Research Article
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The effect of proton pump inhibitor use on the biodistribution of FDG in patients undergoing 18F FDG PET/CT imaging

Year 2023, , 143 - 147, 27.03.2023
https://doi.org/10.38053/acmj.1241530

Abstract

Aim: In this study, we aimed to investigate the effects of proton pump inhibitors (PPIs) administered shortly before intravenous (iv) F-18 fluorodeoxyglucose (FDG) injection on the physiological FDG uptake in the gastrointestinal tract (GIS) of patients undergoing F-18 FDG positron emission tomography/computed tomography (PET/CT) for oncological purposes.
Material and Method: We retrospectively evaluated 350 patients who underwent 18F-FDG PET/CT in our clinic between November 2020 and June 2021. Among these, 178 patients were given iv PPIs before the scan and the remaining 172 patients with similar characteristics were not. FDG uptake in the gastrointestinal tract was analyzed visually and quantitatively.
Results: The mean age of the patients was 51.7±15 years. There was no significant difference between the two groups in terms of age and gender. Quantitative evaluation revealed that the FDG uptakes in the stomach, duodenum, ileum, and transverse colon and their ratio to hepatic uptake were significantly lower in the group receiving iv PPIs (p<0.05). In visual evaluation, gastric and ileal uptake were significantly lower in the intravenous PPI group (p<0.05).
Conclusion: Our findings indicate that intravenous administration of a PPI before FDG PET/CT imaging can decrease the FDG uptake in the gastrointestinal tract. We think that this practice can reduce false positive findings in the gastrointestinal system and help identifying gastric and intestinal cancers by reducing background activity.

References

  • Boellaard R, Delgado-Bolton R, Oyen WJ, et al. European Association of Nuclear Medicine (EANM). FDG PET/CT: EANM procedure guidelines for tumour imaging: version 2.0. Eur J Nucl Med Mol Imaging 2015; 42: 328-54.
  • Howard BA, Wong TZ. 18F-FDG-PET/CT imaging for gastrointestinal malignancies. Radiol Clin North Am 2021; 59: 737-53.
  • de Geus-Oei LF, van der Heijden HF, Corstens FH, Oyen WJ. Predictive and prognostic value of FDG-PET in nonsmall-cell lung cancer: a systematic review. Cancer 2007; 110: 1654-64.
  • Jayaprakasam VS, Paroder V, Schöder H. Variants and pitfalls in PET/CT imaging of gastrointestinal cancers. Semin Nucl Med 2021; 51: 485-501.
  • Jamar F, Buscombe J, Chiti A, et al. EANM/SNMMI guideline for 18F-FDG use in inflammation and infection. J Nucl Med 2013; 54: 647-58.
  • Pijl JP, Nienhuis PH, Kwee TC, Glaudemans AWJM, Slart RHJA, Gormsen LC. Limitations and pitfalls of FDG-PET/CT in infection and inflammation. Semin Nucl Med 2021; 51: 633-45.
