Does 2-FDG-PET Accurately Reflect Quantitative In vivo Glucose Utilization?

摘要: 2-Deoxy-2-18F-fluoro-d-glucose (2-FDG) with PET is undeniably useful in the clinic, being able, among other uses, to monitor change over time using 2-FDG SUV metric. This report suggests some potentially serious caveats for this and related roles PET. Most critical assumption that there an exact proportionality between glucose metabolism metabolism, called lumped constant, or LC. describes LC not constant a specific tissue may be variable before after disease treatment. The purpose of work deny clinical value PET; it reminder when one extends use appropriately qualified imaging method, new observations arise further validation would necessary. current understanding glucose-based energetics vivo based on quantification metabolic rates PET, method permits noninvasive assessment various human disorders. However, good substrate only facilitated-glucose transporters (GLUTs), sodium-dependent cotransporters (SGLTs), which have recently been shown distributed multiple tissues. Thus, GLUT-mediated utilization measured by masked substantial role functional SGLTs transport use. Therefore, under these circumstances, used quantify should expected remain constant. variations especially significant tumors, particularly at different stages cancer development, affecting accuracy quantitative measures limiting prognostic 2-FDG, as well its monitoring treatments. SGLT-mediated can estimated α-methyl-4-deoxy-4-18F-fluoro-d-glucopyranoside (Me-4FDG). Using both Me-4FDG provide more complete picture via GLUT SGLT health states. Given widespread infer relevant appreciate potential limitations surrogate rate reasons variability Even readout study parameter, important, if changes course progression (e.g., evolving tumor).