Is icodextrin use feasible in a peritoneal dialysis patient undergoing 18 F-FDG PET/CT scan?

Abstract

18 F-FDG PET/CT scan is a useful diagnostic tool in patients with neoplasia or inflammatory diseases for further evaluation. Due to interference of glucose with the cellular uptake of the 18 F-FDG tracer via glucose transporter, withhold of any glucose source several hours before imaging is mandatory. This is also the case in peritoneal dialysis patients where glucose-containing peritoneal dialysis fluid cannot be used prior to 18 F-FDG PET/CT scan. Whether the same hold true for icodextrin is not known. We describe two patients with metastatic carcinomas while on peritoneal dialysis on an icodextrin-containing regimen, in whom icodextrin was not discontinued before 18 F-FDG PET/CT scan and where accurate diagnosis of metastatic lesions as well as in one case a simultaneous tunnel infection could be made. Our observation suggests that there is no significant interference of icodextrin with the metabolism of 18 F-FDG and so it is feasible to continue an established icodextrin-containing regimen in peritoneal dialysis patients in case of 18 F-FDG PET/CT scan.