Cohade C. Impact of intravenous insulin on 18F-FDG PET in diabetic cancer patients. J Nucl Med 2009;50:178–83

The aims of this study were to evaluate the effectiveness of a standardized insulin protocol in reducing glycemia, review 18F-FDG biodistribution with such a protocol, and assess its clinical impact. Methods: Sixty-three patients with glycemia greater than 10 mmol/L received insulin doses intravenously according to a standardized protocol. One hundred six consecutive eu-glycemic patients (,6.2 mmol/L) served as controls. 18F-FDG biodistribution was evaluated by 2 experienced PET readers on a 5-point visual scale based onmuscular uptake. The 63 patients who received insulin were divided into insulin subgroup A, with adequate biodistribution (score 0, 1, or 2) and insulin subgroup B, with altered biodistribution (score 3 or 4). 18F-FDG biodistribu-tion was also evaluated semiquantitatively by standardized up-take value (SUV) measurements over the liver, gluteal muscles, and myocardium. Clinical impact (complications and diagnosti