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Spatial and Temporal Heterogeneity of Regional Myocardial Uptake in Patients Without Heart Disease Under Fasting Conditions on Repeated Whole-Body ¹⁸F-FDG PET/CT

¹ Nuclear Medicine Department, University of Eastern Piedmont, Azienda Ospedaliera Maggiore della Carità, Novara, Italy; ² Medical Physics Department, Azienda Ospedaliera Maggiore della Carità, Novara, Italy; and ³ Nuclear Medicine Department, University of Genoa, Ospedale San Martino, Genova, Italy

View larger version (19K): [in this window] [in a new window]   FIGURE 1.  Status of administered chemotherapy to patient population in course of the study.

View larger version (84K): [in this window] [in a new window]   FIGURE 2.  Serial myocardial 18FDG PET results of 58-y-old male patient with non-Hodgkin's lymphoma who submitted 3 times to whole-body PET/CT. Short-axis, horizontal long-axis, and vertical long-axis slices are displayed together with polar maps of the semiquantitative QPS software. Overlays of 20 myocardial segments, coronary artery territories, and myocardial walls are represented on top, middle, and bottom 2-dimensional polar maps, respectively. Patient was asymptomatic and completely free of any sign of cardiovascular diseases during observation period. After 18F-FDG injection in fasting conditions, with blood glucose levels never exceeding 100 mg/dL, a marked variability of regional myocardial uptake over time is evident.

View larger version (15K): [in this window] [in a new window]   FIGURE 3.  Correlation between segmental uptake at first test and segmental uptake variations between subsequent tests.

View larger version (9K): [in this window] [in a new window]   FIGURE 4.  Spatial heterogeneity of regional 18F-FDG uptake in LV myocardium. Frequency distribution of percent maximum 18F-FDG uptake indicates a large variability across LV myocardial segments, even excluding the apical region. This finding was observed in a similar fashion at all 3 scans.