Effect of blood glucose level on standardized uptake value (SUV) in 18F- FDG PET-scan: a systematic review and meta-analysis of 20,807 individual SUV measurements

Mahsa Eskian, Abass Alavi, MirHojjat Khorasanizadeh, Benjamin L Viglianti, Hans Jacobsson, Tara D Barwick, Alipasha Meysamie, Sun K Yi, Shingo Iwano, Bohdan Bybel, Federico Caobelli, Filippo Lococo, Joaquim Gea, Antonio Sancho-Muñoz, Jukka Schildt, Ebru Tatcı, Constantin Lapa, Georgia Keramida, Michael Peters, Raef R BoktorJoemon John, Alexander G Pitman, Tomasz Mazurek, Nima Rezaei

Research output: Contribution to journalReview article

Abstract

OBJECTIVES: To evaluate the effect of pre-scan blood glucose levels (BGL) on standardized uptake value (SUV) in 18F-FDG-PET scan.

METHODS: A literature review was performed in the MEDLINE, Embase, and Cochrane library databases. Multivariate regression analysis was performed on individual datum to investigate the correlation of BGL with SUVmax and SUVmean adjusting for sex, age, body mass index (BMI), diabetes mellitus diagnosis, 18F-FDG injected dose, and time interval. The ANOVA test was done to evaluate differences in SUVmax or SUVmean among five different BGL groups (< 110, 110-125, 125-150, 150-200, and > 200 mg/dl).

RESULTS: Individual data for a total of 20,807 SUVmax and SUVmean measurements from 29 studies with 8380 patients was included in the analysis. Increased BGL is significantly correlated with decreased SUVmax and SUVmean in brain (p < 0.001, p < 0.001,) and muscle (p < 0.001, p < 0.001) and increased SUVmax and SUVmean in liver (p = 0.001, p = 0004) and blood pool (p = 0.008, p < 0.001). No significant correlation was found between BGL and SUVmax or SUVmean in tumors. In the ANOVA test, all hyperglycemic groups had significantly lower SUVs compared with the euglycemic group in brain and muscle, and significantly higher SUVs in liver and blood pool. However, in tumors only the hyperglycemic group with BGL of > 200 mg/dl had significantly lower SUVmax.

CONCLUSION: If BGL is lower than 200 mg/dl no interventions are needed for lowering BGL, unless the liver is the organ of interest. Future studies are needed to evaluate sensitivity and specificity of FDG-PET scan in diagnosis of malignant lesions in hyperglycemia.

Original languageEnglish
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume46
Issue number1
DOIs
Publication statusE-pub ahead of print - Oct 22 2018

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Fluorodeoxyglucose F18
Positron-Emission Tomography
Blood Glucose
Meta-Analysis
MEDLINE
Hyperglycemia
Libraries
Diabetes Mellitus
Analysis of Variance
Body Mass Index
Multivariate Analysis
Regression Analysis
Databases
Sensitivity and Specificity
Liver
Brain

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Effect of blood glucose level on standardized uptake value (SUV) in 18F- FDG PET-scan : a systematic review and meta-analysis of 20,807 individual SUV measurements. / Eskian, Mahsa; Alavi, Abass; Khorasanizadeh, MirHojjat; Viglianti, Benjamin L; Jacobsson, Hans; Barwick, Tara D; Meysamie, Alipasha; Yi, Sun K; Iwano, Shingo; Bybel, Bohdan; Caobelli, Federico; Lococo, Filippo; Gea, Joaquim; Sancho-Muñoz, Antonio; Schildt, Jukka; Tatcı, Ebru; Lapa, Constantin; Keramida, Georgia; Peters, Michael; Boktor, Raef R; John, Joemon; Pitman, Alexander G; Mazurek, Tomasz; Rezaei, Nima.

In: European Journal of Nuclear Medicine and Molecular Imaging, Vol. 46, No. 1, 22.10.2018.

