E. Hutt, G. Goldar, WA. Jaber and PC. Cremer (2024). Standardized ketogenic dietary preparation for metabolic PET imaging in suspected and known cardiac sarcoidosis. European heart journal. Imaging methods and practice, 2(1), qyae037. https://doi.org/10.1093/ehjimp/qyae037

PubMed 39045194

[Abstract]
AIMS: A major limitation of cardiac positron emission tomography (PET) with F18-fluorodeoxyglucose (F18-FDG) for the evaluation of cardiac sarcoidosis (CS) is associated with physiologic myocardial glucose uptake. The optimal dietary protocol to suppress physiologic myocardial F18-FDG uptake is not well-established. We aimed to evaluate the diagnostic performance of a novel dietary preparation using a ketone-based infant formula.

METHODS AND RESULTS: Between 2018 and 2021, consecutive studies using a ketogenic dietary preparation were identified (n = 198). The rate of non-diagnostic studies due to failure to suppress myocardial glucose was 7.1% (n = 14) with a similar incidence in diabetics (n = 6, 8.1%). Among studies reported to have no inflammation (n = 137), 130 studies (66%) had mean myocardial standardized uptake value (SUV) less than or equal to mean blood pool SUV.

CONCLUSION: Patient preparation with a ketone-based infant formula resulted in low rate of inappropriate myocardial glucose suppression in patients undergoing F18-FDG cardiac PET to evaluate CS.