TITLE: OPTIMIZATION OF THE DISCONTINUATION OF METFORMIN IN DIABETIC PATIENTS EXPLORED WITH 18F-FDG PET/CT Abstract Body

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1 CONTROL ID: Abstract Type: Phy/Sci/Pharm CURRENT TRACK: Oncology: Basic, Translational & Therapy CURRENT CATEGORY: Technical Advances & Quantification Awards Applied For: AWARDS: Abstract Title TITLE: OPTIMIZATION OF THE DISCONTINUATION OF METFORMIN IN DIABETIC PATIENTS EXPLORED WITH 18F-FDG PET/CT Abstract Body ABSTRACT BODY: Objectives : To determine if in patients with type 2 diabetes mellitus (T2D), 24 or 48 h of metformin (M) discontinuation could be useful to reduce FDG intestinal uptake keeping patient s glucose level (GL) in normal range and improving PET/CT quality (1,2). Methods : Ninety-one T2D patients treated with antidiabetic drugs (AD) were included. AD regimen included metformin in 72 (group A) and other AD in 19 (group B). 20 patients without T2D served as controls (group C). Group A was divided in 3 subgroups: 30 patients (group A1) were taking M, 21 (group A2) were asked to discontinue M for 24 h before PET/CT and the remaining 21 (group A3) to discontinue M for 48 h. The intestinal FDG uptake was assessed qualitatively (normal, mild, moderate or intense) and semi-quantitatively using SUVmax, SUVmean, SUVpeak values and tissue-to-background ratio (TBR). Results were compared among groups. Results : Intense intestinal uptake in group A3 (9,5%) was lower than in A2 (48%) and A1 (77%) and comparable to B (16%) and C (10%). Intestinal FDG uptake in group A was reduced after M discontinuation for 24 h (TBR A1=1,77 vs TBR A2=1,48; p=ns) and significantly after 48 h (TBR A3=1,10; p<0.001). There were no significant differences among groups A3 (TBR=1,72), B (TBR=1,65) and C (TBR=1,51). There were no statistical differences in age and body mass index (BMI) among groups. GL was higher in group A (123±21) than in B (118±18) and C (93±11) (p<0, 01). Conclusions : AD discontinuation for 48 h is feasible and better than 24 h for reducing intestinal FDG uptake in T2D and it significantly improves PET/CT studies quality. Although GL increased with discontinuation, they were in normal range according to the guidelines. Characteristics and FDG uptake values of the study population GROUP A1 A2 A3 B C AGE 68,6±9,7 70,6±8,5 69,7±10,2 73,5±9,3 65,6±9,1 BMI 29,3±3,8 28,8±4,8 26,5±5,1 27,7±4,2 26,5±4,8 GLUCOSE 121,4±18,9 121,1±19 126,7±24,1 118,1±18,5 93,2±11,1 TBR 6,9±3,1 5,2±2,3 3,8±2,2 3,4±1,9 3,4±2,2 SUVmax 3,3±1,7 2,3±1,0 1,7±1,0 1,6±1,1 1,5±1,0 SUVmean 3,9±1,9 3,0±1,4 2,7±1,6 2,2±1,1 2,2±1,3

2 SUVpeak 5,1±2,2 4,2±1,8 3,2±1,6 2,9±1,7 2,9±1,9 Supporting Data Image (No Image Selected) References: (1) Oh J, Song H, Chong A, et al. Impact of medication discontinuation on increased intestinal FDG accumulation in diabetic patients treated with metformin. Am J Roentgenol 2010;195(6): (2) Özülker T, Özülker F, Mert M, et al. Clearance of the high intestinal 18F-FDG uptake associated with metformin after stopping the drug. European journal of nuclear medicine and molecular imaging 2010;37(5): Presentation Preference PRESENTATION TYPE: Oral or Poster Author Information AUTHORS (FIRST NAME, LAST NAME): Lidia Sancho Rodriguez 1, Edgar F. Guillén Valderrama 1, Maria J. Garcia- Velloso 1, Belén Pérez Pevida 2, Francisco Javier Escalada San Martín 2, Maria J. Ribelles 1, Berta Garcia-Garcia 1, Rocio Ramos Membrive 1, Macarena Rodríguez-Fraile 1, Jose A. Richter 1 INSTITUTIONS (ALL): 1. Nuclear Medicine, Clinica Universidad de Navarra, Pamplona, Spain. 2. Endocrinology, Clínica Universidad de Navarra, Pamplina, Spain. CONTACT PERSON INFORMATION: Lidia Sancho Rodriguez, Avda. Pio XII 36, Pamplona, Spain, PRESENTER: Lidia Sancho Rodriguez Author Disclosures FDA Disclosure -Phy/Sci/Pharm*: I do not have any applicable devices or drugs to disclose. Financial Disclosure 2015: Lidia Sancho Rodriguez: No financial interest/arrangement Edgar Guillén Valderrama: No financial interest/arrangement Maria Garcia-Velloso: No financial interest/arrangement Belén Pérez Pevida: No Answer. Francisco Javier Escalada San Martín: No Answer. Maria Ribelles: No Answer. Berta Garcia-Garcia: No Answer. Rocio Ramos Membrive: No Answer. Macarena Rodríguez-Fraile: No Answer. Jose Richter: No Answer. Membership 2015: Lidia Sancho Rodriguez: No Edgar Guillén Valderrama: No Maria Garcia-Velloso: Yes Belén Pérez Pevida: No Answer. Francisco Javier Escalada San Martín: No Answer. Maria Ribelles: No Answer. Berta Garcia-Garcia: No Answer. Rocio Ramos Membrive: No Answer. Macarena Rodríguez-Fraile: No Answer. Jose Richter: No Answer. Authorship 2015: Lidia Sancho Rodriguez: Returning Author Edgar Guillén Valderrama: New Author Maria Garcia- Velloso: Returning Author Belén Pérez Pevida: No Answer. Francisco Javier Escalada San Martín: No Answer. Maria Ribelles: No Answer. Berta Garcia-Garcia: No Answer. Rocio Ramos Membrive: No Answer. Macarena Rodríguez-Fraile: No Answer. Jose Richter: No Answer.