In the assessment of the impact of various blood glucose levels (BGLs) on18F-FDG uptake values (SUVmax and SUVmean) in normal tissues and neoplastic lesions. There is significant higher SUVmax values among patients with lower BGL in the brain, tonsils as well as in the malignant lesion. In contrary, a significantly higher SUVmax value was found among patients with higher BGL in mediastinal blood pool (MBP), liver, spleen, muscles and bone marrow. Significantly higher SUVmean values were found among patients with lower BGL in the brain. Significantly higher SUVmean values were found among patients with higher BGL in lungs, mediastinal blood pool, liver, spleen, muscles, as well as bone marrow. There was a significant negative correlation between SUVmax and BGL in the brain and tonsils. While a significant positive correlation existed between SUVmax and BGL in the lungs, MBP, liver, spleen and muscles. DM and obesity also significantly affect SUVs measurements in the brain, bone marrow, lungs, mediastinal blood pool, liver, spleen and muscles. More over IV contrast, diabetes, and obesity had non-significant impact on SUV values calculation in malignant tissues, but on the other hand a significantly higher SUVmax values among patients with blood glucose level 120 – 150 mg/dl (P = 0.02) and significantly lower values in patients who received previous chemotherapy was reported.
Conclusion: Blood glucose levels affect SUV values of both reference organs and neoplastic lesions, therefore nuclear medicine physicians should consider the pre-imaging BGLs in their interpretations of FDG-PET/CT scans.