| Summary: | 碩士 === 義守大學 === 資訊工程學系碩士在職專班 === 100 === Purpose:
Although 18F-FDG PET/CT scan has been proven useful in the detection of many tumors, it has a pitfall in detection of urinary tract tumor because of 18F-FDG accumulation in urinary tract due to excretion in urine. This prospective study was to investigate the effect of diuretics injection timing on interpretation of urinary tract system in 18F-FDG PET/CT.
Materials and methods:
Between June 2005 and June 2011, total 186 cases who received 18F-FDG PET/CT scans in our department with well hydration, normal renal function and euglycemia were included. All cases were further divided in to four groups based on the injection timing of diuretics (20 mg of furosemide). Group 1 did not receive furosemide and served as controls. Group 2 received furosemide immediately after injection of 18F-FDG. Group 3 received furosemide 20 min after injection of 18F-FDG. Group 4 received furosemide after first whole-body scan completed and 30 min before second pelvic delayed scan. A 4-point influence interpretation scale of 18F-FDG PET/CT was evaluated visually by experienced PET reader and based on bladder activities. Maximum standardized uptake values (SUVmax) of renal pelvis, ureter, bladder, liver and thigh were also collected.
Results:
Image interpretation was significantly more influenced by bladder radioactivies in the Group 1-2 (score 3.3 ± 0.8) than the Group 3-4 (scores 1.5 ± 0.7) ( P<0.001). Comparing to the control group (Group I), all furosemide groups showed lower bladder SUVmax (especially in Group 3 and 4, P <0.001), lower renal pelvic SUVmax (P < 0.001), lower ureteral SUVmax (P = 0.001).
Conclusions:
Intravenous injection of diuretics can lower 18F-FDG activities in genitourinary tract, well tolerate by patients and avoid invasive bladder catheterization. The lowest bladder activities and best image quality can be easily achieved in Group 4, but it will prolong the whole examination time. However, Group 3 is adequate to improve image quality and will shorten examination time.
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