Skip to main content
SpringerLink
Log in

Factors affecting myocardial 2-[F-18]fluoro-2-deoxy-d-glucose uptake in positron emission tomography studies of normal humans

  • Original Article
  • Published:
European Journal of Nuclear Medicine Aims and scope Submit manuscript

Abstract

The goal of this study was to identify the anatomic and physiologic factors affecting left ventricular myocardial 2-[F-18]fluoro-2-deoxy-d-glucose (FDG) uptake and myocardial glucose utilization rates (MRGlc) in normal humans. Eighteen healthy male volunteers were studied in the fasting state (4–19 h) and 16 after oral glucose loading (100 g dextrose) with positron emission tomography (PET) and FDG. Substrate and hormone concentrations were measured in each study. The kinetics of myocardial FDG uptake were evaluated using both a three-compartment model and Patlak graphical analysis. Systolic blood pressures and rate pressure products were similar in the fasting and postglucose states. MRGlc averaged 0.24±0.17 μmol/min/g in fasting subjects and rose to 0.69±0.11 μmol/min/g after glucose loading. Phosphorylation rate constant, k3, and MRGlc were linearly related (P < 0.001). Increases in MRGIc following glucose loading were correlated with plasma glucose, insulin and free fatty acid concentrations, ratios of insulin to glucagon levels, and influx rate constants of FDG. Glucose loading improved the diagnostic image quality due to more rapid clearance of tracer from blood and higher myocardial FDG uptake. When MRGlc, glucose and insulin concentrations, and insulin to glucagon ratios exceeded 0.2 μmol/min/g, 100 mg/dl, 19 μU/ml, and 0.2 μU/pg, respectively, myocardial uptake of FDG was always adequate for diagnostic use. FDG image quality and MRGlc were similar after relatively short (6 ±2 h) and overnight (16 ± 2 h) fasting. Significant (P<0.05) regional heterogeneity of myocardial FDG uptake and MRGlc was observed in both the fasting and the postglucose studies. MRGlc and FDG uptake values in the posterolateral wall were higher than those in the anterior wall and septum. Thus, both 6-h and overnight fasts resulted in similarly low myocardial glucose utilization rates. While MRGlc and myocardial FDG uptake depended on plasma glucose, free fatty acid, and insulin concentrations, the results also suggest an additional dependency on plasma glucagon levels. Regional heterogeneities in myocardial FDG uptake and MRGlc are evident and independent of the subjects' dietary state. These regional heterogeneities need to be considered in studies of patients with cardiac disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Tillisch JH, Brunken RC, Marshall RC et al. Prediction of cardiac wall motion abnormalities predicted by using positron tomography. N Engl J Med 1986; 314:884–888

    Google Scholar 

  2. Brunken RC, Tillisch JH, Schwaiger M et al. Regional perfusion, glucose metabolism and wall motion in chronic electrocardiographic Q-wave infarctions: evidence for persistence of viable tissue in some infarct regions by positron emission tomography. Circulation 1986; 73:951–963

    Google Scholar 

  3. Brunken RC, Kottou S, Nienaber CA et al. PET detection of viable tissue in myocardial segments with persistent defects at T1–201 SPELT. Radiology 1989; 1972:65–73

    Google Scholar 

  4. Schelbert HR, Schwaiger M. PET studies of the heart. In: Phelps ME, Mazziotta JC, Schelbert HR, eds. Positron emission tomography and autoradiography: principles and applications for the brain and heart. New York: Raven Press; 1986:581–661

    Google Scholar 

  5. Schelbert HR. Positron emission tomography for the assessment of myocardial viability. Circulation 1991; 84 Suppl I:I-122-I-131

    Google Scholar 

  6. Gropler RJ, Siegel BA, Lee KJ et al. Nonuniformity in myocardial accumulation of fluorine-18-fluorodeoxyglucose in normal fasted humans. J Nucl Med 1990; 31:1749–1756

    Google Scholar 

  7. Hicks RJ, Herman WH, Kalff V et al. Quantitative evaluation of regional substrate metabolism in the human heart by positron emission tomography. J Am Coll Cardiol 1991; 81:101–111

    Google Scholar 

  8. Berry JJ, Baker JA, Pieper KS et al. The effects of the metabolic milieu on cardiac PET imaging using fluorine- l8-deoxyglucose and nitrogen-l3-ammonia in normal volunteers. J Nucl Med 1991;32:1518–1525

