Patient Preparation

- Day before and till exam, have the patient avoid exercise and rich carbohidrates meals. Consider intravenous dextrose solutions as well. In children cough syrups have to be avoided.

- Fasting for 8-12 h. is essential to augment cell avidity especially in malignant tissue and also diminish  heart uptake.

-  BGL should be below 160 mg/dl or less at injection time. In diabetics a BGL below 200 mg/dl is acceptable. If insulin is injected before F18-FDG, the myocardium and muscles may increase their uptake, which may hamper malignant lesions visualization.

- Withdraw metformin for 48 h, as of day of exam. If previous reactions to contrast material have been noted, antiallergic and/or steroids are recommended. The following medications are useful,

  1. Prednisone 50 mg (2,5 20 mg tablets) 12h, 7h and 1h before the procedure and
  2. Chlorphenamine 4 mg (1 tablet) 1h before the procedure.

-  Keep the patient in a quiet room, resting up until imaging.

-  Have the patient void inmediately before imaging. Use of diuretics or bladder catheterization is optional.

References:

1  Schelbert H. R. et al. Procedure Guideline for Tumor Imaging Using F-18 FDG. Society of Nuclear Medicine Manual 2002: 133-137.

2  Rohren EM, Turkington TG, Coleman RE. Clinical applications of PET in oncology. Radiology. 2004 May;231(2):305-32.

 

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