Impact of 100mL Lipid Emulsion for Intravenous for Suppression of Myocardial Glucose Metabolism in 18F-FDG PET/CT

Study Overview
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Brief Summary
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There is increasing evidence that [18F]-2-fluoro-2-deoxy-D-glucose (18F-FDG) PET/CT is useful in the identification and treatment of disease processes that involve cardiac inflammation and infection. Current applications include imaging intra-cardiac device and prosthetic valve infections, evaluating patients with known or suspected cardiac sarcoidosis or other inflammatory cardiomyopathies. However, because normal myocardium can metabolize both glucose and free fatty acids (FFAs), physiological accumulation of FDG in the myocardium can interfere with the recognition of abnormal FDG uptake. The use of a low-carbohydrate diet with a prolonged fast ≥ 12 h nutrition followed by a fast of at least four hours is the effective preparation recommended to suppress physiological myocardial FDG uptake. However, the rate of suppression of physiological accumulation of FDG with this method in our center is only 50%.

Detailed Description
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Methodology : Group of 30 consecutive patients with cardiac FDG PET prescribed, prospectively enrolled, compared to a group with the last 30 patients referred for cardiac FDG PET in the nuclear medicine department of the Centre Hospitalier Princesse Grace. Procedures : Infusion of 100mL lipid emulsion for intravenous two hours before cardiac FDG PET/CT: Infusion rate will be 20 mL/hour during the initial 10 minutes (3 mL Intralipid) The dose will be then increased to 40 mL/hour for the next 10 minutes (6 mL Intralipid) Finally, for the next 50 minutes the dose will be increased to 100 mL/hour (83mL Intralipid)

Official Title
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Impact of 100mL Lipid Emulsion for Intravenous for Suppression of Myocardial Glucose

Conditions
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Metabolic Preparation, Myocardial Inflammation

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with an FDG PET/CT prescribed to explore cardiac disease process Exclusion Criteria: renal insufficiency, uncompensated diabetes mellitus, pancreatitis, liver insufficiency, hypothyroidism metabolic disorders sepsis. soy protein allergy

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 99 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Prospective patients<br>30 consecutive patients with cardiac FDG PET prescribed | |
| Control<br>30 patients referred for cardiac FDG PET in the nuclear medicine department of the Centre Hospitalier Princesse Grace | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Uptake in the heart scoring according to a visual scale | Score of 0: complete myocardial suppression Score of 1: incomplete myocardial suppression with increased myocardial FDG uptake hampering myocardial interpretation but not cardiac valves. Score of 2: incomplete myocardial suppression with increased myocardial FDG uptake hampering myocardial and mitral or aortic valve interpretations. Score of 3: incomplete myocardial suppression with increased myocardial FDG uptake hampering myocardial and both mitral and aortic valves interpretations. | day 1 |