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Aortic 18F-FDG PET/CT uptake pattern at 60 min (early) and 180 min (delayed) acquisition in a control population: a visual and semiquantitative comparative analysis

Martínez-Rodríguez, Isabel; Del Castillo-Matos, Rosangie; Quirce, Remedios; Banzo, Ignacio; Jiménez-Bonilla, Julio; Martínez-Amador, Nestor; Ibáñez-Bravo, Susana; Lavado-Pérez, Carmen; Bravo-Ferrer, Zully; Carril, José M.

doi: 10.1097/MNM.0b013e32836370fb
Technical Note

18F-Fluoro-2-deoxy-D-glucose (18F-FDG) PET/CT acquisition is generally performed 60 min after injection. The normal biodistribution pattern of 18F-FDG includes activity in the aortic territory due to blood pool activity, which could interfere in the diagnosis of aortic diseases by overlapping the wall uptake. The aim of the study was to evaluate the change over time of 18F-FDG uptake by the aortic wall and the activity in the lumen in a control population and to establish normal reference values. This prospective study included 15 control patients (mean age: 58.2 years). PET/CT was acquired 60 min (early scan) and 180 min (delayed scan) after an 18F-FDG injection at a dose of 7 MBq/kg. A visual and semiquantitative analysis of the 18F-FDG aortic wall uptake was carried out, and lumen activity and the aortic wall to lumen ratio [target-to-background ratio (TBR)] were determined. In the visual analysis all patients showed 18F-FDG activity at the aortic territory at 60 and 180 min. The pattern of uptake at 60 min was diffuse in all 15 patients (100%), without delineation of the aortic wall uptake; however, at 180 min the uptake pattern of the aortic wall changed to lineal in 14 patients (93.3%). The aortic wall maximum standardized uptake value decreased from 2.07±0.34 to 1.7±0.46 during the delayed acquisition (P=0.0279) and the lumen maximum standardized uptake value decreased highly significantly (1.99±0.35 vs. 1.36±0.32, P=0.0001). Therefore, TBR also increased highly significantly from 1.04±0.06 to 1.25±0.16 (P<0.0001). The high decrease in blood pool activity from 60 to 180 min provides a better delineation of the aortic wall uptake, which corresponds to the normal pattern at that time. The TBR increased significantly at 180 min, and 1.25±0.16 is suggested as the threshold for diagnostic purposes, especially for the diagnosis of vasculitis.

Nuclear Medicine Department, ‘Marqués de Valdecilla’ University Hospital, University of Cantabria, Santander, Spain

Correspondence to Isabel Martínez-Rodríguez, MD, Nuclear Medicine Department, ‘Marqués de Valdecilla’ University Hospital, University of Cantabria, Avda. Valdecilla s/n, 39008 Santander, Spain Tel: +34 942 315155; fax: +34 942 315167; e-mail:

Received February 15, 2013

Accepted May 20, 2013

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins