Effects of Fever on 18F-FDG Distribution In Vivo: a Preliminary Study

Yutang Yao; Junjun Cheng; Minggang Su; Xiaohong Ou

doi:10.1007/s11307-020-01486-9

Effects of Fever on ¹⁸F-FDG Distribution In Vivo: a Preliminary Study

Mol Imaging Biol. 2020 Aug;22(4):1116-1123. doi: 10.1007/s11307-020-01486-9.

Authors

Yutang Yao^{1

2}, Junjun Cheng¹, Minggang Su³, Xiaohong Ou⁴

Affiliations

¹ Department of Nuclear Medicine, West China Hospital, Sichuan University, No.37, Guoxue Alley, Chengdu, 610041, Sichuan, People's Republic of China.
² PET/CT Center, Department of Nuclear Medicine, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, No.55, Section 4, South People's Road, Chengdu, 610041, Sichuan, People's Republic of China.
³ Department of Nuclear Medicine, West China Hospital, Sichuan University, No.37, Guoxue Alley, Chengdu, 610041, Sichuan, People's Republic of China. suminggang@sina.com.
⁴ Department of Nuclear Medicine, West China Hospital, Sichuan University, No.37, Guoxue Alley, Chengdu, 610041, Sichuan, People's Republic of China. xiaohong_ou@163.com.

PMID: 32100227
DOI: 10.1007/s11307-020-01486-9

Abstract

Purpose: Elevated body temperature might change glucose metabolism in human organs. The purpose of this study is to explore ¹⁸F-FDG distribution in febrile patients on the day of ¹⁸F-FDG PET/CT scanning and compare it with patients with a normal temperature.

Procedures: ¹⁸F-FDG PET/CT was performed on 69 febrile patients and 82 patients with a normal temperature. Patient sociodemographic data, blood glucose levels before PET/CT, body temperature on the day of the exam, and laboratory test results were collected. Maximal standard uptake values (SUV_max) in the brain, mediastinal blood pool, liver, spleen, and the bone marrow were compared.

Results: Compared with the controls, SUV_max of the febrile patients was significantly lower in the brain, mediastinal blood pool, and the liver (p < 0.01), and higher in the spleen and bone marrow (p < 0.01). In the febrile group, SUV_max was not significantly different between the FDG burden and non-FDG burden patients (p > 0.05). Body temperature was found negatively correlated with SUV_max in the brain (r = - 0.646), mediastinal blood pool (r = - 0.530), and the liver (r = - 0.384), and positively correlated with the SUV_max in the spleen (r = 0.592) and bone marrow (r = 0.651). Multivariate linear regression established body temperature on the day of PET/CT as an independent affecting factor (p < 0.01) for the SUV_max in the brain, mediastinal blood pool, liver, spleen, and bone marrow. The SUV in the brain, liver, and mediastinal blood pool remained different (p < 0.05) after corrected with the SUV_max in the blood pool or liver.

Conclusions: Fever influences ¹⁸F-FDG distribution in multiple human tissues and organs. Altered ¹⁸F-FDG distribution in vivo might affect results of disease lesion detection and tumor therapy response assessment. Correction with blood pool or liver SUV fails to cancel the effects of fever. The day of fever should be avoided for PET/CT scan, especially in assessing tumor therapy response.

Keywords: 18F-FDG distribution; Fever; Maximal standard uptake value; PET/CT; Tumor therapy response assessment.

MeSH terms

Body Temperature
Case-Control Studies
Female
Fever / diagnostic imaging*
Fluorodeoxyglucose F18 / chemistry*
Humans
Linear Models
Liver / metabolism
Male
Middle Aged
Multivariate Analysis
Positron Emission Tomography Computed Tomography
Tissue Distribution

Substances

Fluorodeoxyglucose F18