Image Quality and Interpretation of [18F]-FES-PET: Is There any Effect of Food Intake?

Jorianne Boers; Katerina Giatagana; Carolina P Schröder; Geke A P Hospers; Erik F J de Vries; Andor W J M Glaudemans

doi:10.3390/diagnostics10100756

Image Quality and Interpretation of [¹⁸F]-FES-PET: Is There any Effect of Food Intake?

Diagnostics (Basel). 2020 Sep 26;10(10):756. doi: 10.3390/diagnostics10100756.

Authors

Jorianne Boers¹, Katerina Giatagana¹, Carolina P Schröder¹, Geke A P Hospers¹, Erik F J de Vries², Andor W J M Glaudemans²

Affiliations

¹ Department of Medical Oncology, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands.
² Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands.

Abstract

Background: High physiological 16α-[¹⁸F]-fluoro-17β-estradiol ([¹⁸F]-FES) uptake in the abdomen is a limitation of this positron emission tomography (PET) tracer. Therefore, we investigated the effect of food intake prior to PET acquisition on abdominal background activity in [¹⁸F]-FES-PET scans.

Methods: Breast cancer patients referred for [¹⁸F]-FES-PET were included. Three groups were designed: (1) patients who consumed a chocolate bar (fatty meal) between tracer injection and imaging (n = 20), (2) patients who fasted before imaging (n = 20), and (3) patients without diet restrictions (control group, n = 20). We compared the physiological [¹⁸F]-FES uptake, expressed as mean standardized uptake value (SUV_mean), in the abdomen between groups.

Results: A significant difference in [¹⁸F]-FES uptake in the gall bladder and stomach lumen was observed between groups, with the lowest values for the chocolate group and highest for the fasting group (p = 0.015 and p = 0.011, respectively). Post hoc analysis showed significant differences in the SUVmean of these organs between the chocolate and fasting groups, but not between the chocolate and control groups.

Conclusion: This exploratory study showed that, compared to fasting, eating chocolate decreases physiological gall bladder and stomach [¹⁸F]-FES uptake; further reduction through a normal diet was not seen. A prospective study is warranted to confirm this finding.

Keywords: FES-PET; abdominal distribution; breast cancer; chocolate; fasting.