Blood glucose levels in a pediatric population undergoing F18-FDG PET/CT

Objectives To evaluate the need for blood sugar measurements in pediatric populations undergoing F18 FDG-PET/CT imaging.

Methods Data from 552 pediatric whole body PET/CT studies performed from April 2008 to March 2010 were reviewed. Blood glucose levels (mmol/L) were measured just before the F18-FDG injection. F18-FDG PET images were reviewed to identify diffuse muscular uptake as well as medication history for corticosteroids.

Results 102 patients were receiving corticosteroids at the time of examination. Their blood glucose levels were slightly higher (5.6 ± 1.5 mmol/L; range 3.2-15.1 mmol/L ) when compared to the patients without (5.2± 0.7 mmol/L; range 2.6-8.0 mmol/L) (p = 0.008, 2 tailed unpaired T-test). However, only 14 patients of all patients had elevated blood sugar levels between 7 and 8.4 mmol/L (6 with steroids) and only 3 over 8.5 mmol/L (all with steroids). Diffuse muscular uptake was found in 8 patients .

Conclusions Most pediatric patients, even those under corticosteroids medication, have normal blood glucose levels. Furthermore, the glucose levels were not able to predict those with altered FDG biodistribution. Therefore, blood glucose level measurements may not be necessary in a pediatric population. What is more important in the pediatric population is to carefully interview the patients and identify those who did not adequately complete the fasting period, recently exercised and who are currently taking corticosteroids

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