Effect of hepatic steatosis on liver FDG uptake measured in mean standard uptake values

The negative impact of fatty liver on maximum standard uptake value of liver on FDG PET

PURPOSE

The purpose of the study is to evaluate the impact of fatty liver on maximum standard uptake value (SUVmax) of liver on 2-fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET).

MATERIALS AND METHODS

A total of 173 consecutive healthy subjects were retrospectively recruited for analysis. Subjects with acute renal disease, chronic renal disease, or malignancy were excluded. Demographic data were collected from chart records. All subjects performed whole-body FDG PET, sonography of liver, and glutamic pyruvic transaminase (GPT) level. The SUVmax of liver on FDG PET was calculated. The relationship between the severity of fatty liver and SUVmax of liver on FDG PET was analyzed.

RESULTS

There were significant differences in SUVmax of liver on FDG PET in four groups: no fatty liver, mild-degree, moderate-degree, and severe-degree fatty liver on sonography diagnosis (P=.041). After adjusting for possible covariates age, sex, body mass index, and GPT, there was a significantly negative correlation between the severity of fatty liver and SUVmax of liver on FDG PET (β=-.20, P<.001).

CONCLUSION

Based on the results of this study, the liver cannot be used as a comparator of extrahepatic foci of equivocal increased FDG activity in patients with fatty liver disease.

Altered hepatic metabolic activity in patients with hepatic steatosis on FDG PET/CT

OBJECTIVE

FDG PET studies frequently use the liver as an internal reference organ to assess the significance of FDG uptake in pathologic processes involving other organs. The purpose of this study was to assess whether hepatic steatosis has a significant effect on the standardized uptake value (SUV) of the liver.

SUBJECTS AND METHODS

This prospective case-control study analyzed FDG PET/CT scans of patients with frank hepatic steatosis on the unenhanced CT portion of the study. Maximum SUVs (corrected for both body weight [SUV(bw)] and lean body mass [SUV(lbm)]) in 37 patients with hepatic steatosis were compared with those in 37 control patients without hepatic steatosis.

RESULTS

Patients with hepatic steatosis had statistically significant smaller mean (± SD) values than did the control subjects for liver SUV(lbm) (1.91 ± 0.57 vs 2.17 ± 0.36), liver SUV(lbm)-mediastinum ratio (1.23 ± 0.19 vs 1.35 ± 0.19), and liver SUV(bw)-mediastinum ratio (1.24 ± 0.16 vs 1.39 ± 0.22).

CONCLUSION

Hepatic steatosis results in a small statistically significant decrease in hepatic metabolic activity, as measured by FDG PET. However, because the degree of change is small, compared with healthy control subjects, this decrease is unlikely to have any clinical significance on the use of the liver as an internal reference organ.

Microminipig, a non-rodent experimental animal optimized for life science research:novel atherosclerosis model induced by high fat and cholesterol diet

Atherosclerotic lesions were observed in male and ovariectomized female Microminipig (MMP) fed a high fat and cholesterol diet with sodium cholate (HFCD/SC) for 3 months. HFCD/SC induced hypercholesterolemia accompanied by an increase in serum total cholesterol (T-Cho), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and cholesterol ester (CE). Unlike the mouse or rabbit, a dominant LDL-C fraction in the intact MMP, similar to that in humans, was observed by serum lipoprotein analysis. HFCD/SC increased body weight gain. At the end of the experiment, computed tomography scans of conscious animals showed that HFCD/SC had decreased liver attenuation values (Hounsfield unit) and increased subcutaneous and abdominal fat, suggesting the induction of fatty liver and obesity. HFCD/SC induced atherosclerotic lesions in systemic arteries, including the external and internal iliac arteries, abdominal aorta, coronary artery, and cerebral arterial circle. Atherosclerosis and pathological findings induced by HFCD/SC in MMP were similar to those in humans. The MMP is a potentially suitable tool for investigating human atherosclerosis.