  • Abouzied MM, Crawford ES, Nabi HA. 18F-FDG imaging: pitfalls and artifacts. J Nucl Med Technol 2005; 33: 145-55
  • Shreve PD, Anzai Y, Wahl RL. Pitfalls in oncologic diagnosis with FDG PET imaging: physiologic and benign variants. Radiographics 1999; 19: 61-77.
  • Wang X, Koch S. Positron emission tomography/computed tomography potential pitfalls and artifacts. Curr Probl Diagn Radiol 2009; 38: 156-69.
  • Pilkington P, Lopci E, Adam JA, Kobe C, Goffin K, Herrmann K. FDG-PET/CT variants and pitfalls in haematological malignancies. Semin Nucl Med 2021; 51: 554-71.
  • Koppula BR, Fine GC, Salem AE, et al. PET-CT in clinical adult oncology: III. gastrointestinal malignancies. Cancers (Basel) 2022; 14: 2668.
  • Shmidt E, Nehra V, Lowe V, Oxentenko AS. Clinical significance of incidental [18 F]FDG uptake in the gastrointestinal tract on PET/CT imaging: a retrospective cohort study. BMC Gastroenterol 2016; 16: 125.
  • Kousgaard SJ, Thorlacius-Ussing O. Incidental colorectal FDG uptake on PET/CT scan and lesions observed during subsequent colonoscopy: a systematic review. Tech Coloproctol 2017; 21: 521-9.
  • Le Roux PY, Duong CP, Cabalag CS, Parameswaran BK, Callahan J, Hicks RJ. Incremental diagnostic utility of gastric distension FDG PET/CT. Eur J Nucl Med Mol Imaging 2016; 43: 644-53.
  • Yamamoto F, Nakada K, Zhao S, Satoh M, Asaka M, Tamaki N. Gastrointestinal uptake of FDG after N-butylscopolamine or omeprazole treatment in the rat. Ann Nucl Med 2004; 18: 637-40.
  • Domeki Y, Yamazaki E, Matsuura A, Kitajima K, Murakami K, Kato H. Effects of a proton pump inhibitor on the physiological accumulation of fluoro-2-deoxy-D-glucose (FDG) in FDG-positron emission tomography. Surg Today 2012; 42: 927-33.
  • Okabe S, Takagi K, Inoue K. Effect of NC-1300-O-3 on healing of acetic acid-induced gastric ulcers in rats. Jpn J Pharmacol 1993; 62: 25–33.
  • Suzuki M, Nakamura M, Mori M, Miura S, Tsuchiya M, Ishii H. Lansoprazole inhibits oxygen-derived free radical production from neutrophils activated by Helicobacter pylori. J Clin Gastroenterol 1995; 20: 93–6.
  • Yoshida N, Yosikawa T, Tanaka Y, Fujita N, Kassai K, Naito Y. A new mechanism for anti-inflammatory actions of proton pump inhibitors-inhibitory effects on neutrophil-endothelial cell interactions. Aliment Pharmacol Ther 2000; 14: 74–81.
  • Wandall JH. Effects of omeprazole on neutrophil chemotaxis, super oxide production, degranulation and translocation of cytochrome b-245. Gut 1992; 33: 617–21.
  • Suzuki M, Mori M, Fukumura D, et al. Omeprazole attenuates neutrophil-endothelial cell adhesive interaction induced by extract of Helicobactor pylori. J Gastroenterol Hepatol 1999; 14: 27–31.
Year 2023, , 143 - 147, 27.03.2023
https://doi.org/10.38053/acmj.1241530