    Google Scholar 

  9. Kuhle W, Porenta G, Huang SC, Phelps ME, Schelbert HR. Issues in the quantitation of reoriented cardiac PET images. J Nucl Med 1992; 33:1235–1242

    Google Scholar 

  10. Porenta G, Kuhle W, Czernin J et al. Gated PET FDG imaging permits parameter estimation of cardiac geometry: validation using gated MR imaging and echocardiography. J Nucl Med 1991;32:927

    Google Scholar 

  11. Phelps ME, Hoffman EJ, Selin CE et al. Investigation of [18F]2-fluoro-2-deoxyglucose for the measurement of myocardial glucose metabolism. J Nucl Med 1978; 19:1311–1319

    Google Scholar 

  12. Krivokapich J, Huang SC, Selin CE, Phelps ME. Fluorodeoxyglucose rate constants, lumped constant, and glucose metabolic rate in rabbit heart. Am J Physiol 1987; 252: H777-H787

    Google Scholar 

  13. Gambhir SS, Schwaiger M, Huang SC et al. Simple noninvasive quantification method for measuring myocardial glucose utilization in humans employing positron emission tomography and fluorine-18 deoxyglucose. J Nucl Med 1989; 30:359–366

    Google Scholar 

  14. Patlak CS, Blasberg RG, Fenstermacher JD. Graphical evaluation of blood-to-brain transfer constants from multiple-time uptake data. J Cereb Blood Flow Metab 1983; 3:1–7

    CAS  PubMed  Google Scholar 

  15. Choi Y, Hawkins RA, Huang SC, Gambhir SS, Brunken RC, Phelps ME, Schelbert HR. Parametric images of myocardial metabolic rate of glucose generated from dynamic cardiac PET and 2-[18F]fluoro-2-deoxy-D-glucose studies. J Nucl Med 1991; 32:733–738

    Google Scholar 

  16. Sokoloff L, Reivich M, Kennedy C et al. The [I4C]deoxyglucose method for the measurement of local cerebral glucose utilization: theory, procedure, and normal values in the conscious and anesthetized albino rat. J Neurochem 1977; 28:897–916

    CAS  PubMed  Google Scholar 

  17. Phelps ME, Huang SC, Hoffman EJ, Selin CJ, Sokoloff L, Kuhl DE. Tomographic measurement of local cerebral glucose metabolic rate in humans with (F-18)2-fluoro-d-deoxy-d-glucose: validation of method. Ann Neurol 1979; 6:371–388

    Google Scholar 

  18. Huang SC, Phelps ME, Hoffman EJ et al. Noninvasive determination of local cerebral metabolic rate of glucose in man. Am J Physiol 1980; 238: E69-E82

    Google Scholar 

  19. Ido T, Wan WN, Casella V et al. Labeled 2-deoxy-d-glucose analogs. 18F-labeled 2-deoxy-2-fluoro-d-glucose, 2-deoxy-2-fluoro-d-mannose, and 14C-2-deoxy-2-fluoro-d-glucose. J Label Compd Radiopharm 1978; 14:174–183

    Google Scholar 

  20. Padgett HC, Schmidt DG, Luxen A, Bida GT, Satyamurthy N, Barrio JR Computer-controlled radiochemical synthesis: a chemistry process control unit for the automated production of radiochemicals. Appl Radiat Isot 1989; 40:433–445

    Google Scholar 

  21. Weinberg IN, Huang SC, Hoffman EJ et al. Validation of PET-acquired input functions for cardiac studies. J Nucl Med 1988; 29:241–247

    Google Scholar 

  22. Hawkins RA, Phelps ME, Huang SC. Effects of temporal sampling glucose metabolic rates, and disruptions of the blood-brain barrier on the FDG model with or without a vascular compartment: studies in human brain tumors with PET. J Cereb Blood Flow Metab 1986; 6:170–183

    Google Scholar 

  23. Ratib O, Phelps ME, Huang SC et al. Positron tomography with deoxyglucose for estimating local myocardial glucose metabolism. J Nucl Med 1982; 23: 577–586

    Google Scholar 

  24. Fagan TC, Sawyer PR, Gourley LA, Lee JT, Gaffney TE. Postprandial alterations in hemodynamics and blood pressure in normal subjects. Am J Cardiol 1986; 58:636–641

    Google Scholar 

  25. Ferrannini E, Bjorkman O, Reichard GA et al. The disposal of an oral glucose load in healthy subjects. Diabetes 1985; 34:580–588

