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Usefulness of Low Dose Oral Contrast Media in $^{18}F-FDG$ PET/CT  

An Young-Sil (Department of Nuclear Medicine and Molecular Imaging, Ajou University School of medicine)
Yoon Joon-Kee (Department of Nuclear Medicine and Molecular Imaging, Ajou University School of medicine)
Hong Seon Pyo (Department of Nuclear Medicine and Molecular Imaging, Ajou University School of medicine)
Joh Chul-Woo (Department of Nuclear Medicine and Molecular Imaging, Ajou University School of medicine)
Yoon Seok-Nam (Department of Nuclear Medicine and Molecular Imaging, Ajou University School of medicine)
Publication Information
Nuclear Medicine and Molecular Imaging / v.40, no.5, 2006 , pp. 257-262 More about this Journal
Abstract
Purpose: The standard protocol using large volume of oral contrast media may cause gastrointestinal discomfort and contrast-related artifacts in PET/CT. The aim of this study was to evaluate the usefulness of low dose oral contrast in $^{18}F-FDG$ PET/CT. Materials and Methods: We retrospectively reviewed the whole-body PET/CT images in a total of 435 patients. About 200 ml of oval contrast agent (barium sulfate) was administered immediately before injection of $^{18}F-FDG$. The FDG uptake of intestines was analyzed by visual and semi- quantitative method on transaxial, coronal and saggital planes. Results: Seventy (16%, 113 sites) of 435 images showed high FDG uptake (peak SUV > 4); 50 (74%, 84 sites) with diffuse and 20 (15%, 29 sites) with focal uptake. The most commonly delivered site of oral contrast media was small bowel (n=27, 39%). On PET/CT images, FDG uptake coexisted with oral contrast media in 26 patients (54%, 38 sites) with diffuse pattern and 9 (45%, 9 sites) with focal pattern, and by sites, those were 38 (45%) and 9 (31%), respectively. In small bowel regions, the proportion of coexistence reached as high as 61% (29/47 sites). A visual analysis of available non-attenuation corrected PET images of 27 matched regions revealed no contrast-related artifact. Conclusion: We concluded that the application of low dose contrast media could be helpful in the evaluation of abdominal uptake in the FDG PET/CT image.
Keywords
PET/CT; FDG; oral contrast; artifact; low dose;
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1 Beyer T, Townsend DW, Brun T, Kinahan PE, Charron M, Roddy R et al. A combined PET/CT scanner for clinical oncology. J Nucl Med 2000;41:1369-79
2 Dizendorf EV, Treyer V, Von Schulthess GK, Hany TF. Application of oral contrast media in coregistered positron emission tomography-CT. AJR 2002;179:477-81   DOI   ScienceOn
3 Garrett PR, Meshkov SL, Perlmutter GS. Oral contrast agents in CT of the abdomen. Radiology 1984;153:545-6   DOI
4 Otsuka H, Graham MM, Kubo A, Nishitani H. The effect of oral contrast on large bowel activity in FDG-PET/CT. Ann Nucl Med 2005; 19(2): I 01-8   DOI
5 Dizendorf E, Hany TF, Buck A, von Schulthess GK, Burger C. Cause and magnitude of the error induced by oral CT contrast agent in CT -based attenuation correction of PET emission studies. J Nucl Med 2003;44:732-8
6 Antoch G, Kuehl H, Kanja J, Lauenstein TC, Schneemann H, Hauth E, et al. Dual-modality PET/CT scanning with negative oral contrast agent to avoid artifacts: introduction and evaluation. Radiology 2004;230:879-85   DOI   ScienceOn
7 Kim S, Chung JK, Kim BT, Kim SJ, Jeong JM, Lee DS et al. Relationship between Gastrointestinal F-18-fluorodeoxyglucose Accumulation and Gastrointestinal Symptoms in Whole-Body PET. Clin Positron Imaging. 1999 Oct;2( 5):273-9   DOI   ScienceOn
8 Cohade C, Osman M, Nakamoto Y, Marshall LT, Links JM, Fishman EK et al. Initial experience with oral contrast in PET/CT: phantom and clinical studies. J Nucl Med 2003;44:412-6
9 Tsang BD, Panacek EA, Brant WE, Wisner DH. Effect of oral contrast administration for abdominal computed tomography in the evaluation of acute blunt trauma. Ann Emerg Med 1997;30:7-13   DOI   ScienceOn
10 Warshauer DM, Wehmueller MD, Molina PL, Muller KE, DeLuca MC, Lee JK. Hepatic enhancement and metastatic lesion conspicuity on CT scans: influence of intravenous glucagons and oral CT contrast materials. Radiology 1997;202:394-8   DOI
11 Jadvar H, Schambaye RB, Segall GM. Effect of atropine and sincalide on the intestinal uptake of F -18 fluorodeoxyglucose. Clin Nucl Med 1999;24:965-7   DOI
12 Geral A, Lutz SF, Thomas B, et al. To enhance or not to enhance? $^{18}F$-FDG and CT contrast agents in dual-modality$^{18}F$- FDG PET/CT. J Nucl Med 2004;45:56S-65S
13 Stafford RE, McGonigal MD, Weigelt JA, Johnson TJ. Oral contrast solution and computed tomography for blunt abdominal trauma: a randomized study. Arch Surg 1999;134:622-6   DOI   ScienceOn
14 Mitchell DG, Bjorgvinsson E, terMeulen D, Lane P, Greberman M, Friedman AC. Gastrografin versus dilute barium for colonic CT examination: a blind, randomized study. J Comput Assist Tomogr 1985;9:451-3   DOI   ScienceOn
15 Antoch G, Freudenberg LS, Beyer T, Bockisch A, Debatin JF. Effect of oral contrast agents on CT -based PET attenuation correction in dual-modality PET/CT image. Invest Rad. 2003; 38:784-9
16 Goerres GW, Hany TF, Kamel E, von Schulthess GK, Buck A. Head and neck imaging with PET and PET/CT: artefacts from dental metallic implants, Eur J Nucl Med Mol Imaging. 2002; 29:367-70   DOI   ScienceOn
17 Hausegger K, Reinprecht P, Kau T, Igerc I, Lind P. Clinical experience with a commercially available negative oral contrast medium in PET/CT. Rofo 2005;177:796-9   DOI   ScienceOn
18 Groves AM, Kayani I, Dickson JC, Townsend C, Croasdale I, Syed R et al. Oral contrast medium in PET/CT: should you or shouldn't you? Eur J Nucl Med Mol Imaging 2005;4(epub). DOI:10.1007/s00259-005-1833-9