Discontinuation of metformin to prevent metformin-induced high colonic FDG uptake: is 48 h sufficient?

Autor: Schreuder N; Groningen Research Institute of Pharmacy, Pharmacotherapy, Epidemiology and Economics, University of Groningen, Antonius Deusinglaan 1, Groningen, The Netherlands. n.schreuder@rug.nl.; GE Healthcare Radiopharmacy Zwolle, Zwolle, The Netherlands. n.schreuder@rug.nl., Klarenbeek H; Groningen Research Institute of Pharmacy, Pharmacotherapy, Epidemiology and Economics, University of Groningen, Antonius Deusinglaan 1, Groningen, The Netherlands., Vendel BN; Department of Nuclear Medicine, Isala Hospital, Zwolle, The Netherlands., Jager PL; Department of Nuclear Medicine, Isala Hospital, Zwolle, The Netherlands., Kosterink JGW; Groningen Research Institute of Pharmacy, Pharmacotherapy, Epidemiology and Economics, University of Groningen, Antonius Deusinglaan 1, Groningen, The Netherlands.; Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., van Puijenbroek EP; Groningen Research Institute of Pharmacy, Pharmacotherapy, Epidemiology and Economics, University of Groningen, Antonius Deusinglaan 1, Groningen, The Netherlands.; Netherlands Pharmacovigilance Centre Lareb, 's Hertogenbosch, The Netherlands.
Jazyk: angličtina
Zdroj: Annals of nuclear medicine [Ann Nucl Med] 2020 Nov; Vol. 34 (11), pp. 833-839. Date of Electronic Publication: 2020 Aug 19.
DOI: 10.1007/s12149-020-01509-z
Abstrakt: Objective: In this retrospective, single-center observational study, we investigated whether discontinuing metformin for at least 48 h prevents metformin-induced [ 18 F]fluorodeoxyglucose (FDG) uptake in all segments of the colon.
Methods: Patients with type 2 diabetes who were using metformin before undergoing an FDG PET/CT scan were included. Two groups were created: patients who discontinued metformin for less than 48 h (< 48 h group) and patients who discontinued metformin for between 48 and 72 h (≥ 48 h group). A control group comprised non-diabetic patients who were not using metformin before undergoing an FDG PET/CT. We visually scored the uptake of FDG in four segments of the colon-the ascendens, transversum, descendens, and rectosigmoid-using a four-point scale (1-4) and considered scores of 3 or 4 to be clinically significant.
Results: Colonic FDG uptake in the ≥ 48 h group (n = 23) was higher than uptake in the control group (n = 96) in the colon descendens [odds ratio (OR) 14.0; 95% confidence interval (CI) 4.8-40.9; p value: 0.001] and rectosigmoid (OR 11.3; 95% CI 4.0-31.9; p value: 0.001), and there was no difference in the colon ascendens and transversum. Colonic FDG uptake in the < 48 h group (n = 25) was higher than uptake in the ≥ 48 h group (n = 23) in the colon transversum (OR 4.8; 95% CI 1.3-18.5; p value: 0.022) and rectosigmoid (p value: 0.023), and there was no difference in the colon ascendens and descendens.
Conclusions: Discontinuing metformin for 48 h before undergoing an FDG PET/CT still gives a high uptake in the distal parts of the colon when compared with non-diabetic patients who are not using metformin. Discontinuing metformin for 48 h seems to be useful for scanning the more proximal segments of the colon.
Databáze: MEDLINE
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