The combined effects of serum lipids, BMI, and fatty liver on 18F-FDG uptake in the liver in a large population from China

Liu, Guobing; Li, Yanli; Hu, Pengcheng; Cheng, Dengfeng; Shi, Hongcheng

doi:10.1097/mnm.0000000000000301

Cited by 18 publications

(18 citation statements)

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“…[ 24 ] For BMI and TC, their positive associations with background liver uptake of 18 F-FDG have been reported previously. [ 11 , 25 , 26 ] The theoretical basis may be related to the increased chronic inflammation in people with obesity or hyperlipidemia causing an increase in background liver uptake of 18 F-FDG because of the response of the liver parenchyma to chronic inflammation. [ 27 ]…”

Section: Discussionmentioning

confidence: 99%

“…However, it has been reported that the liver SUV is vulnerable to variations of many plasma biochemical parameters, such as blood glucose, serological liver enzymes, and serological lipids. [ 7 – 11 ] Another method, where liver activity is corrected by the plasma FDG activity, might be an important alternative, and theoretically, might be more suitable for hepatic tissue, because of its high blood flow. [ 12 ] Hunter et al [ 13 ] originally described this kind of method by including the total blood volume to obtain an estimate of the arterial input curve, which showed a significantly improved value compared with the SUV.…”

Section: Introductionmentioning

confidence: 99%

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Variations of the liver standardized uptake value in relation to background blood metabolism

Liu

Zhao

et al. 2018

Medicine

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To investigate the influence of background blood metabolism on liver uptake of 2-[18F]fluoro-2-deoxy-D-glucose (18F-FDG) and search for an appropriate corrective method.Positron emission tomography/computed tomography (PET/CT) and common serological biochemical tests of 633 healthy people were collected retrospectively. The mean standardized uptake value (SUV) of the liver, liver artery, and portal vein (i.e., SUVL, SUVA, and SUVP) were measured. SUVL/A was calculated as SUVL/SUVA, while SUVL/P was calculated as SUVL/SUVP. SUV of liver parenchyma (SUVLP) was calculated as SUVL − .3 × (.75 × SUVP + .25 × SUVA). The coefficients of variation (CV) of SUVL, SUVL/A, SUVL/P, and SUVLP were compared to assess their interindividual variations. Univariate and multivariate analyses were performed to identify vulnerabilities of these SUV indexes to common factors assessed using serological liver functional tests.SUVLP was significantly larger than SUVL (2.19 ± .497 vs 1.88 ± .495, P < .001), while SUVL/P was significantly smaller than SUVL (1.72 ± .454 vs 1.88 ± .495, P < .001). The difference between SUVL/A and SUVL was not significant (1.83 ± .500 vs 1.88 ± .495, P = .130). The CV of SUVLP (22.7%) was significantly smaller than that of SUVL (22.7%:26.3%, P < .001), while the CVs of SUVL/A (27.2%) and SUVL/P (26.4%) were not different from that of SUVL (P = .429 and .929, respectively). Fewer variables independently influenced SUVLP than influenced SUVL, SUVL/A, and SUVL/P; Only aspartate aminotransferase, body mass index, and total cholesterol, all P-values <.05.The activity of background blood influences the variation of liver SUV. SUVLP might be an alternative corrective method to reduce this influence, as its interindividual variation and vulnerability to effects from common factors of serological liver functional tests are relatively lower than the commonly used SUVL.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Variations of the liver standardized uptake value in relation to background blood metabolism

Liu

Zhao

et al. 2018

Medicine

Self Cite

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show abstract

“…Some authors described a controversial increase in liver SUVmean values in patients with fatty liver. Liu et al (12) reported a positive relationship between liver SUVmean and fatty infiltration when the severity was mild to moderate, while there is a negative effect when more severe. They also noted that FDG uptake of liver gradually increase in patients as the body mass index (BMI) increases from underweight to overweight, but a decrease in SUVmean values occur when the patient is obese.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have been conducted to investigate the possible effect of fatty infiltration on liver SUVs (8)(9)(10)(11)(12)(13)(14)(15). Some of these studies have reported no correlation between low attenuation due to high fat content of liver and 18 F-FDG uptake (10,13).…”

