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Comparison of 1-¹¹C-Glucose and ¹⁸F-FDG for Quantifying Myocardial Glucose Use with PET

¹ Cardiovascular Imaging Laboratory, Division of Radiological Sciences, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri
² Cardiovascular Division, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri

In this study, we compared the accuracy of the rate of myocardial glucose use (rMGU) measured using PET and 1-¹¹C-glucose with the rate measured using PET and the more conventional tracer ¹⁸F-FDG. Methods: PET measurements of myocardial tracer uptake (K, in mL/g/min) and rMGU (in nmol/g/min) were obtained with 1-¹¹C-glucose and ¹⁸F-FDG in 21 dogs using kinetic modeling and the Patlak graphical method, respectively. Eighteen dogs were studied during hyperinsulinemic-euglycemic clamp performed either at rest or combined with phenylephrine, dobutamine, intralipid infusion, or intralipid infusion and dobutamine. Three dogs were studied during intralipid infusion alone under resting conditions. Arterial-coronary sinus sampling was performed to measure the K of both tracers (n = 14) and rMGU by the Fick method (n = 21). Results: PET-derived values for K from either 1-¹¹C-glucose or ¹⁸F-FDG correlated closely with directly measured tracer K values (glucose: y = 0.98x + 0.01, r = 0.79, P < 0.001; ¹⁸F-FDG: y = 0.74x + 0.03, r = 0.77, P < 0.001). In contrast, correlation with K values of unlabeled glucose measured directly was better for 1-¹¹C-glucose (y = 0.92x + 0.02, r = 0.96, P < 0.0001) than for ¹⁸F-FDG (y = 0.66x + 0.05, r = 0.72, P < 0.01) (P < 0.001 for comparison of correlation coefficients). As a consequence, PET-derived values for rMGU correlated more closely with Fick-derived measurements of unlabeled glucose using 1-¹¹C-glucose (y = 0.82x + 168, r = 0.97, P < 0.0001) than with ¹⁸F-FDG (y = 0.81x + 278, r = 0.79, P < 0.001) (P < 0.001 for comparison of correlation coefficients). Conclusion: Over a wide range of conditions, PET-derived measurements of rMGU are obtained more accurately with 1-¹¹C-glucose than with ¹⁸F-FDG.

Key Words: glucose • metabolism • myocardium • tomography

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