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Effects of Fever on 18F-FDG Distribution In Vivo: a Preliminary Study

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Abstract

Purpose

Elevated body temperature might change glucose metabolism in human organs. The purpose of this study is to explore 18F-FDG distribution in febrile patients on the day of 18F-FDG PET/CT scanning and compare it with patients with a normal temperature.

Procedures

18F-FDG PET/CT was performed on 69 febrile patients and 82 patients with a normal temperature. Patient sociodemographic data, blood glucose levels before PET/CT, body temperature on the day of the exam, and laboratory test results were collected. Maximal standard uptake values (SUVmax) in the brain, mediastinal blood pool, liver, spleen, and the bone marrow were compared.

Results

Compared with the controls, SUVmax of the febrile patients was significantly lower in the brain, mediastinal blood pool, and the liver (p < 0.01), and higher in the spleen and bone marrow (p < 0.01). In the febrile group, SUVmax was not significantly different between the FDG burden and non-FDG burden patients (p > 0.05). Body temperature was found negatively correlated with SUVmax in the brain (r = − 0.646), mediastinal blood pool (r = − 0.530), and the liver (r = − 0.384), and positively correlated with the SUVmax in the spleen (r = 0.592) and bone marrow (r = 0.651). Multivariate linear regression established body temperature on the day of PET/CT as an independent affecting factor (p < 0.01) for the SUVmax in the brain, mediastinal blood pool, liver, spleen, and bone marrow. The SUV in the brain, liver, and mediastinal blood pool remained different (p < 0.05) after corrected with the SUVmax in the blood pool or liver.

Conclusions

Fever influences 18F-FDG distribution in multiple human tissues and organs. Altered 18F-FDG distribution in vivo might affect results of disease lesion detection and tumor therapy response assessment. Correction with blood pool or liver SUV fails to cancel the effects of fever. The day of fever should be avoided for PET/CT scan, especially in assessing tumor therapy response.

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Author notes

  1. Yutang Yao and Junjun Cheng contributed equally to this work and shared joint first authorship. Minggang Su and **aohong Ou shared joint corresponding authorship.

Authors and Affiliations

  1. Department of Nuclear Medicine, West China Hospital, Sichuan University, No.37, Guoxue Alley, Chengdu, 610041, Sichuan, People’s Republic of China

    Yutang Yao, Junjun Cheng, Minggang Su & **aohong Ou

  2. PET/CT Center, Department of Nuclear Medicine, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, No.55, Section 4, South People’s Road, Chengdu, 610041, Sichuan, People’s Republic of China

    Yutang Yao

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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Yutang Yao, Junjun Cheng, Minggang Su, and **aohong Ou. The first draft of the manuscript was written by Yutang Yao and Junjun Cheng. The draft was reviewed and edited by Minggang Su and **aohong Ou. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Minggang Su or **aohong Ou.

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Yao, Y., Cheng, J., Su, M. et al. Effects of Fever on 18F-FDG Distribution In Vivo: a Preliminary Study. Mol Imaging Biol 22, 1116–1123 (2020). https://doi.org/10.1007/s11307-020-01486-9

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