TY - JOUR T1 - Optimal Patient Preparation For Cardiac FDG PET/CT for Cardiac Sarcoid Imaging JF - Journal of Nuclear Medicine JO - J Nucl Med SP - 774 LP - 774 VL - 58 IS - supplement 1 AU - Thomas Owens AU - Panithaya Chareonthaitawee AU - John Bois Y1 - 2017/05/01 UR - http://jnm.snmjournals.org/content/58/supplement_1/774.abstract N2 - 774Objectives: Fluorine-18 fluorodeoxyglucose (18FDG) positron emission tomography (PET) imaging for cardiac sarcoid (CS) can be a very challenging. It is therefore critical to design patient dietary preparation protocols, which will result in suppression of physiologic 18FDG uptake. However, prior investigation, as well as clinical experience has demonstrated sub-optimal patient compliance with dietary instruction. Our objective was to determine if a new simplified dietary instruction plan would result in improved patient adherence, blood pool glucose suppression and better image quality.Methods: 75 patients underwent dietary preparation protocol one, which entailed eating a high-fat, high-protein diet the evening before their test as well as two hours before their appointment. 101 patients underwent dietary preparation protocol two, which entailed eating three high-fat, high-protein meals the day before their test with the last meal being before 5 pm the evening before their scan. The patient could alternatively choose to be fasting for 18 hours priors to their appointment. Regardless of protocol, all patients were called the day before their test to clarify the dietary instructions and their itinerary had a list of foods they could choose from. The imaging protocols for both patient groups consisted of a resting perfusion PET scan using 12 mCi of 13N-Ammonia and imaged with a GE 710-Discovery camera. Images were acquired in list mode and the study was gated to calculate a resting ejection fraction. Patients were subsequently injected with 15 mCi of 18F-FDG with a one-hour uptake period prior to a 10 minute list mode scan with no gating. An important component of 18FDG metabolism in CS imaging is patient preparation. Having patients closely follow a high-protein, high fat diet is vital to increase free fatty acids in the blood stream, enabling visualization of inflammatory CS.Results: Prior to implementing our new dietary guidelines, we found patients had difficulty complying with the dietary instructions and ingesting the correct foods for the meal two hours prior to their test. We estimate that 20% of them either ate the wrong type of food (carbohydrates) or ate too close to their appointment time. This resulted in many patients having to reschedule their test. With the new dietary instructions, we had 97 of 101 patients follow the diet as instructed which, was a 96% compliance rate. Of these 11 chose the 18-hour complete fast and the rest had a meal by 5:00 PM the night before their test. There was an average fasting time of 16.5 hours and an average glucose level of 97.35 mg/dl in patients following the new dietary protocol.Conclusion: We found that the change in our dietary instructions to eliminate the meal two hours prior to scanning lead to our patients being more compliant in following our instructions. There were fewer tests cancelled due to dietary non-compliance. This in turn lead to higher quality scans and more confidence that we had truly suppressed blood glucose levels leading to better visualization of truly inflammatory CS. ER -