Metformin May Be Associated with False-Negative Cancer Detection in the Gastrointestinal Tract on Pet/Ct |
| |
| Institution: | 1. Section of Endocrinology, Diabetes and Nutrition, Boston Medical Center; Boston University School of Medicine, Boston, Massachusetts;2. Division of Endocrinology, Diabetes and Hypertension, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts;3. Section of Nuclear Medicine, Department of Radiology, Boston Medical Center/Boston University School of Medicine, Boston, Massachusetts.;1. Division of Pediatric Endocrinology, University of Miami, Miami, Florida;2. Department of Radiology, Children’s Hospital and Medical Center of Akron, Akron, Ohio;3. Center for Diabetes and Endocrinology, Children’s Hospital and Medical Center of Akron, Akron, Ohio.;1. Department of Medicine, Division of Endocrinology, Metabolism, and Nutrition, Durham, North Carolina.;2. Department of Surgery, Duke University Medical Center, Duke University, Durham, North Carolina.;1. Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey;2. Department of Otolaryngology – Head & Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey;3. Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey;4. Department of Neurosurgery, University of Utah School of Medicine, Salt Lake City, Utah. |
| |
| Abstract: | ObjectiveConcurrent therapy with the antihyperglycemic drug metformin can hinder the detection of malignancy in the abdominal and pelvic portions of 18F-fluordeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) imaging performed for the diagnosis or staging of malignancy, as well as for treatment response and radiation therapy planning. This is due to the metformin-induced increase in intestinal FDG radiotracer uptake. We aim to bring this potentially important interaction to the attention of clinicians who care for cancer patients with diabetes.MethodsWe searched MEDLINE (from 1970 to January 2014)and Google Scholar for relevant English-language articles using the following search terms: “metformin and FDG/PET, metformin and bowel uptake, metformin, and cancer, metformin and the intestine, metformin pharmacokinetics, hyperglycemia and FDG/PET.” We reviewed the reference lists of pertinent articles with respect to metformin gut physiology, impact on FDG uptake and the effect on diagnostic accuracy of abdominal-pelvic PET/CT scans with concurrent metformin therapy.ResultsWe reviewed the action of metformin in the intestine, with particular emphasis on the role of metformin in PET/CT imaging and include a discussion of clinical studies on the topic to help refine knowledge and inform practice. Finally, we discuss aspects pertinent to the management of type 2 diabetes (T2D) patients on metformin undergoing PET/CT.ConclusionsMetformin leads to intense, diffusely increased FDG uptake in the colon, and to a lesser degree, the small intestine, which limits the diagnostic capabilities of FDG PET/CT scanning and may mask gastrointestinal malignancies. We suggest that metformin be discontinued 48 hours before FDG PET/CT scanning is performed in oncology patients. More rigorous data are needed to support the widespread generalizability of this recommendation. (Endocr Pract. 2014;20:1079-1083) |
| |
| Keywords: | |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
