Impact of implanted chest port utilization for the administration of F¹⁸-FDG in PET/CT imaging

Objectives: Implanted chest ports are convenient for patients who would otherwise need repeated venous access throughout their treatment plan. To minimize tracer hang up, peripheral intravenous lines were the preferred method of administration for F¹⁸-FDG over chest ports. The purpose of this study is to determine if utilizing implanted chest ports for the administration of F¹⁸-FDG causes tracer hang-up with an SUV_max greater than 2.0, suggesting an area of metabolic activity.

Methods: Over the course of 15 months, patients’ whose chest ports were utilized for the administration of F¹⁸-FDG via a MEDRAD Intego were added to this study. The dictation for each of these patients’ scans was reviewed to determine if tracer hang up in the port was noted. Utilizing GE’s AW Server program, a region of interest was drawn around the port chamber, the distal catheter, and anywhere proximal to the catheter termination when increased uptake was visualized. The SUV_max was recorded and separated into two groups based on values greater than and less than 2.0. A t-test was performed to determine statistical difference of the port chamber SUV_max values only.

Results: Of the 58 patients selected, 27 (47%) had an SUV_max greater than 2.0 in the port chamber. 1 (2%) had an SUV_max greater than 2.0 in the distal catheter, and 4 (7%) had an SUV_max greater than 2.0 along the proximal catheter. Only 2 (3%) of the dictations mentioned increased uptake in the port. A t-test calculation of the port chamber SUV_max values yielded a t-value of 1.5 with a p-value of 0.071.

Conclusions: There is no evidence to support a statistical difference between the port chamber values greater than 2.0 and less than 2.0. Due to the nature of metabolic myocardial activity, it was difficult to determine whether there was significant uptake at the distal catheter. Each patients’ myocardial uptake varies depending on several factors, including exercise and diet prior to injection. Therefore, these SUV_max values couldn’t be statistically compared. None of the dictations mentioned increased activity in the port chamber even though 47% of patients had SUV_max values greater than 2.0. It may then be concluded that this uptake does not affect the physician’s dictation of these PET/CT scans and implanted chest ports may be utilized for the administration of F¹⁸-FDG.