Impact of peritoneal dialysis fluid composition and infusion timing on 18F-fluoro-2-deoxy-2- d -glucose positron emission tomography–computed tomography interpretability in peritoneal dialysis patients

Abstract

Background

Glucose and insulin blood levels are well known altering factors for 18F-fluoro-2-deoxy-2-d-glucose positron emission tomography–computed tomography ([18F]-FDG PET-CT) interpretability in peritoneal dialysis (PD) patients. A potential influence of glucose-based solutions and Icodextrin in PD patients has not been studied. The aim of this study was to assess PET-CT interpretability in PD patients according to the osmotic agent used in the dialysis fluid (Icodextrin vs. glucose) and the timing of dialysate infusion before imaging.

Methods

We searched for all PET-CT performed on individuals receiving PD between January 2020 and March 2024 at Cliniques universitaires Saint-Luc, Brussels, Belgium. Peritoneal membrane characteristics, data regarding dialysis solutions, PET-CT parameters and results were collected. We analyzed available data regarding insulinemia and glycemia during a PD exchange.

Results

Fourteen PET-CTs were available for study of which four were performed on PD patients with a glucose-based solution dwell at imaging, six with Icodextrin, and three with an empty abdomen. Data regarding the presence or absence of PD fluid was missing for one patient. The only uninterpretable exam was performed on a patient injected with [18F]-FDG 86 min after an exchange with a glucose-based solution. All other exams in the glucose-based group were interpretable with a mean PD fluid infusion to [18F]-FDG injection time of 186 min. All PET-CTs in patients with an Icodextrin dwell were interpretable.

Conclusion

In this small PD cohort, PET-CT interpretability appears preserved with Icodextrin dwells and may be adequate with glucose-based solutions if sufficient time elapses, requiring confirmation in larger studies.