Research output: Contribution to journalReview article

Eskian, M, Alavi, A, Khorasanizadeh, M, Viglianti, BL, Jacobsson, H, Barwick, TD, Meysamie, A, Yi, SK, Iwano, S, Bybel, B, Caobelli, F, Lococo, F, Gea, J, Sancho-Muñoz, A, Schildt, J, Tatcı, E, Lapa, C, Keramida, G, Peters, M, Boktor, RR, John, J, Pitman, AG, Mazurek, T & Rezaei, N 2018, 'Effect of blood glucose level on standardized uptake value (SUV) in 18F- FDG PET-scan: a systematic review and meta-analysis of 20,807 individual SUV measurements', European Journal of Nuclear Medicine and Molecular Imaging, vol. 46, no. 1. https://doi.org/10.1007/s00259-018-4194-x
Eskian, Mahsa ; Alavi, Abass ; Khorasanizadeh, MirHojjat ; Viglianti, Benjamin L ; Jacobsson, Hans ; Barwick, Tara D ; Meysamie, Alipasha ; Yi, Sun K ; Iwano, Shingo ; Bybel, Bohdan ; Caobelli, Federico ; Lococo, Filippo ; Gea, Joaquim ; Sancho-Muñoz, Antonio ; Schildt, Jukka ; Tatcı, Ebru ; Lapa, Constantin ; Keramida, Georgia ; Peters, Michael ; Boktor, Raef R ; John, Joemon ; Pitman, Alexander G ; Mazurek, Tomasz ; Rezaei, Nima. / Effect of blood glucose level on standardized uptake value (SUV) in 18F- FDG PET-scan : a systematic review and meta-analysis of 20,807 individual SUV measurements. In: European Journal of Nuclear Medicine and Molecular Imaging. 2018 ; Vol. 46, No. 1.
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abstract = "OBJECTIVES: To evaluate the effect of pre-scan blood glucose levels (BGL) on standardized uptake value (SUV) in 18F-FDG-PET scan.METHODS: A literature review was performed in the MEDLINE, Embase, and Cochrane library databases. Multivariate regression analysis was performed on individual datum to investigate the correlation of BGL with SUVmax and SUVmean adjusting for sex, age, body mass index (BMI), diabetes mellitus diagnosis, 18F-FDG injected dose, and time interval. The ANOVA test was done to evaluate differences in SUVmax or SUVmean among five different BGL groups (< 110, 110-125, 125-150, 150-200, and > 200 mg/dl).RESULTS: Individual data for a total of 20,807 SUVmax and SUVmean measurements from 29 studies with 8380 patients was included in the analysis. Increased BGL is significantly correlated with decreased SUVmax and SUVmean in brain (p < 0.001, p < 0.001,) and muscle (p < 0.001, p < 0.001) and increased SUVmax and SUVmean in liver (p = 0.001, p = 0004) and blood pool (p = 0.008, p < 0.001). No significant correlation was found between BGL and SUVmax or SUVmean in tumors. In the ANOVA test, all hyperglycemic groups had significantly lower SUVs compared with the euglycemic group in brain and muscle, and significantly higher SUVs in liver and blood pool. However, in tumors only the hyperglycemic group with BGL of > 200 mg/dl had significantly lower SUVmax.CONCLUSION: If BGL is lower than 200 mg/dl no interventions are needed for lowering BGL, unless the liver is the organ of interest. Future studies are needed to evaluate sensitivity and specificity of FDG-PET scan in diagnosis of malignant lesions in hyperglycemia.",
author = "Mahsa Eskian and Abass Alavi and MirHojjat Khorasanizadeh and Viglianti, {Benjamin L} and Hans Jacobsson and Barwick, {Tara D} and Alipasha Meysamie and Yi, {Sun K} and Shingo Iwano and Bohdan Bybel and Federico Caobelli and Filippo Lococo and Joaquim Gea and Antonio Sancho-Mu{\~n}oz and Jukka Schildt and Ebru Tatcı and Constantin Lapa and Georgia Keramida and Michael Peters and Boktor, {Raef R} and Joemon John and Pitman, {Alexander G} and Tomasz Mazurek and Nima Rezaei",
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TY - JOUR

T1 - Effect of blood glucose level on standardized uptake value (SUV) in 18F- FDG PET-scan

