Impact of Plasma Glucose Level at the Time of Fluorodeoxyglucose Administration on the Accuracy of FDG-PET/CT in the Diagnosis of Pancreatic Lesions

Background: high fasting plasma glucose (fpg) levels before fluorodeoxyglucose (fdg) administration for positron emission tomography/computed tomography (pet/ct) might affect the accuracy of 18-fluoro-deoxy-glucose-positron emission tomography-computed tomography (fdg-pet/ct) in diagnosis of pancreatic lesions. current guidelines require fpg levels of < 200 mg/dl before fdg administration; however, the literature on the effect of fpg levels of < 200 mg/dl on the accuracy of fdg-pet/ct is scarce.objectives: the aim of this study was to evaluate the effect of fpg levels of < 200 mg/dl on the accuracy of fdg-pet/ct in diagnosis of pancreatic lesions.patients and methods: in this retrospective study, 161 patients who had fdg-pet/ct for initial diagnosis of pancreatic lesions were included. fasting plasma glucose levels before fdg administration were recorded. accuracy of fdg-pet/ct in diagnosis of pancreatic lesions was compared between patients who were normoglycemic (fpg < 126 mg/dl) and hyperglycemic (126 ≤ fpg < 200 mg/dl).results: thirty-four patients were hyperglycemic and 127 normoglycemic. sensitivity, specificity, positive predictive value and negative predictive value of fdg-pet/ct were 90%, 88%, 87% and 91% in normoglycemic and 82%, 92%, 95% and 73% in hyperglycemic patients, respectively. overall, the accuracy was higher in normoglycemic than hyperglycemic patients (89% vs. 85%).conclusions: accuracy of fdg-pet/ct for primary diagnosis of pancreatic lesions is higher in patients with fpg levels < 126 mg/dl than in patients with fpg levels between 126 and 200 mg/dl.