Section: Introductionmentioning

confidence: 99%

Assessment of the Effect of Fatty Infiltration on Hepatic FDG Uptake

Özülker¹,

Özülker²

2019

eamr

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In fluorodeoxyglucose (FDG) positron emission tomography (PET)/computerized tomography (CT) studies, physiological liver FDG uptake has been used as a reference in the evaluation of FDG uptake in pathological processes, even in malignancies. There is an ongoing debate on the effect of liver attenuation and FDG uptake in the liver. We aimed to evaluate the possible effect of fatty infiltration on the standardized uptake value (SUV) of the liver. Methods: A total of 88 patients were included in this study. Subjects were divided into 2 groups by calculating the Hounsfield unit (HU) of the liver from the unenhanced CT part of the PET/CT study and comparing it with that of the spleen. Fatty liver group included 42 patients (26 female, 16 male) with a mean age of 59.6±11.6 years, while control group consisted of 46 patients (22 female, 24 male) with a mean age of 60.2±11 years. The patients with a mean liver attenuation value (in HU) equal and greater than that of spleen were enrolled in the control group, while the patients with a mean liver attenuation value lower than the spleen were included in the fatty liver group. A subset of patients in the fatty liver group with difference in attenuation between the liver and spleen of more than 10 HU (HUS-HUL >10) were evaluated separately. Age, weight, history of diabetes mellitus (DM) and chemotherapy, serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels, simultaneous blood glucose levels during PET scan and the elapsed time between FDG injection and the beginning of PET scan were recorded. Results: The average SUVmean and SUVmax values were 2.7±0.7 and 3.6±0.9 in the fatty liver group, 2.8±0.7 and 3.8±1 in the HUS-HUL >10 group and 3.3±0.6 and 4.4±0.9 in the control group, respectively. The average SUVmean and SUVmax values of the fatty liver group and HUS-HUL >10 group were significantly different from the control group (p<0.05). The patients in the fatty liver group had higher ALT (p=0.025) and glucose levels (p=0.001), weight (p=0.001), and DM rate (p=0.002) compared to the control group. Conclusion: Hepatic steatosis causes a statistically significant decrease in SUVmean and SUVmax values in liver. Therefore, we must be careful when using the liver as an internal reference organ

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“…The available literature assessing the relationship between hepatic FDG uptake and the spectrum of NAFLD is still fairly scant; however there is evidence that FDG uptake in NASH is higher than in normal livers due to irreversible FDG uptake in inflammatory cells, 1 whilst it is suggested that the hepatic FDG uptake in NAFLD may vary depending on the steatosis severity, explaining our constellation of PET-CT appearances. 2 However, interestingly, contradictory findings have been described including a recent study using dynamic PET-CT showing that FDG transport from blood to hepatic tissue was reduced in NASH, 3 whilst another recent study, which utilised labelled galactose, also showed that NASH was less metabolically active than either simple steatosis or healthy controls. 4 This case provides an important example of a false-positive finding on the FDG PET-CT due to NASH mimicking a solitary liver metastasis.…”

Section: Non-alcoholic Steatohepatitis Mimicking Solitary Liver Metasmentioning

confidence: 99%

Non‐alcoholic steatohepatitis mimicking solitary liver metastasis

2019

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The combined effects of serum lipids, BMI, and fatty liver on 18F-FDG uptake in the liver in a large population from China

Cited by 18 publications

References 30 publications

Variations of the liver standardized uptake value in relation to background blood metabolism

Variations of the liver standardized uptake value in relation to background blood metabolism

Assessment of the Effect of Fatty Infiltration on Hepatic FDG Uptake

Non‐alcoholic steatohepatitis mimicking solitary liver metastasis

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