    Google Scholar 

  26. Neely JR, Morgan HE. Relationship between carbohydrate and lipid metabolism and the energy balance of heart muscle. Ann Rev Physiol 1974; 36:412–459

    Google Scholar 

  27. Opie LH. Fuels: carbohydrate and lipids. In: Opie LH ed. The heart: physiology and metabolism, 2nd edn. New York: Raven Press; 1991:208–246

    Google Scholar 

  28. Consoli A, Nurjhan N, Gerich J. Rates of appearance and disappearance of plasma lactate after oral glucose: implications for indirect-pathway hepatic glycogen repletion in man. Clin Physiol Biochem 1989; 7:70–78

    Google Scholar 

  29. Mitrakou A, Milde J, Michenfelder J, Gerich J. Rates of appearance and disappearance and brain lactate balance after oral glucose in the dog. Horm Metabol Res 1989; 21:236–239

    Google Scholar 

  30. Merhige ME, Ekas R, Mossberg K, Taegtmeyer H, Gould KL. Catecholamine stimulation, substrate competition, and myocardial glucose uptake in conscious dogs assessed with positron emission tomography. Circ Res 1987; 61 Suppl II: II-124-II-129

    Google Scholar 

  31. Busch-Sørensen M, Holst JJ, Lyngsøe J. Short time effects of growth hormone on glucose metabolism and insulin and glucagon secretion in normal man. J Endocrinol Invest 1991; 14:25–30

    Google Scholar 

  32. De Feo P, Perriello G, Torlone E et al. Demonstration of a role for growth hormone in glucose counterregulation. Am J Physiol 1989; 256: E835-E843

    Google Scholar 

  33. De Feo P, Perriello G, Torlone E et al. Contribution of cortisol to glucose counterregulation in humans. Am J Physiol 1989; 257:E35-E42

    Google Scholar 

  34. Emanuelsson H, Mannheimer C, Waagstein F. Changes of arterial levels and myocardial metabolism of catecholamines during pacing-induced angina pectoris. Clin Cardiol 1991; 14:567–572

    Google Scholar 

  35. Ng CK, Holden JE, DeGrado TR, Raffel DM, Kornguth ML, Gatley SJ. Sensitivity of myocardial fluorodeoxyglucose lumped constant to glucose and insulin. Am J Physiol 1991; 260: H593-H603

    Google Scholar 

  36. Schwaiger M, Hicks R. Regional heterogeneity of cardiac substrate metabolism? J Nucl Med 1991; 31:1757–1760

    Google Scholar 

  37. Porenta G, Kuhle W, Czernin J et al. Semiquantitative assessment of myocardial viability and flow from cardiac PET polar maps. J Nucl Med 1992; 33:1623–1631

    Google Scholar 

  38. Czernin J, Porenta G, Müller P et al. Perfusion defect extent determines LV function in patients with PET ischemia. Circulation 1991; 84:11–474

    Google Scholar 

  39. Tamaki N, Yonekura Y, Kawamoto M et al. Simple quantification of regional myocardial uptake of fluorine- l8-deoxyglucose in the fasting condition. J Nucl Med 1991; 32:2152–2157

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Nuclear Medicine and Biophysics, Department of Radiological Sciences, Laboratory of Nuclear Medicine (DOE), Laboratory of Biomedical and Environmental Sciences, and The Crump Institute for Biological Imaging, School of Medicine, University of California, 0024-1721, Los Angeles, CA, USA

    Yong Choi, Richard C. Brunken, Randall A. Hawkins, Sung-Cheng Huang, Denis B. Buxton, Carl K. Hoh, Michael E. Phelps & Heinrich R. Schelbert

Authors
  1. Yong Choi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Richard C. Brunken
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Randall A. Hawkins
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sung-Cheng Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Denis B. Buxton
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Carl K. Hoh
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Michael E. Phelps
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Heinrich R. Schelbert
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

Laboratory of Biomedical and Environmental Sciences operated for the US Department of Energy by the University of California under Contract DE-FC03-87ER60615

Correspondence to: Y Choi

Rights and permissions

Reprints and permissions

About this article

Cite this article

Choi, Y., Brunken, R.C., Hawkins, R.A. et al. Factors affecting myocardial 2-[F-18]fluoro-2-deoxy-d-glucose uptake in positron emission tomography studies of normal humans. Eur J Nucl Med 20, 308–318 (1993). https://doi.org/10.1007/BF00169806

Download citation

  • Received:

  • Revised:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00169806

Key words

Search

Navigation