TY - JOUR T1 - Additional Heparin Preadministration Improves Cardiac Glucose Metabolism Suppression over Low-Carbohydrate Diet Alone in <sup>18</sup>F-FDG PET Imaging JF - Journal of Nuclear Medicine JO - J Nucl Med SP - 568 LP - 573 DO - 10.2967/jnumed.115.166884 VL - 57 IS - 4 AU - Asbjørn M. Scholtens AU - Hein J. Verberne AU - Ricardo P.J. Budde AU - Marnix G.E.H. Lam Y1 - 2016/04/01 UR - http://jnm.snmjournals.org/content/57/4/568.abstract N2 - Adequate suppression of cardiac glucose metabolism increases the interpretability and diagnostic reliability of 18F-FDG PET studies performed to detect cardiac inflammation and infection. There are no standardized guidelines, though prolonged fasting (&gt;6 h), carbohydrate-restricted diets, fatty meals, and heparin loading all have been proposed. The aim of this study was to compare the 3 preparatory protocols used in our institution. Methods: 18F-FDG PET scans were selected and grouped according to 3 preparatory protocols (50 consecutive scans per group): 6-h fast (group 1), low-carbohydrate diet plus 12-h fast (group 2), and low-carbohydrate diet plus 12-h fast plus intravenous heparin preadministration (50 IU/kg) (group 3). Consecutive scans were retrospectively included from time frames during which the particular protocol was used. Group 1 included oncologic indications, and groups 2 and 3 infection or inflammation detection. Cardiac segments for which inflammation or infection foci had been confirmed on other imaging modalities were excluded from the analysis. 18F-FDG uptake in normal myocardium was scored according to a scale ranging from 0 (uptake less than that in left ventricle blood pool) to 4 (diffuse uptake greater than that in liver). Adequate suppression was defined as uptake less than that in liver and without any focus (scores 0–2). Results: Adequate suppression differed significantly between groups: 28% in group 1, 54% in group 2, and 88% in group 3 (P &lt; 0.0001 for all comparisons). Conclusion: Single-dose heparin administration before 18F-FDG PET in addition to a low-carbohydrate diet significantly outperforms a low-carbohydrate diet alone in adequately suppressing cardiac glucose metabolism. ER -