nuclear medicine Vol. 30; no. 9; pp. 629 - 636
• Main Authors: Lee, Suk Hyun, Jin, Soyoung, Lee, Hyo Sang, Ryu, Jin-Sook, Lee, Jong Jin
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.11.2016; Springer Nature B.V
• Subjects: Biological Transport - drug effects; Diabetes Mellitus - drug therapy; Female; Fluorodeoxyglucose F18 - metabolism; Humans; Imaging; Intestines - diagnostic imaging; Intestines - drug effects; Intestines - metabolism; Male; Medicine; Medicine & Public Health; Metformin - pharmacology; Metformin - therapeutic use; Middle Aged; Nuclear Medicine; Original Article; Positron Emission Tomography Computed Tomography - methods; Radiology; Retrospective Studies; Time Factors; Withholding Treatment; Metformin; Diabetes; FDG PET/CT; Bowel uptake
• ISSN: 0914-7187; 1864-6433
• DOI: 10.1007/s12149-016-1106-7

Objective Metformin-induced [F-18] fluorodeoxyglucose (FDG) bowel uptake can hinder positron emission tomography/computed tomography (PET/CT) evaluation of the bowel. This study aimed to investigate the segmental bowel uptake of FDG according to metformin discontinuation times up to 72 h. Methods We retrospectively divided 240 diabetic patients into four groups: metformin discontinuation <24 h (group A; n  = 86), 24–48 h (group B; n  = 40), 48–72 h (group C; n  = 12), and no metformin (control group; n  = 102). Segmental FDG bowel uptakes were measured visually (four-point scale) and semi-quantitatively (maximum standardized uptake value). Results Compared with the control group, FDG uptake increased significantly from the ileum to the rectosigmoid colon in group A, from the transverse to the rectosigmoid colon in group B, and from the descending colon to the rectosigmoid colon in group C in both visual and semi-quantitative analyses. Conclusions Metformin discontinuation for <72 h is likely suboptimal for PET/CT image interpretation, especially with respect to the distal segments of the colon.