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

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%.

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Key information

Conditions

Metabolic Preparation Cardiomyopathies Cardiovascular Diseases Heart Diseases Myocardial Inflammation Myocarditis

Age range

18 year–99 year

Sex eligibility

All sexes

Study type

Observational

Primary location

Centre Hospitalier Princesse Grace

Monaco

About this study

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)

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

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

Treatment and study plan

Primary outcomes

Uptake in the heart scoring according to a visual scale

Time frame: day 1
- 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.

Sponsors and collaborators

Lead sponsor

Centre Hospitalier Princesse Grace

Other

Registry information

Official study title

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

Important dates

Study start: 2020
Primary completion: 2020
Study completion: 2020
First posted: Jun 18, 2020
Registry last updated: Nov 9, 2020

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

Published trials that share one or more normalized conditions with this study.

Completed