Abstract

References

  • Boellaard R, Delgado-Bolton R, Oyen WJ, et al. European Association of Nuclear Medicine (EANM). FDG PET/CT: EANM procedure guidelines for tumour imaging: version 2.0. Eur J Nucl Med Mol Imaging 2015; 42: 328-54.
  • Howard BA, Wong TZ. 18F-FDG-PET/CT imaging for gastrointestinal malignancies. Radiol Clin North Am 2021; 59: 737-53.
  • de Geus-Oei LF, van der Heijden HF, Corstens FH, Oyen WJ. Predictive and prognostic value of FDG-PET in nonsmall-cell lung cancer: a systematic review. Cancer 2007; 110: 1654-64.
  • Jayaprakasam VS, Paroder V, Schöder H. Variants and pitfalls in PET/CT imaging of gastrointestinal cancers. Semin Nucl Med 2021; 51: 485-501.
  • Jamar F, Buscombe J, Chiti A, et al. EANM/SNMMI guideline for 18F-FDG use in inflammation and infection. J Nucl Med 2013; 54: 647-58.
  • Pijl JP, Nienhuis PH, Kwee TC, Glaudemans AWJM, Slart RHJA, Gormsen LC. Limitations and pitfalls of FDG-PET/CT in infection and inflammation. Semin Nucl Med 2021; 51: 633-45.
  • Abouzied MM, Crawford ES, Nabi HA. 18F-FDG imaging: pitfalls and artifacts. J Nucl Med Technol 2005; 33: 145-55
  • Shreve PD, Anzai Y, Wahl RL. Pitfalls in oncologic diagnosis with FDG PET imaging: physiologic and benign variants. Radiographics 1999; 19: 61-77.
  • Wang X, Koch S. Positron emission tomography/computed tomography potential pitfalls and artifacts. Curr Probl Diagn Radiol 2009; 38: 156-69.
  • Pilkington P, Lopci E, Adam JA, Kobe C, Goffin K, Herrmann K. FDG-PET/CT variants and pitfalls in haematological malignancies. Semin Nucl Med 2021; 51: 554-71.
  • Koppula BR, Fine GC, Salem AE, et al. PET-CT in clinical adult oncology: III. gastrointestinal malignancies. Cancers (Basel) 2022; 14: 2668.
  • Shmidt E, Nehra V, Lowe V, Oxentenko AS. Clinical significance of incidental [18 F]FDG uptake in the gastrointestinal tract on PET/CT imaging: a retrospective cohort study. BMC Gastroenterol 2016; 16: 125.
  • Kousgaard SJ, Thorlacius-Ussing O. Incidental colorectal FDG uptake on PET/CT scan and lesions observed during subsequent colonoscopy: a systematic review. Tech Coloproctol 2017; 21: 521-9.
  • Le Roux PY, Duong CP, Cabalag CS, Parameswaran BK, Callahan J, Hicks RJ. Incremental diagnostic utility of gastric distension FDG PET/CT. Eur J Nucl Med Mol Imaging 2016; 43: 644-53.
  • Yamamoto F, Nakada K, Zhao S, Satoh M, Asaka M, Tamaki N. Gastrointestinal uptake of FDG after N-butylscopolamine or omeprazole treatment in the rat. Ann Nucl Med 2004; 18: 637-40.
  • Domeki Y, Yamazaki E, Matsuura A, Kitajima K, Murakami K, Kato H. Effects of a proton pump inhibitor on the physiological accumulation of fluoro-2-deoxy-D-glucose (FDG) in FDG-positron emission tomography. Surg Today 2012; 42: 927-33.
  • Okabe S, Takagi K, Inoue K. Effect of NC-1300-O-3 on healing of acetic acid-induced gastric ulcers in rats. Jpn J Pharmacol 1993; 62: 25–33.
  • Suzuki M, Nakamura M, Mori M, Miura S, Tsuchiya M, Ishii H. Lansoprazole inhibits oxygen-derived free radical production from neutrophils activated by Helicobacter pylori. J Clin Gastroenterol 1995; 20: 93–6.
  • Yoshida N, Yosikawa T, Tanaka Y, Fujita N, Kassai K, Naito Y. A new mechanism for anti-inflammatory actions of proton pump inhibitors-inhibitory effects on neutrophil-endothelial cell interactions. Aliment Pharmacol Ther 2000; 14: 74–81.
  • Wandall JH. Effects of omeprazole on neutrophil chemotaxis, super oxide production, degranulation and translocation of cytochrome b-245. Gut 1992; 33: 617–21.
  • Suzuki M, Mori M, Fukumura D, et al. Omeprazole attenuates neutrophil-endothelial cell adhesive interaction induced by extract of Helicobactor pylori. J Gastroenterol Hepatol 1999; 14: 27–31.
There are 21 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Research Articles
Authors

İhsan Kaplan 0000-0002-5727-4702

Yunus Güzel 0000-0002-8555-0460

Canan Can 0000-0002-0255-5830

Cihan Gündoğan 0000-0001-5700-6292

Mehmet Serdar Yıldırım 0000-0001-9422-1346

Ferat Kepenek 0000-0002-5631-7643

Bekir Taşdemir 0000-0002-7787-0341

Halil Kömek 0000-0001-8168-136X

Publication Date March 27, 2023
Published in Issue Year 2023

Cite

AMA Kaplan İ, Güzel Y, Can C, Gündoğan C, Yıldırım MS, Kepenek F, Taşdemir B, Kömek H. The effect of proton pump inhibitor use on the biodistribution of FDG in patients undergoing 18F FDG PET/CT imaging. Anatolian Curr Med J / ACMJ / acmj. March 2023;5(2):143-147. doi:10.38053/acmj.1241530

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