T2 - a systematic review and meta-analysis of 20,807 individual SUV measurements

AU - Eskian, Mahsa

AU - Alavi, Abass

AU - Khorasanizadeh, MirHojjat

AU - Viglianti, Benjamin L

AU - Jacobsson, Hans

AU - Barwick, Tara D

AU - Meysamie, Alipasha

AU - Yi, Sun K

AU - Iwano, Shingo

AU - Bybel, Bohdan

AU - Caobelli, Federico

AU - Lococo, Filippo

AU - Gea, Joaquim

AU - Sancho-Muñoz, Antonio

AU - Schildt, Jukka

AU - Tatcı, Ebru

AU - Lapa, Constantin

AU - Keramida, Georgia

AU - Peters, Michael

AU - Boktor, Raef R

AU - John, Joemon

AU - Pitman, Alexander G

AU - Mazurek, Tomasz

AU - Rezaei, Nima

PY - 2018/10/22

Y1 - 2018/10/22

N2 - OBJECTIVES: To evaluate the effect of pre-scan blood glucose levels (BGL) on standardized uptake value (SUV) in 18F-FDG-PET scan.METHODS: A literature review was performed in the MEDLINE, Embase, and Cochrane library databases. Multivariate regression analysis was performed on individual datum to investigate the correlation of BGL with SUVmax and SUVmean adjusting for sex, age, body mass index (BMI), diabetes mellitus diagnosis, 18F-FDG injected dose, and time interval. The ANOVA test was done to evaluate differences in SUVmax or SUVmean among five different BGL groups (< 110, 110-125, 125-150, 150-200, and > 200 mg/dl).RESULTS: Individual data for a total of 20,807 SUVmax and SUVmean measurements from 29 studies with 8380 patients was included in the analysis. Increased BGL is significantly correlated with decreased SUVmax and SUVmean in brain (p < 0.001, p < 0.001,) and muscle (p < 0.001, p < 0.001) and increased SUVmax and SUVmean in liver (p = 0.001, p = 0004) and blood pool (p = 0.008, p < 0.001). No significant correlation was found between BGL and SUVmax or SUVmean in tumors. In the ANOVA test, all hyperglycemic groups had significantly lower SUVs compared with the euglycemic group in brain and muscle, and significantly higher SUVs in liver and blood pool. However, in tumors only the hyperglycemic group with BGL of > 200 mg/dl had significantly lower SUVmax.CONCLUSION: If BGL is lower than 200 mg/dl no interventions are needed for lowering BGL, unless the liver is the organ of interest. Future studies are needed to evaluate sensitivity and specificity of FDG-PET scan in diagnosis of malignant lesions in hyperglycemia.

AB - OBJECTIVES: To evaluate the effect of pre-scan blood glucose levels (BGL) on standardized uptake value (SUV) in 18F-FDG-PET scan.METHODS: A literature review was performed in the MEDLINE, Embase, and Cochrane library databases. Multivariate regression analysis was performed on individual datum to investigate the correlation of BGL with SUVmax and SUVmean adjusting for sex, age, body mass index (BMI), diabetes mellitus diagnosis, 18F-FDG injected dose, and time interval. The ANOVA test was done to evaluate differences in SUVmax or SUVmean among five different BGL groups (< 110, 110-125, 125-150, 150-200, and > 200 mg/dl).RESULTS: Individual data for a total of 20,807 SUVmax and SUVmean measurements from 29 studies with 8380 patients was included in the analysis. Increased BGL is significantly correlated with decreased SUVmax and SUVmean in brain (p < 0.001, p < 0.001,) and muscle (p < 0.001, p < 0.001) and increased SUVmax and SUVmean in liver (p = 0.001, p = 0004) and blood pool (p = 0.008, p < 0.001). No significant correlation was found between BGL and SUVmax or SUVmean in tumors. In the ANOVA test, all hyperglycemic groups had significantly lower SUVs compared with the euglycemic group in brain and muscle, and significantly higher SUVs in liver and blood pool. However, in tumors only the hyperglycemic group with BGL of > 200 mg/dl had significantly lower SUVmax.CONCLUSION: If BGL is lower than 200 mg/dl no interventions are needed for lowering BGL, unless the liver is the organ of interest. Future studies are needed to evaluate sensitivity and specificity of FDG-PET scan in diagnosis of malignant lesions in hyperglycemia.

U2 - 10.1007/s00259-018-4194-x

DO - 10.1007/s00259-018-4194-x

M3 - Review article

C2 - 30350009

VL - 46

JO - European Journal of Nuclear Medicine and Molecular Imaging

JF - European Journal of Nuclear Medicine and Molecular Imaging

SN - 1619-7070

IS - 1

ER -