Effects of a proton pump inhibitor on the physiological accumulation of fluoro-2-deoxy-D-glucose (FDG) in FDG-positron emission tomography

Purposes The physiological accumulation of fluoro-2- deoxy-D-glucose (FDG) is common in medical examinations of the digestive tract conducted using FDG-positron emission tomography (PET). The aim of this study was to determine the effects of a proton pump inhibitor (PPI) on the physiological FDG accumulation in the digestive tract. Methods A total of 130 patients examined from July 2007 to October 2008 were included in the final analysis. A PPI was administered orally prior to FDG-PET in 65 patients. The remaining 65 patients underwent FDG-PET without administration of the PPI. The assessments used visual and quantitative evaluations. Results Visual evaluation showed that physiological FDG accumulation in the stomach was significantly reduced (p = 0.037) in the PPI group compared with the control group. The quantitative evaluation also revealed a significant reduction in the maximum standardized uptake values (SUV_max) in the stomach in the PPI group compared with the control group (p<0.0001). Physiological FDG accumulation in the colon showed a decreasing trend on visual evaluation in the PPI group compared with the control group, and the quantitative evaluation found a significant reduction in the physiological FDG accumulation in the colon in the PPI group (p = 0.045). Conclusions The oral administration of a PPI was effective for reducing the physiological accumulation of the FDG in the alimentary tract. However, based on the error associated with SUVmax measurement, a quantitative evaluation should therefore be combined with the visual evaluation.