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

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.

Keywords

• Positron emission tomography
• proton pump inhibitor
• physiological uptake
• gastrointestinal tract

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